Blood Cells Indices are Determinants of the COVID-19 Outcome: A Cross-Sectional Study from ‎Kurdistan Region-Iraq
Marwan S.M. Al-Nimer 1 2 * , Talar Ahmad Merza 2, ‎Karwan Yasin Mohammed‎ Yasin Mohammed‎ 3, ‎Hiwa Abdullah Mohammed 3
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1 College of Medicine, University of Diyala, Baqubah, IRAQ
2 College of Pharmacy, Hawler Medical University, Kurdistan Region, Erbil, IRAQ
3 West Erbil Emergency Hospital (Corona Center), Kurdistan Region, Erbil, IRAQ
* Corresponding Author


Introduction: The complete blood picture of patients with COVID-19 showed lymphocytopenia and neutrophilia. Changes in the circulating blood cells are served as prognostic factors of COVID-19. This study aimed to investigate the clinical importance of determining the hematological indices and ratios as diagnostic and/or prognostic markers of COVID-19.
Methods: This cross-sectional observational study was performed in the West Erbil Emergency Hospital, Kurdistan region, Erbil- Iraq, between August 10 and November 19, 2020. A total of 204 patients with COVID-19 were included in this study. The hematological indices and their derived ratios were determined, C-reactive protein and the outcome events were the primary outcome measures.
Results: The mean value of leukocytes is ≥ 10,000 cell/mm3, which characterized by neutrophilia and lymphocytopenia. The percentage of monocyte is significantly higher in patients with hypertension with and without diabetes mellitus compared with other patients. There are no significant differences between patients with and without concomitant diseases in the erythrocyte sedimentation rate and C-reactive protein. The mortality rate was 31.3% (64 out of 204). Red distribution width and neutrophil-to-lymphocyte ratio are significant discriminators of the non-survivor patients with COVID-19 (The area under the curve with 95% confidence interval: 0.618 (0.510-0.726) and 0.612 (0.505-0.718), with odd ratios of 3.02, 2.407, at cutoff values ≥13.2 % and 12.0), respectively.
Conclusion: Significant high values of red distribution width and lymphocyte-to-neutrophil ratio are associated with unpleasant outcome events of COVID-19 patients, while a higher percentage of monocyte is commonly found in hypertensive patients presented with COVID-19.


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Article Type: Original Article

ELECTRON J GEN MED, 2021 - Volume 18 Issue 5, Article No: em304

Publication date: 23 Jun 2021

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