Evaluation of Absolute Neutrophil Count in COVID-19 Patients in a Tertiary Care Hospital

Coronavirus disease 2019 (COVID-19) is a communicable disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The clinical manifestations of COVID-19 vary from asymptomatic to acute respiratory distress syndrome. In severely-ill patients, neutrophil count is significantly increased. This study aimed to evaluate absolute neutrophil count (ANC) in patients with COVID-19 and healthy individuals.

This retrospective, cross-sectional study was carried out on patients admitted to the outpatient department of OBGY Rural Hospital (Maharashtra, India) from April 2021 to June 2021. A peripheral venous blood sample (3 ml) was taken from 143 patients with COVID-19 and 143 healthy controls. The blood samples were analyzed using a fully automated blood cell counter for the estimation of complete blood count. A peripheral blood smear was prepared and stained with Leishman stain for evaluation of morphological changes.

The ANC of COVID-19 patients was significantly higher than that of healthy control subjects (p=0.00001). Toxic granules (48.9%) were the most common morphological neutrophil abnormality, followed by hypolobation, hypogranulation, Pseudo-Pelger-Huet anomaly (20.9%), and shift to left with the presence of immature myeloid series cells.

High ANC along with morphological changes in neutrophils could be used as a simple and inexpensive surrogate marker of COVID-19 and its severity.