Hemograms and serial hemogram-derived ratios in survivors and non-survivors of COVID-19 in Campinas, Brazil

Introduction: The hemogram and hemogram-derivative ratios (HDRs) are becoming markers of the severity and mortality of COVID-19. We evaluated the hemograms and serial weekly HDRs [neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet -lymphocyte ratio (PLR), neutrophil-platelet ratio (NPR) and systemic immune -in flammatory index (SII)] in the survivors and non -survivors of COVID-19. Methods: We retrospectively reviewed the medical notes and serial hemograms of real-time reverse -transcription polymerase chain reaction (RT-PCR)-con firmed COVID-19 adults hospitalized from April 2020 to March 2021 from the time of diagnosis to the 3(rd) week of diagnosis. Results: Of the 320 adults, 257 (80.3%) were survivors and had a lower mean age than the non -survivors (57.73 vs. 64.65 years, p < 0.001). At diagnosis, the non -survivors had lower hematocrit (p = 0.021), and lymphocyte (p = 0.002) and basophil (p = 0.049) counts and the hematocrit showed a p -value (Is this what you meant???) of 0.021); higher NLR (p < 0.001), PLR (p = 0.047), NPR (p = 0.022) and SII (p = 0.022). Using general linear models, the survivors and non -survivors showed significant variations with weekly lymphocyte count (p < 0.001), neutrophil count (p = 0.005), NLR (p = 0.009), MLR (p = 0.010) and PLR (p = 0.035). All HDRs remained higher in the non -survivors in the 2(nd) week and 3(rd) week of diagnosis and the HDRs were higher in the intubated patients than in the non-intubated patients. The NLR and SII were more efficient predictors of mortality in COVID-19 patients. Conclusions: This study shows that serial lymphocyte and neutrophil counts, NLR, PLR,MLR, NPR and SII could serve as good and easily accessible markers of severity and predictors of outcomes in COVID-19 patients and should be used for the monitoring of treatment response