Lymphocyte percentage and hemoglobin as a joint parameter for the prediction of severe and nonsevere COVID-19: a preliminary study

Ann Transl Med. 2020 Oct;8(19):1231. doi: 10.21037/atm-20-6001.

Abstract

Background: Coronavirus disease 2019 (COVID-19) has spread rapidly around the world since December, 2019. This study aimed to identify parameters in routine blood tests that could be used to evaluate the severity of coronavirus disease 2019 (COVID-19) and, thus, assist with the clinical prediction of the extent of progression.

Methods: This retrospective study analyzed the epidemiological, clinical symptom, and laboratory examination data of 159 patients diagnosed with COVID-19. The percentage of lymphocytes (Lym%) and hemoglobin (HGB) were integrated into a joint parameter, Lym% & HGB, through binary logistic regression.

Results: Individually, Lym% and HGB decreased gradually with disease progression whereas the joint parameter Lym% & HGB increased gradually with disease progression. When Lym%, HGB, and Lym% & HGB were used to predict the severity of COVID-19, the area under the receiver operating characteristic (ROC) curve (AUC) was 0.89, 0.79, and 0.92, respectively. The dynamic change curves showed that Lym% and HGB continued to decline while Lym% & HGB continued to increase with disease progression in patients with severe COVID. The change in Lym% & HGB was more prominent than those in Lym% and HBG.

Conclusions: The joint parameter Lym% & HGB could serve as an effective tool for differentiating severe and nonsevere COVID-19, and its sensitivity and specificity are higher than those of Lym% or HGB alone.

Keywords: Coronavirus disease 2019 (COVID-19); dynamic profile; hemoglobin (HGB); lymphocyte (Lym); receiver operating characteristic curve (ROC); severity indicator.