J Assoc Physicians India. 2020 Aug;68(8):39-42.
OBJECTIVE: The present study was undertaken to evaluate prognostic relevance of select circulating immune mechanistic biomarkers in COVID-19 positive patients for early identification and categorization of symptomatic patients who would need critical care with consequent adequate and optimal resource allocation and definitive management protocol.
MATERIALS AND METHODS: The present retrospective observational study, on 35 symptomatic and 35 asymptomatic patients, was carried out in SMS Medical College and Hospital, Jaipur comparatively assessing epidemiological history, clinical features and laboratory investigations.
RESULTS: During the course of study, 35 symptomatic and 35 asymptomatic patients were assessed. All the patients were of Indian ethnicity and had a history of contact with a COVID 19 positive case. Male patients constituted of 67 % of the population. The median age of patients in symptomatic and asymptomatic group was 60 years and 30 years, respectively. Out of the 70 patients studied, 47 (67%) patients recovered and were discharged whereas 23 (32.8 %) succumbed to the disease process. Lymphopenia was observed in 80% of symptomatic patient population, though only 11.5% of asymptomatic patients documented lymphopenia. Among the patients who died of COVID 19 (n=23), lymphopenia was observed in 18 (82%) patients, with moderate lymphopenia present in 13 (59 %) and severe lymphopenia present in 5 (22.7%) patients. Neutrophilia was observed across both category of patients, symptomatic and asymptomatic. Neutrophilia featured prominently in the symptomatic COVID-19 group with a median nadir in ALC of 7 × 109/L as compared to that of 3.8 × 109/L so observed in asymptomatic sample population. Red cell distribution width was slightly raised in both groups with a median RDW of 15.3% in COVID 19 patients which was raised as compared to that observed in normal population (range: 12.8 ± 1.2 %).
CONCLUSION: Lymphopenia is an effective and reliable indicator of onset of symptoms and severity of disease in COVID-19 patients. RDW was found to be higher in COVID 19 patients in comparison to normal patients, however it had no significant relationship with appearance of symptoms or severity of the disease.