Complete Blood Picture Profile of Covid-19 Patients Admitted in a Tertiary Care Hospital, Dhaka, Bangladesh

Context: COVID-19 is the pandemic disease causes severe acute respiratory infection. T-cell mediated responses are activated and responses are initiated by antigen presentation via DCs and macrophages. Immunologically SARS-CoV showed that virus infected lung epithelial cells produced IL-8 in addition to IL-6. A hyperinflammatory environment has been a hallmark of COVID‐19 infection and is thought to be a key mediator of morbidity and mortality. In most cases the clinical presentation is that of a respiratory infection with a symptom severity ranging from a mild influenza like illness, to a severe viral pneumonia leading to acute respiratory distress syndrome that is potentially fatal.

Methods: This study was a cross-sectional observational study, conducted in Department of Medicine, Shaheed Suhrawardy Medical College Hospital. Patients with COVID-19 positive were enrolled after fulfilling the inclusion and exclusion criteria. Samples were selected by purposive sampling technique. Sample size was 200. Detail socio-demographic data were collected from the informant and recorded in structured case report form. Clinical examination and relevant investigation were done.

Result: Present study demonstrates that maximum number of patients (43.0%) were between 41-50 years age group. Mean age of the patient was 42.35 ± 11.7 years. Out of 200 cases 78% were male and 22% were female. Male and female ratio was 3.54:1. Socioeconomically poor class 42% comprising the major percentage of the patients, and 68.0% patients came from urban area and 32.0% from rural area. In this study fever and cough was commonest presentation, 79.0% & 36.0% of patients respectively. Other manifestations were headache (16.0%), diarrhea (20.0%), tachycardia in (29.0%) and fast breathing in 21.0% of patients. Clinical characteristics revealed that mild were 44.0% patients, moderate disease was 37.0% patients, and severe to critical was 19.0% of patients. On evaluation of complete blood count report, hemoglobin level was depleted in 17.0% patients, leukocytosis was observed in 39.0% patients and decreased platelet count (thrombocytopenia) in 58.0% patients with mean value 137.2±24.5×109/l. Increased neutrophils count (neutrophilia) and decreased lymphocytes count (lymphocytopenia) was predominant findings, with mean value 7.9±1.3×109/l and 1.3±0.8×109/l respectively. Present study shows that thrombocytopenia and leukocytosis was significantly associated with severity of COVID-19. In severe to critical illness, maximum patients were detected thrombocytopenia (94.7%). Similarly maximum patients were detected leukocytosis was detected in 78.9% patients. The result was significant (p<0.05). So thrombocytopenia and leukocytosis are predictor of severity of COVID-19.

Conclusions: Several haematological parameters, such as platelets, white blood cell total count, lymphocytes, neutrophils and haemoglobin were described to be associated with COVID-19 infection and severity. Present study concluded that decreased platelet, lymphocyte, haemoglobin, eosinophil, and basophil count, increased neutrophil count and neutrophil-lymphocyte ratio have been associated with COVID-19 infection and a worse clinical outcome.

Keywords: Blood Picture Profile, Of Covid-19, Lymphocytes, Neutrophils.