Utility of Differential White Cell Count and Cell Population Data for Ruling Out COVID-19 Infection in Patients With Community-Acquired Pneumonia

• Ane Uranga ^[3] ; Eloisa Urrechaga ^[1] ; Urko Aguirre ^[4] ; Maider Intxausti ^[2] ; Carlos Ruiz-Martinez ^[5] ; Maria Jose Lopez de Goicoechea ^[6] ; Cristina Ponga ^[1] ; Jose María Quintana ^[4] ; Cristina Sancho ^[2] ; Pilar Sanz ^[7] ; Pedro Pablo España ^[3]
  1. [1] Instituto de Investigación Sanitaria Biocruces Bizkaia

     Instituto de Investigación Sanitaria Biocruces Bizkaia

     Barakaldo, España

     
  2. [2] Hospital Universitario de Basurto

     Hospital Universitario de Basurto

     Bilbao, España

     
  3. [3] Departamento de Neumología, Hospital Universitario de Galdakao-Usansolo, Galdakao, España
  4. [4] Osakidetza Servicio Vasco de Salud, Hospital Universitario Galdakao-Usansolo, Unidad de Investigación, Galdakao, España
  5. [5] Servicio de Neumología, Hospital Universitario de San Pedro Logroño, La Rioja, España
  6. [6] Departamento de Microbiología, Hospital Universitario de Galdakao-Usansolo, Galdakao, España
  7. [7] Departamento de Diagnóstico Biomédico, Hospital Universitario de San Pedro Logroño, La Rioja, España GRUPO DE ESTUDIO LEUCOCAP

  Mostrar afiliaciones +
• Localización: Archivos de bronconeumología: Organo oficial de la Sociedad Española de Neumología y Cirugía Torácica SEPAR y la Asociación Latinoamericana de Tórax ( ALAT ), ISSN 0300-2896, Vol. 58, Nº. 12 (December), 2022, págs. 802-808
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Introduction The main aim of this study was to assess the utility of differential white cell count and cell population data (CPD) for the detection of COVID-19 in patients admitted for community-acquired pneumonia (CAP) of different etiologies.

    Methods This was a multicenter, observational, prospective study of adults aged ≥18 years admitted to three teaching hospitals in Spain from November 2019 to November 2021 with a diagnosis of CAP. At baseline, a Sysmex XN-20 analyzer was used to obtain detailed information related to the activation status and functional activity of white cells.

    Results The sample was split into derivation and validation cohorts of 1065 and 717 patients, respectively. In the derivation cohort, COVID-19 was confirmed in 791 patients and ruled out in 274 patients, with mean ages of 62.13 (14.37) and 65.42 (16.62) years, respectively (p<0.001). There were significant differences in all CPD parameters except MO-Y. The multivariate prediction model showed that lower NE-X, NE-WY, LY-Z, LY-WY, MO-WX, MO-WY, and MO-Z values and neutrophil-to-lymphocyte ratio were related to COVID-19 etiology with an AUC of 0.819 (0.790, 0.846). No significant differences were found comparing this model to another including biomarkers (p=0.18).

    Conclusions Abnormalities in white blood cell morphology based on a few cell population data values as well as NLR were able to accurately identify COVID-19 etiology. Moreover, systemic inflammation biomarkers currently used were unable to improve the predictive ability. We conclude that new peripheral blood biomarkers can help determine the etiology of CAP fast and inexpensively.