Comparison of Leukocyte, Neutrophil, and Lymphocyte Levels in Child Patients that Experienced Breathlessness with COVID-19 and Non-COVID-19 (2020–2021) in Medan, Indonesia

Hendri Wijaya; Ayodhia Pitaloka; Ivnke Lubis; Rina Amelia

doi:10.3889/oamjms.2022.8065

Authors

Hendri Wijaya Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia; Adam Malik General Hospital, Medan, North Sumatera, Indonesia
Ayodhia Pasaribu Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia; Adam Malik General Hospital, Medan, North Sumatera, Indonesia
Inke Lubis Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia
Rina Amelia Department of Community Medicine and Public Health, Faculty of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia https://orcid.org/0000-0002-0419-9622

DOI:

https://doi.org/10.3889/oamjms.2022.8065

Keywords:

Comparison of leukocyte, Neutrophil, Lymphocyte levels, Congested children, COVID-19 children

Abstract

BACKGROUND: COVID-19 is a disease caused by severe acute respiratory syndrome coronavirus-2. Various risk factors affect the morbidity and mortality of COVID-19, such as age, gender, ethnicity, comorbid conditions, and laboratory parameters. Clinical manifestations of COVID-19 in children are asymptomatic mild degrees or with acute upper respiratory tract symptoms and moderate degrees with clinical pneumonia. In the course of the COVID-19 pandemic, several biomarkers are needed that can be useful in risk stratification to predict the severity and fatality of COVID-19. Several biomarkers are used as markers of disease progression to a critical degree, such as leukocytes, lymphocytes, platelets, interleukin-6, and serum ferritin. Increased leukocytes and neutrophils and decreased lymphocytes are associated with severity and mortality in COVID-19. Laboratory findings in children with COVID-19 include decreased lymphocytes, leukopenia, and increased procalcitonin. In severe COVID-19, children often have abnormal laboratory parameters that suggest a systemic inflammatory response.

AIM: This study aims to compare leukocytes, neutrophils, and lymphocytes levels in children with the complaints of shortness of breath with COVID-19 and non-COVID-19 pediatric patients.

MATERIALS AND METHODS: This study is an analytic study with a cross-sectional approach to pediatric patients treated in Haji Adam Malik General Hospital Medan with the complaints of shortness of breath. Patient data were assessed based on the characteristic values of hemoglobin, leukocytes, neutrophils, lymphocytes, and COVID-19 polymerase chain reaction results and then analyzed using SPSS for Windows software. The study samples were 276 patients, with 43 confirmed positive COVID-19 patients and 233 negative patients. The source of this research data is data from the patient’s medical record for 1 year (2020–2021).

RESULTS: The statistical analysis results found differences in the levels of leukocytes, neutrophils, and lymphocytes in children diagnosed with COVID-19 and non-COVID-19 (p < 0.05). However, there was no difference in hemoglobin levels in children who were congested with COVID-19 and non-COVID-19 (p > 0.05).

CONCLUSION: These results are consistent with several cases and previous studies where the levels of leukocytes, neutrophils, and lymphocytes can be used as a detection tool and a diagnostic and prognostic tool in COVID-19 patients.

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References

Gorbalenya AE, Baker SC, Baric RS, de Groot RJ, Drosten C, Gulyaeva AA, et al. The species Severe acute respiratory syndrome-related coronavirus: Classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol. 2020;5:536. https://doi.org/10.1038/s41564-020-0695-z DOI: https://doi.org/10.1038/s41564-020-0695-z

Rothan HA, Byraredy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;109:102433. https://doi.org/10.1016/j.jaut.2020.102433 PMid:32113704 DOI: https://doi.org/10.1016/j.jaut.2020.102433

Gandhi RT, Lynch JB, Delrio C. Mild or moderate COVID-19. N Engl J Med. 2020;383(18):1757-66. https://doi.org/10.1056/NEJMcp2009249 PMid:32329974 DOI: https://doi.org/10.1056/NEJMcp2009249

Bhopal SS, Bagaria J, Olabi, B, Bhopal R. Children and young people remain at low risk of COVID-19 mortality. Lancet. 2021;5(5):e12-3. https://doi.org/10.1016/S2352-4642(21)00066-3 PMid:33713603 DOI: https://doi.org/10.1016/S2352-4642(21)00066-3

Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: An observational cohort study. Lancet Infect Dis. 2020;20(6):30198. https://doi.org/10.1016/S1473-3099(20)30198-5 DOI: https://doi.org/10.1016/S1473-3099(20)30198-5

She J, Liu L, Liu W. COVID-19 epidemic: Disease characteristics in children. J Med Virol. 2020;92(7):747-54. https://doi.org/10.1002/jmv.25807 PMid:32232980 DOI: https://doi.org/10.1002/jmv.25807

Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, et al. Hematological findings and complications of COVID-19. Am J Hemato. 2020;95(7):834-47. https://doi.org/10.1002/ajh.25829 PMid:32282949 DOI: https://doi.org/10.1002/ajh.25829

Henry BM, Deoliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): A meta-analysis. Clin Chem Lab Med. 2020;58(7):1021-8. https://doi.org/10.1515/cclm-2020-0369 PMid:32286245 DOI: https://doi.org/10.1515/cclm-2020-0369

Sastroasmoro S, Ismael S. Dasar-Dasar Metodologi Penelitian Klinis. Jakarta: Sagung Seto; 2016.

Wagner J, DuPont A, Larson S, Cash B, Farooq A. Absolute lymphocyte count is a prognostic marker in Covid-19: A retrospective cohort review. Int J Lab Hematol. 2020;42(6):761-5. https://doi.org/10.1111/ijlh.13288 PMid:32779838 DOI: https://doi.org/10.1111/ijlh.13288

Fuad M, Oehadian A, Prihatni D. Neutrophil-to-lymphocyte ratio and Covid-19 symptom-based severity at admission. Althea Med J. 2021;8(1):1-6. DOI: https://doi.org/10.15850/amj.v8n1.2255

Du H, Dong X, Zhang JJ, Cao YY, Akdis M, Huang PQ, et al. Clinical characteristics of 182 pediatric COVID-19 patients with different severities and allergic status. Allergy. 2021;76(2):510-32. https://doi.org/10.1111/all.14452 PMid:32524611 DOI: https://doi.org/10.1111/all.14452

Nalbant, Ahmet KT. Can the neutrophil/lymphocyte ratio (NLR) have a role in the diagnosis of coronavirus 2019 disease (COVID-19)? Rev Assoc Med Bras (1992). 2020;90(264):746-51. https://doi.org/10.1590/1806-9282.66.6.746 PMid:32696861 DOI: https://doi.org/10.1590/1806-9282.66.6.746

Shahri MK, Niazkar HR. COVID-19 and hematology findings based on the current evidences: A puzzle with many missing pieces. Int J Lab Hematol. 2021;43(2):160-8. https://doi.org/10.1111/ijlh.13412 PMid:33264492 DOI: https://doi.org/10.1111/ijlh.13412

Zhao K, Li R, Wu X, Zhao Y, Wang T, Zheng Z, et al. Clinical features in 52 patients with COVID-19 who have increased leukocyte count: A retrospective analysis. Eur J Clin Microbiol Infect Dis. 2020;39(12):2279-87. https://doi.org/10.1007/s10096-020-03976-8 PMid:32651736 DOI: https://doi.org/10.1007/s10096-020-03976-8

Selim S. Leukocyte count in COVID-19: An important consideration. Egypt J Bronchol. 2020;8(1):4-5. DOI: https://doi.org/10.1186/s43168-020-00045-8