Preliminary study to identify severe from moderate cases of COVID-19 using NLR&RDW-SD combination parameter

changzheng wang; Chengbin Li

Of the 45 patients, 40 (89%) had fever and 27 (60%) had dry cough, 19 (42%) had fatigue, 15 (33%) had chills and 13 (28.9%) had myalgia. Fever and dry cough were still the most common symptoms in patients with COVID-19. Although there are not many cases reviewed, but the trend is similar to that reported in the literature [26, 33] . In the comparison of hematological parameters, WBC, Neu#, NLR, PLR, RDW-CV and RDW-SD in the severe group were significantly higher than that in the moderate group (P <0.05); meanwhile, Lym#, Eos#, HFC%, RBC, HGB and HCT in the severe group were significantly lower than that in the moderate group (P <0.05). Among them, WBC and Neu # are significantly higher in severe patients. It may be related to the persistent infection and prolonged hypoxia, leading to compensatory hyperplasia of the bone marrow to release more granulocytes and the results are consistent with the findings of Chen et al [27] . The significant lymphopenia in the severe group may be caused by the SARS-CoV-2 continuing to invade more lymphocytes, proliferate and cause the lymphocytes to die even to become depleted when they reach the spleen and other immune organs. The lymphopenia has been reported by many scholars [9, 11, 14, 16, [25] [26] [27] [28] . The same phenomenon was also seen in SARS-CoV and MERS-CoV infections [29] [30] . The trend of LYM # we found is consistent with the description mentioned in the Diagnosis and Treatment Guidelines (Trial Version 6) [2] . A study of . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.