AUTHOR=Jin Qiaoyan , Ma Wenxian , Zhang Wei , Wang Huiyuan , Geng Yiongxiang , Geng Yan , Zhang Yang , Gao Dan , Zhou Jing , Li Lin , Gou Yaping , Zhong Bo , Li Jing , Hou Wei , Lu Shemin 

TITLE=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

JOURNAL=Frontiers in Pediatrics

VOLUME=12

YEAR=2024

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2024.1305639

DOI=10.3389/fped.2024.1305639

ISSN=2296-2360

ABSTRACT=<sec><title>Purpose</title><p>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.</p></sec><sec><title>Methods</title><p>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.</p></sec><sec><title>Results</title><p>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 (<italic>p</italic> = 0.048), eosinophil count (<italic>p</italic> = 0.006), mean corpuscular volume (<italic>p</italic> = 0.033), mean platelet volume (<italic>p</italic> = 0.006), platelet-large cell ratio (<italic>p</italic> = 0.043), and red blood cell distribution width-standard deviation (<italic>p</italic> = 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; <italic>p</italic> &lt; 0.001), and the AUC increased with a decrease in age.</p></sec><sec><title>Conclusions</title><p>Combination of the NLR and eosinophil count might be a promising indicator for identifying severe COVID-19 in children at infection onset.</p></sec>