Pediatric COVID-19 diagnosis: The utility of hematological and inflammatory indices

Abstract

This study aims to systematically assess the diagnostic utility of specific hematological parameters and indices in pediatric patients for the early and accurate diagnosis of COVID-19, thereby contributing to enhanced clinical management and diagnosis of children. The study evaluated the diagnostic potential of hematological and inflammatory markers in 90 pediatric patients, including 49 with COVID-19 and 41 without. It focused on complete blood counts, systemic immune-inflammatory index (SII, calculated as platelet count multiplied by neutrophil count divided by lymphocyte count), platelet to mean platelet volume ratio (PLT/MPV), neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, C-reactive protein, and procalcitonin, comparing these markers between patients with and without COVID-19. COVID-19 positive patients exhibited higher hemoglobin levels and immature granulocyte percentages, along with lower total leukocyte, neutrophil, platelet counts, and procalcitonin levels (p-values: 0.02, 0.006, 0.01, 0.002, 0.007, and 0.01, respectively). The SII and PLT/MPV ratio were significantly lower in the COVID-19 positive group (p=0.01 and p=0.006, respectively), suggesting their potential diagnostic relevance. Receiver Operating Characteristic (ROC) analysis revealed that procalcitonin, PLT/MPV, and SII had comparable diagnostic utility, with area under the curve (AUC) values indicating moderate diagnostic accuracy (procalcitonin AUC: 0.65, p=0.013; PLT/MPV AUC: 0.67, p=0.004; SII AUC: 0.65, p=0.01). Our research highlights the PLT/MPV ratio and SII as breakthrough markers for early detection of COVID-19 in children, providing a significant advance in pediatric diagnostics and enhancing our ability to meet the challenges of the pandemic.