Simple Parameters from Complete Blood Count Predict In-Hospital Mortality in COVID-19
Authors: Bellan Mattia , Azzolina Danila , Hayden Eyal , Gaidano Gianluca , Pirisi Mario , Acquaviva Antonio , Aimaretti Gianluca , Aluffi Valletti Paolo , Angilletta Roberto , Arioli Roberto , Avanzi Gian Carlo , Avino Gianluca , Balbo Piero Emilio , Baldon Giulia , Baorda Francesca , Barbero Emanuela , Baricich Alessio , Barini Michela , Barone-Adesi Francesco , Battistini Sofia , Beltrame Michela , Bertoli Matteo , Bertolin Stephanie , Bertolotti Marinella , Betti Marta , Bobbio Flavio , Boffano Paolo , Boglione Lucio , Borrè Silvio , Brucoli Matteo , Calzaducca Elisa , Cammarata Edoardo , Cantaluppi Vincenzo , Cantello Roberto , Capponi Andrea , Carriero Alessandro , Casciaro Giuseppe Francesco , Castello Luigi Mario , Ceruti Federico , Chichino Guido , Chirico Emilio , Cisari Carlo , Cittone Micol Giulia , Colombo Crizia , Comi Cristoforo , Croce Eleonora , Daffara Tommaso , Danna Pietro , Della Corte Francesco , De Vecchi Simona , Dianzani Umberto , Di Benedetto Davide , Esposto Elia , Faggiano Fabrizio , Falaschi Zeno , Ferrante Daniela , Ferrero Alice , Gagliardi Ileana , Galbiati Alessandra , Gallo Silvia , Garavelli Pietro Luigi , Gardino Clara Ada , Garzaro Massimiliano , Gastaldello Maria Luisa , Gavelli Francesco , Gennari Alessandra , Giacomini Greta Maria , Giacone Irene , Giai Via Valentina , Giolitti Francesca , Gironi Laura Cristina , Gramaglia Carla , Grisafi Leonardo , Inserra Ilaria , Invernizzi Marco , Krengli Marco , Labella Emanuela , Landi Irene Cecilia , Landi Raffaella , Leone Ilaria , Lio Veronica , Lorenzini Luca , Maconi Antonio , Malerba Mario , Manfredi Giulia Francesca , Martelli Maria , Marzari Letizia , Marzullo Paolo , Mennuni Marco , Montabone Claudia , Morosini Umberto , Mussa Marco , Nerici Ilaria , Nuzzo Alessandro , Olivieri Carlo , Padelli Samuel Alberto , Panella Massimiliano , Parisini Andrea , Paschè Alessio , Patrucco Filippo , Patti Giuseppe , Pau Alberto , Pedrinelli Anita Rebecca , Percivale Ilaria , Ragazzoni Luca , Re Roberta , Rigamonti Cristina , Rizzi Eleonora , Rognoni Andrea , Roveta Annalisa , Salamina Luigia , Santagostino Matteo , Saraceno Massimo , Savoia Paola , Sciarra Marco , Schimmenti Andrea , Scotti Lorenza , Spinoni Enrico , Smirne Carlo , Tarantino Vanessa , Tillio Paolo Amedeo , Tonello Stelvio , Vaschetto Rosanna , Vassia Veronica , Zagaria Domenico , Zavattaro Elisa , Zeppegno Patrizia , Zottarelli Francesca , Sainaghi Pier Paolo 
Published: May 2021

Introduction. The clinical course of Coronavirus Disease 2019 (COVID-19) is highly heterogenous, ranging from asymptomatic to fatal forms. The identification of clinical and laboratory predictors of poor prognosis may assist clinicians in monitoring strategies and therapeutic decisions. Materials and Methods. In this study, we retrospectively assessed the prognostic value of a simple tool, the complete blood count, on a cohort of 664 patients (

F

260; 39%, median age 70 (56-81) years) hospitalized for COVID-19 in Northern Italy. We collected demographic data along with complete blood cell count; moreover, the outcome of the hospital in-stay was recorded. Results. At data cut-off, 221/664 patients (33.3%) had died and 453/664 (66.7%) had been discharged. Red cell distribution width (RDW) (

χ

2

10.4;

p
<
0.001

), neutrophil-to-lymphocyte (NL) ratio (

χ

2

7.6;

p
=
0.006

), and platelet count (

χ

2

5.39;

p
=
0.02

), along with age (

χ

2

87.6;

p
<
0.001

) and gender (

χ

2

17.3;

p
<
0.001

), accurately predicted in-hospital mortality. Hemoglobin levels were not associated with mortality. We also identified the best cut-off for mortality prediction: a

NL

ratio
>
4.68

was characterized by an odds ratio for in-hospital

mortality

OR

=
3.40

(2.40-4.82), while the OR for a

RDW
>
13.7

% was 4.09 (2.87-5.83); a

platelet

count
>
166,000

/μL was, conversely, protective (OR: 0.45 (0.32-0.63)). Conclusion. Our findings arise the opportunity of stratifying COVID-19 severity according to simple lab parameters, which may drive clinical decisions about monitoring and treatment.