Simple Parameters from Complete Blood Count Predict In-Hospital Mortality in COVID-19

Mattia Bellan; Danila Azzolina; Eyal Hayden; Gianluca Gaidano; Mario Pirisi; Antonio Acquaviva; Gianluca Aimaretti; Paolo Aluffi Valletti; Roberto Angilletta; Roberto Arioli; Gian Carlo Avanzi; Gianluca Avino; Piero Emilio Balbo; Giulia Baldon; Francesca Baorda; Emanuela Barbero; Alessio Baricich; Michela Barini; Francesco Barone-Adesi; Sofia Battistini; Michela Beltrame; Matteo Bertoli; Stephanie Bertolin; Marinella Bertolotti; Marta Betti; Flavio Bobbio; Paolo Boffano; Lucio Boglione; Silvio Borrè; Matteo Brucoli; Elisa Calzaducca; Edoardo Cammarata; Vincenzo Cantaluppi; Roberto Cantello; Andrea Capponi; Alessandro Carriero; Giuseppe Francesco Casciaro; Luigi Mario Castello; Federico Ceruti; Guido Chichino; Emilio Chirico; Carlo Cisari; Micol Giulia Cittone; Crizia Colombo; Cristoforo Comi; Eleonora Croce; Tommaso Daffara; Pietro Danna; Francesco Della Corte; Simona De Vecchi; Umberto Dianzani; Davide Di Benedetto; Elia Esposto; Fabrizio Faggiano; Zeno Falaschi; Daniela Ferrante; Alice Ferrero; Ileana Gagliardi; Alessandra Galbiati; Silvia Gallo; Pietro Luigi Garavelli; Clara Ada Gardino; Massimiliano Garzaro; Maria Luisa Gastaldello; Francesco Gavelli; Alessandra Gennari; Greta Maria Giacomini; Irene Giacone; Valentina Giai Via; Francesca Giolitti; Laura Cristina Gironi; Carla Gramaglia; Leonardo Grisafi; Ilaria Inserra; Marco Invernizzi; Marco Krengli; Emanuela Labella; Irene Cecilia Landi; Raffaella Landi; Ilaria Leone; Veronica Lio; Luca Lorenzini; Antonio Maconi; Mario Malerba; Giulia Francesca Manfredi; Maria Martelli; Letizia Marzari; Paolo Marzullo; Marco Mennuni; Claudia Montabone; Umberto Morosini; Marco Mussa; Ilaria Nerici; Alessandro Nuzzo; Carlo Olivieri; Samuel Alberto Padelli; Massimiliano Panella; Andrea Parisini; Alessio Paschè; Filippo Patrucco; Giuseppe Patti; Alberto Pau; Anita Rebecca Pedrinelli; Ilaria Percivale; Luca Ragazzoni; Roberta Re; Cristina Rigamonti; Eleonora Rizzi; Andrea Rognoni; Annalisa Roveta; Luigia Salamina; Matteo Santagostino; Massimo Saraceno; Paola Savoia; Marco Sciarra; Andrea Schimmenti; Lorenza Scotti; Enrico Spinoni; Carlo Smirne; Vanessa Tarantino; Paolo Amedeo Tillio; Stelvio Tonello; Rosanna Vaschetto; Veronica Vassia; Domenico Zagaria; Elisa Zavattaro; Patrizia Zeppegno; Francesca Zottarelli; Pier Paolo Sainaghi

doi:10.1155/2021/8863053

Simple Parameters from Complete Blood Count Predict In-Hospital Mortality in COVID-19

Dis Markers. 2021 May 13:2021:8863053. doi: 10.1155/2021/8863053. eCollection 2021.

