Comparison result of peripheral blood count and severity of acute respiratory distress syndrome due to COVID-19

Abstract

Background: Patients who confirmed COVID-19, 15-22% of total cases have got respiratory failure due to acute respiratory distress syndrome (ARDS). Recent studies have shown high level of peripheral blood count result, such as neutrophil/lymphocyte ratio, are associated with worsening clinical outcome and increasing mortality rate with COVID-19 patients, same as C-reactive protein. Therefore, the basis of this study was to determine whether peripheral blood count results are an early predictor of deteriorating condition in patients with ARDS. Materials and Methods: This is single-centred, retrospective observational study that included 212 patients with infected COVID-19 and treated at the Intensive Care Unit of Mongolian-Japan hospital from 18 April 2021 to 1 December 2021. Results: The group of patients with ARDS was case of chronic kidney disease higher (p-0.025) and the number of patients transferred between hospitals was higher (p-0.01). Among 212 patients, 98 (46.2%) have got ARDS. All patients were divided two groups according to their neutrophil/lymphocyte ratio: normal and increased (1.93±0.68 vs 12.02±9.37, p-0.000) that were significantly assosiated with moderate-severe ARDS (p-0.000), SpO2 (0.000), FiO2 (0.000), PaO2/FiO2 ratio (0.000), requirement of mechanical ventilation (p-0.001), and mortality rate (0.016). The ROC curve was constructed to assess whether neutrophil/lymphocyte ratios (p-0.000) and C-reactive protein (p-0.000) were predictive factors of deteriorating for ARDS, were significantly different. Conclusion: 1. Clinical deterioration of patient with Covid-19 associated with patient transport from another hospital and chronic kidney disease. 2. The neutrophil/lymphocyte ratio, like that of C-reactive protein, may be a low-cost diagnostic test for the deterioration of the clinical status of ARDS.