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. 2024 Jun 24:12:1305639.
doi: 10.3389/fped.2024.1305639. eCollection 2024.

Clinical and hematological characteristics of children infected with the omicron variant of SARS-CoV-2: role of the combination of the neutrophil: lymphocyte ratio and eosinophil count in distinguishing severe COVID-19

Qiaoyan Jin #  1   2 , Wenxian Ma #  2 , Wei Zhang #  3 , Huiyuan Wang  1 , Yiongxiang Geng  1 , Yan Geng  1 , Yang Zhang  1 , Dan Gao  1 , Jing Zhou  1 , Lin Li  3 , Yaping Gou  4 , Bo Zhong  1 , Jing Li  1 , Wei Hou  1 , Shemin Lu  2   5
Affiliations

Clinical and hematological characteristics of children infected with the omicron variant of SARS-CoV-2: role of the combination of the neutrophil: lymphocyte ratio and eosinophil count in distinguishing severe COVID-19

Qiaoyan Jin et al. Front Pediatr. .

Abstract

Purpose: Investigate the clinical/hematological characteristics of children infected with the Omicron variant of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and identify an effective indicator to distinguish coronavirus disease 2019 (COVID-19) severity in children.

Methods: A retrospective study was conducted through electronic medical records from pediatric patients. The demographic, clinical, and routine blood test (RBT) features of children diagnosed by real-time PCR for SARS-CoV-2 were collected.

Results: Data of 261 patients were analyzed. The most common abnormality shown by RBTs was increased monocyte count (68%). Children had "mild-moderate" or "severe" forms of COVID-19. Prevalence of abnormal neutrophil count (p = 0.048), eosinophil count (p = 0.006), mean corpuscular volume (p = 0.033), mean platelet volume (p = 0.006), platelet-large cell ratio (p = 0.043), and red blood cell distribution width-standard deviation (p = 0.031) were significantly different in the two types. A combination of the neutrophil: lymphocyte ratio (NLR) and eosinophil count for diagnosing severe COVID-19 presented the largest AUC (0.688, 95% CI = 0.599-0.777; p < 0.001), and the AUC increased with a decrease in age.

Conclusions: Combination of the NLR and eosinophil count might be a promising indicator for identifying severe COVID-19 in children at infection onset.

Keywords: COVID-19; children; eosinophil count; neutrophil: lymphocyte ratio; severe infection.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Receiver operating characteristic curves for the NLR, eosinophil count, and NLR combined with the eosinophil count in the diagnosis of severe COVID-19 in children. NLR, neutrophil: lymphocyte ratio; COVID-19, coronavirus disease-2019.
See this image and copyright information in PMC

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