Predictive value of haematological indices on incidence and severity of
pulmonary embolism in COVID-19 patients
Abstract
Background: Pulmonary thromboembolism (PTE) is a common complication of
SARS-CoV-2, which raises the COVID-19 disease’s fatality rate from 3%
to 45%. Nevertheless, due to fairly indistinguishable clinical symptoms
and a lack of validated clinical prediction models, PTE diagnosis in
COVID-19 patients is challenging. This study aims to investigate the
applicability of hematological indices to predict PTE incidence and its
severity in SARS-CoV-2 patients. Methods: A retrospective cohort study
was conducted on hospitalized patients with a confirmed diagnosis of
SARS-CoV-2 infection who underwent CT angiography to assess probable PTE
in them. The correlation between CBC parameters one day prior to CT
angiography and CT angiography outcomes, and simplified Pulmonary
Embolism Severity Index (s-PESI) was investigated. Results: We
discovered that among individuals with a probable PTE, males and those
with higher platelet-to-lymphocyte (PLR) and neutrophil-to-lymphocyte
(NLR) ratios had a greater likelihood of PTE incidence. PLR was a
significant and independent predictor of PTE. Moreover, a higher
neutrophil count was associated with a higher s-PESI score in COVID-19
patients developing PTE. Conclusions: Among haematological indices, NLR
and more precisely PLR are cost-effective and simply calculable markers
that can assist physicians in determining whether or not COVID-19
patients with clinically probable PTE require CT angiography and the
higher neutrophil count can be employed as an indicator of PTE severity
in COVID-19 patients. Further large multicenter and prospective studies
are warranted to corroborate these observations.