A comparative study of absolute lymphocyte count (alc), neutrophil lymphocyte ratio (nlr) and red cell distribution width (rdw) among covid 19 death and survival group

Background-At the end of 2019, a novel coronavirus was identified as the cause of a cluster of pneumonia cases in Wuhan, a city in the Hubei Province of China. It rapidly spread throughout the world. Identifying patients at highest risk for severe disease is important to facilitate early, aggressive intervention and to mitigate the crises occurring throughout the world. Biomarkers were needed for patient stratification into those likely to develop severe disease and with high risk of mortality. Present study aims to find out those indicators. Methods: Total patients admitted over a period of 1 year from 1st April 2020 to 31th March 2021 in Dedicated COVID Hospital of RNT Medical College and MB hospital Udaipur was 4304 out of which 620 died and 3498 got discharged, 186 couldn’t be followed up as they took leave against medical advise. From death group (620 patients) and Survival group (3498 patients), 400 patients were selected randomly from each group and were analysed and comparison was made between both the groups including parameters like ALC(Absolute lymphocyte count), NLR (Neutrophil Lymphocyte)ratio and RDW(Red cell distribution width). Results: Median age in death and survival group was 62.03 and 47.18 respectively. Mean Absolute lymphocyte count was 0.88 and 0.93 in death and survival group respectively. Mean Neutrophil -Lymphocyte ratio in death and survival group was 8.37 and 4.34 respectively. Mean RDW- CV was 1.86 and 1.67 in death and survival group respectively. Conclusion: From the present study we conclude that Decreased ALC and Elevated NLR are a reliable indicator of death as an outcome in COVID 19 disease whereas RDW was high in COVID19 patients but had no significant relationship with outcome of the disease.