Authors

Mattia Bellan^{1

2}, Danila Azzolina¹, Eyal Hayden^{1

2}, Gianluca Gaidano^{1

2}, Mario Pirisi^{1

2}, Antonio Acquaviva^{1

2}, Gianluca Aimaretti^{1

2}, Paolo Aluffi Valletti^{1

2}, Roberto Angilletta³, Roberto Arioli^{1

2}, Gian Carlo Avanzi^{1

2}, Gianluca Avino^{1

2}, Piero Emilio Balbo², Giulia Baldon^{1

2}, Francesca Baorda^{1

4}, Emanuela Barbero^{1

2}, Alessio Baricich^{1

2}, Michela Barini², Francesco Barone-Adesi¹, Sofia Battistini^{1

2}, Michela Beltrame^{1

2}, Matteo Bertoli^{1

2}, Stephanie Bertolin^{1

2}, Marinella Bertolotti³, Marta Betti³, Flavio Bobbio², Paolo Boffano^{1

2}, Lucio Boglione^{1

4}, Silvio Borrè⁴, Matteo Brucoli^{1

2}, Elisa Calzaducca^{1

2}, Edoardo Cammarata^{1

2}, Vincenzo Cantaluppi^{1

2}, Roberto Cantello^{1

2}, Andrea Capponi², Alessandro Carriero^{1

2}, Giuseppe Francesco Casciaro^{1

2}, Luigi Mario Castello^{1

2}, Federico Ceruti^{1

2}, Guido Chichino³, Emilio Chirico^{1

2}, Carlo Cisari^{1

2}, Micol Giulia Cittone^{1

2}, Crizia Colombo^{1

2}, Cristoforo Comi^{1

4}, Eleonora Croce^{1

4}, Tommaso Daffara^{1

2}, Pietro Danna^{1

2}, Francesco Della Corte^{1

2}, Simona De Vecchi^{1

2}, Umberto Dianzani^{1

2}, Davide Di Benedetto^{1

2}, Elia Esposto^{1

2}, Fabrizio Faggiano¹, Zeno Falaschi^{1

2}, Daniela Ferrante¹, Alice Ferrero^{1

2}, Ileana Gagliardi^{1

2}, Alessandra Galbiati^{1

2}, Silvia Gallo^{1

4}, Pietro Luigi Garavelli², Clara Ada Gardino^{1

2}, Massimiliano Garzaro^{1

2}, Maria Luisa Gastaldello^{1

2}, Francesco Gavelli^{1

2}, Alessandra Gennari^{1

2}, Greta Maria Giacomini^{1

2}, Irene Giacone^{1

4}, Valentina Giai Via^{1

2}, Francesca Giolitti^{1

2}, Laura Cristina Gironi^{1

2}, Carla Gramaglia^{1

2}, Leonardo Grisafi^{1

2}, Ilaria Inserra^{1

2}, Marco Invernizzi^{1

2}, Marco Krengli^{1

2}, Emanuela Labella^{1

2}, Irene Cecilia Landi^{1

2}, Raffaella Landi^{1

2}, Ilaria Leone^{1

2}, Veronica Lio^{1

2}, Luca Lorenzini^{1

2}, Antonio Maconi³, Mario Malerba^{1

4}, Giulia Francesca Manfredi^{1

2}, Maria Martelli^{1

2}, Letizia Marzari^{1

2}, Paolo Marzullo^{1

2}, Marco Mennuni^{1

2}, Claudia Montabone^{1

4}, Umberto Morosini^{1

2}, Marco Mussa³, Ilaria Nerici^{1

2}, Alessandro Nuzzo^{1

2}, Carlo Olivieri^{1

4}, Samuel Alberto Padelli^{1

4}, Massimiliano Panella¹, Andrea Parisini³, Alessio Paschè^{1

2}, Filippo Patrucco^{1

2}, Giuseppe Patti^{1

2}, Alberto Pau^{1

2}, Anita Rebecca Pedrinelli^{1

2}, Ilaria Percivale^{1

2}, Luca Ragazzoni¹, Roberta Re^{1

4}, Cristina Rigamonti^{1

2}, Eleonora Rizzi^{1

2}, Andrea Rognoni^{1

2}, Annalisa Roveta³, Luigia Salamina², Matteo Santagostino^{1

2}, Massimo Saraceno^{1

2}, Paola Savoia^{1

2}, Marco Sciarra³, Andrea Schimmenti³, Lorenza Scotti¹, Enrico Spinoni^{1

2}, Carlo Smirne^{1

2}, Vanessa Tarantino^{1

2}, Paolo Amedeo Tillio^{1

4}, Stelvio Tonello¹, Rosanna Vaschetto^{1

2}, Veronica Vassia^{1

2}, Domenico Zagaria^{1

2}, Elisa Zavattaro^{1

2}, Patrizia Zeppegno^{1

2}, Francesca Zottarelli^{1

2}, Pier Paolo Sainaghi^{1

2}

Affiliations

¹ Università del Piemonte Orientale UPO, Novara, Italy.
² "AOU Maggiore della Carità", Novara, Italy.
³ Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
⁴ "Sant'Andrea" Hospital, Vercelli, Italy.

Abstract

Introduction: The clinical course of Coronavirus Disease 2019 (COVID-19) is highly heterogenous, ranging from asymptomatic to fatal forms. The identification of clinical and laboratory predictors of poor prognosis may assist clinicians in monitoring strategies and therapeutic decisions.

Materials and methods: In this study, we retrospectively assessed the prognostic value of a simple tool, the complete blood count, on a cohort of 664 patients (F 260; 39%, median age 70 (56-81) years) hospitalized for COVID-19 in Northern Italy. We collected demographic data along with complete blood cell count; moreover, the outcome of the hospital in-stay was recorded.

Results: At data cut-off, 221/664 patients (33.3%) had died and 453/664 (66.7%) had been discharged. Red cell distribution width (RDW) (χ ² 10.4; p < 0.001), neutrophil-to-lymphocyte (NL) ratio (χ ² 7.6; p = 0.006), and platelet count (χ ² 5.39; p = 0.02), along with age (χ ² 87.6; p < 0.001) and gender (χ ² 17.3; p < 0.001), accurately predicted in-hospital mortality. Hemoglobin levels were not associated with mortality. We also identified the best cut-off for mortality prediction: a NL ratio > 4.68 was characterized by an odds ratio for in-hospital mortality (OR) = 3.40 (2.40-4.82), while the OR for a RDW > 13.7% was 4.09 (2.87-5.83); a platelet count > 166,000/μL was, conversely, protective (OR: 0.45 (0.32-0.63)).

Conclusion: Our findings arise the opportunity of stratifying COVID-19 severity according to simple lab parameters, which may drive clinical decisions about monitoring and treatment.

Publication types

Observational Study

MeSH terms

Adult
Aged
Aged, 80 and over
Blood Cell Count*
COVID-19 / blood*
COVID-19 / diagnosis
COVID-19 / mortality*
Clinical Decision Rules*
Female
Hospital Mortality*
Humans
Italy / epidemiology
Male
Middle Aged
Multivariate Analysis
Prognosis
Retrospective Studies
Severity of Illness Index*