Modern hemogram parameters in the diagnosis of infectious pathology

Introduction. The algorithm for examining hospital patients includes a complete blood count  and a number of biochemical parameters, which often do not have pathognomonic significance  and require time and financial costs. There are hemogram parameters that have prognostic  value for patients with infectious pathology.

Objective — to evaluate the clinical and diagnostic significance of changes in advanced inflammation parameters of automated hematological analysis (neutrophil reactivity NEUT-RI, relative content of reactive neutrophils RE-NEUT, total number of immature forms of granulocytes TOTAL IG) in hospital patients with infectious pathology.

Materials and methods. A retrospective cohort single-center study was conducted. Criteria  for inclusion in the survey program: age 18–86 years, length of stay in the hospital > 7 days,  no mortality until the end of the hospitalization period. The study included 51 patients hospitalized between December 2021 and December 2022 and were divided into two groups. Main  group: patients with a confirmed pathogen (adenovirus, parainfluenza, bocavirus, rhinovirus,  coronavirus) by REAL TIME PCR, C-reactive protein level 5 mg/l, absolute number of band  neutrophils ≥ 6 % (n = 41). Control group: patients with confirmed absence of infection, C-re[1]active protein level ≤ 5 mg/l, absolute number of stab neutrophils ≤ 6 % (n = 12). In both groups of patients, extended parameters of inflammation of the complete blood count  were assessed on the hematological analyzer Sysmex XN-9000 (Sysmex Co., Japan) on days  2 and 7 of hospital stay. At the same time in the blood serum samples, the level of C-reactive protein (CRP) and ferritin were determined on the biochemical analyzer ARCHITECT c16000 (Abbot, USA) using  Werfen, Biokit (Barcelona, Madrid) and Abbot (USA) reagents Statistical processing of the obtained data was carried out using the analytical software IBM  SPSS Statistics v.21 (“Statistical Package for the Social Sciences”).

Results. The mean age of patients included in the study is 63 years. Comparative analysis was carried out by calculating Student’s t-test for dependent samples.  RE-NEUT, TOTAL IG and CRP (RE-NEUT 9.5 ± 13.14; t = 2.7 at p = 0.009; TOTAL IG 11.13  ± 13.29; t = 2.7 at p = 0.009; CRP 84.84 ± 105.97; t = 3.13 at p = 0.003) show a statistically  significant change after therapy. Both parameters are effective diagnostic criteria. Changes in  the level of ferritin and NEUT-RI had no statistically significant differences. Extended parameters of inflammation had significant (p < 0.005) correlations with classical  markers of inflammation at both measurement points (2/7 days) in patients of the main group:  RE-NEUT and NEUT-RI 0.65/0.78; RE-NEUT and CRP 0.72/0.65; TOTAL IG and NEUT-RI  0.59/0.73; TOTAL IG and CRP 0.7/0.64, respectively.

Conclusions. Advanced hemogram parameters provide accurate diagnostic values comparable to inflammatory markers and may have a priority recommendation for use in  operational diagnostics due to low cost and a significant reduction in the time to obtain the result.

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