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Neutrophil/lymphocyte ratio and Lymphopenia as a severity marker rather than diagnostic marker of Covid-19 in pregnant population, A retrospective case series.
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  • Hashem Elhossamy,
  • Sivanandana Korrapati,
  • Florence Cole,
  • Maheshwari Srinivasan
Hashem Elhossamy
Sandwell and West Birmingham Hospitals NHS Trust
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Sivanandana Korrapati
Sandwell and West Birmingham Hospitals NHS Trust
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Florence Cole
Sandwell and West Birmingham Hospitals NHS Trust
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Maheshwari Srinivasan
Sandwell and West Birmingham Hospitals NHS Trust
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Abstract

Objective: Recommending using lymphopenia and neutrophil/lymphocyte ratio(NLR) as a severity marker rather than diagnostic marker for pregnant patients with COVID-19. Design: retrospective study. Setting :Birmingham city hospital, Birmingham, United Kingdom maternity unit admissions to delivery suite between 10 March 2020 and 31 May 2020. Population: We reviewed all patients who tested positive for COVID-19 and were pregnant. Methods: We looked at the white blood cell counts of all the patients and their outcomes. We specifically looked at lymphocyte count as well as neutrophil count and calculated the neutrophil lymphocyte ratio(NLR) for every case in our series. Main Outcome Measures: Only 15.3% of pregnant patients who tested positive for COVID-19 had lymphopenia and raised NLR in contrast with up to 90% in non-pregnant population. Results: Our results  indicate that out of 13 patients who tested positive, for COVID-19, only 2 915.3% had lymphopenia and raised NLR more than 8. Conclusions: There are very conflicting results for normal values of white blood cells and lymphocytes in pregnancy. In our study Lymphopenia and raised NLR do not seem to be common findings in confirmed pregnant cases of COVID-19 but can help determine morbidity as patients that had lymphopenia and raised NLR displayed severe symptoms, were more unwell and needed high dependency unit admission.