# Identifying Key Hematological and Biochemical Indicators of Disease Severity in COVID-19 and Non-COVID-19 Patients

## TL;DR

This study identifies blood and biochemical markers linked to severe outcomes in both COVID-19 and non-COVID-19 patients, which could help guide treatment and resource allocation.

## Contribution

The study identifies specific hematological and biochemical indicators that are uniquely and commonly associated with disease severity in both COVID-19 and non-COVID-19 patients.

## Key findings

- Elevated NE-SFL, PLR, glucose, and AST, along with decreased plateletcrit, are linked to severe outcomes in COVID-19 patients.
- Decreased hemoglobin, LY-SSC, and albumin, along with increased leukocyte and MO-SSC, are associated with greater severity in both patient groups.
- These biomarkers could improve clinical decision-making and severity stratification in real-time.

## Abstract

Background: This study investigated hematological and biochemical parameters, including cell population data (CPD), to evaluate their association with severity in COVID-19 and non-COVID-19 patients. Identifying these parameters could aid in disease monitoring and clinical decision-making. Methods: A retrospective analysis of 8401 patients, including 603 COVID-19 cases and 7546 non-COVID-19 cases, were conducted. Complete blood count (CBC) and routine chemistry results obtained near the time of real-time polymerase chain reaction testing were analyzed to assess their associations with disease severity. A matched cohort analysis was performed to adjust for potential confounding factors, such as age and sex. Results: COVID-19 patients with elevated neutrophil side fluorescence light (NE-SFL), platelet-to-lymphocyte ratio (PLR), glucose, and aspartate aminotransferase (AST), along with decreased plateletcrit, were more likely to experience severe outcomes, such as hospitalization or death. In addition, decreased hemoglobin, lymphocyte side scatter (LY-SSC), and albumin, as well as increased leukocyte and monocyte side scatter (MO-SSC), were associated with a greater severity, regardless of COVID-19 status. Conclusions: We identified hematologic and chemical assay biomarkers that correlate with severe COVID-19. These findings may provide important information regarding the disease progression and clinical management. Incorporating these biomarkers into clinical decision support systems could facilitate personalized treatment strategies, optimize resource allocation, and enable real-time severity stratification.