SELECTED LABORATORY PARAMETERS IN PEDIATRIC PATIENTS WITH COVID-19 STRATIFIED BY WHITE BLOOD CELL AND PLATELET PROFILES.

OBJECTIVES

Pediatric COVID-19 generally has a milder clinical course than adult disease, although hematological, inflammatory, hepatic, coagulation-related, and renal laboratory abnormalities may accompany infection. White blood cell (WBC) and platelet (PLT) counts are routinely available hematological measures; however, the relationship between combined WBC/PLT profiles and broader laboratory patterns in pediatric COVID-19 remains incompletely characterized. This study aimed to compare selected laboratory parameters among pediatric patients with COVID-19, stratified according to predefined WBC and platelet profiles.

METHODS

This retrospective, laboratory-based comparative study included 142 pediatric patients with RT-PCR-confirmed COVID-19 from the Adjara region of Georgia between 2020 and 2021. Patients were classified as WBC+PLT-N/CT (reference; n=94), WBC+PLT-H (n=16), WBC-H (n=3), or PLT-H (n=29). Alanine aminotransferase (ALT), aspartate aminotransferase (AST), C-reactive protein (CRP), D-dimer, ferritin, and creatinine were evaluated. The WBC+PLT-H and PLT-H groups were compared separately with the reference group using two-sided independent-samples Welch's t-tests. The WBC-H subgroup was analyzed descriptively because of its very small size. Analyses were exploratory and were not adjusted for age or multiple comparisons.

RESULTS

The overall mean age was 5.71±5.36 years, with both platelet-elevated groups being younger on average than the reference group. Compared with the reference group, the WBC+PLT-H group had higher CRP (16.71±9.17 vs 11.38±6.98 mg/L; p=0.0396) and lower creatinine (58.93±10.20 vs 68.09±15.91 µmol/L; p=0.0052). The PLT-H group had higher ALT (27.29±22.37 vs 18.60±6.65 U/L; p=0.0479). No other comparison met the nominal p<0.05 threshold.

CONCLUSION

Combined WBC/platelet profiles were associated with different laboratory patterns in pediatric COVID-19. These exploratory findings warrant confirmation in larger pediatric cohorts using appropriately age-adjusted analyses.