Diagnostic Utility of Neutrophil Lymphocyte Ratio and C-Reactive Protein among Sudanese Patients with COVID -19 Infection

Abstract

Background: Neutrophil lymphocytes ratio (NLR) and C-reactive protein (CRP) are established markers that reflect systemic inflammation in the body, and these parameters altered in patients with novel coronavirus (SARS-CoV-2) pneumonia (COVID-19). Objectives: This study was aimed to determine the diagnostic utility of Neutrophil/lymphocyte ratio and CRP among Sudanese patients with COVID -19 infection. Method: During the period from October 2021 to March 2022, a total of 80 subjects were involved in this study, of which 30 were cases with COVID-19 infection and the rest were 50 individuals age matched healthy controls. Among cases population 17 (56.7%) were male, while the rest 13 (43.3%) were female. About 3-5 ml of venous blood was collected from each case or control. Full blood count including was estimated by using Sysmex KX21 three parts automated hematology cell counter. NLR was calculated by dividing the absolute neutrophil count by absolute Lymphocyte count. Whole blood was used to determine CRP level by using commercially available kits manufactured by Finecare™ FIA Meter Operation according to manufacture instruction. Data was analyzed by using SPSS version 20. Independent T test was used to compare between cases and controls in the study variables. Results: Our results demonstrated that cases have significant higher NLR (7.6±5.7 vs 1.5±0.85), CRP mg/l (64.9 vs 64.8 vs 6.0±0.0), TWBCs ×10^3/ul (10.5±9.3 vs 5.3±1.6), PLR (270±195 vs 142±42), RDW-CV% (15.5±2.6 vs 13.7±1.8), ANC ×10^3/ul (7.9±6.4 vs 4.5±2.5) with P- value of <0.05 for each . Cases showed a significant lower level of ALC ×10^3/ul (1.01±0.5 vs 2.75±1.25) and Hb g/dl (10.6±2.1 vs 14.5±1.5) with P-value of <0.05 for each. Our results showed that among cases group, gender have no effect on the result of all study variables with P-value of more than 0.05. Conclusion: Cases have significant higher levels of CRP and N/L compared to controls. Among cases group, gender have no effect on the result of all study variables.