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\begin{document}

\title{Predictive value of haematological indices on incidence and severity of
pulmonary embolism in COVID-19 patients}



\author[1]{Hanieh  Radkhah}%
\author[1]{Ensieh Sadat Mansouri}%
\author[2]{Shiva  Rahimipour Anaraki}%
\author[2]{Milad Gholizadeh}%
\author[1]{Ali  Sheikhy}%
\author[1]{Mohamad Mehdi  Khadembashiri}%
\author[1]{Mohamad Amin  Khadembashiri}%
\author[1]{Mohamad  Eslami}%
\author[1]{Tara  Mahmoodi}%
\author[1]{Behnaz  Inanloo}%
\affil[1]{Tehran University of Medical Sciences}%
\affil[2]{Iran University of Medical Sciences}%


\vspace{-1em}



  
  \date{May 22, 2024}


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\selectlanguage{english}
\begin{abstract}
Background: Pulmonary thromboembolism (PTE) is a common complication of
SARS-CoV-2, which raises the COVID-19 disease's fatality rate from 3\%
to 45\%. Nevertheless, due to fairly indistinguishable clinical symptoms
and a lack of validated clinical prediction models, PTE diagnosis in
COVID-19 patients is challenging. This study aims to investigate the
applicability of hematological indices to predict PTE incidence and its
severity in SARS-CoV-2 patients. Methods: A retrospective cohort study
was conducted on hospitalized patients with a confirmed diagnosis of
SARS-CoV-2 infection who underwent CT angiography to assess probable PTE
in them. The correlation between CBC parameters one day prior to CT
angiography and CT angiography outcomes, and simplified Pulmonary
Embolism Severity Index (s-PESI) was investigated. Results: We
discovered that among individuals with a probable PTE, males and those
with higher platelet-to-lymphocyte (PLR) and neutrophil-to-lymphocyte
(NLR) ratios had a greater likelihood of PTE incidence. PLR was a
significant and independent predictor of PTE. Moreover, a higher
neutrophil count was associated with a higher s-PESI score in COVID-19
patients developing PTE. Conclusions: Among haematological indices, NLR
and more precisely PLR are cost-effective and simply calculable markers
that can assist physicians in determining whether or not COVID-19
patients with clinically probable PTE require CT angiography and the
higher neutrophil count can be employed as an indicator of PTE severity
in COVID-19 patients. Further large multicenter and prospective studies
are warranted to corroborate these observations.%
\end{abstract}%



\sloppy


\textbf{Predictive value of haematological indices on incidence and
severity of pulmonary embolism in COVID-19 patients}

\emph{Hanieh Radkhah\textsuperscript{1}, Ensieh Sadat
Mansouri\textsuperscript{2}, Shiva Rahimipour
Anaraki\textsuperscript{3}, Milad Gholizadeh
Mesgarha\textsuperscript{4}*, Ali Sheikhy\textsuperscript{5}, Mohamad
Mehdi Khadembashiri\textsuperscript{6}, Mohamad Amin
Khadembashiri\textsuperscript{7}, Mohamad Eslami\textsuperscript{8},
Tara Mahmoodi\textsuperscript{9}, Behnaz Inanloo\textsuperscript{10}}

\begin{enumerate}
\tightlist
\item
  Department of Internal Medicine, School of Medicine, Sina Hospital,
  Tehran University of Medical Sciences (TUMS), Tehran, Iran.
  hanieh-radkhah@sina.tums.ac.ir
\item
  Department of Internal Medicine, School of Medicine, Sina Hospital,
  Tehran University of Medical Sciences (TUMS), Tehran, Iran.
  encyesaadaat@yahoo.com
\item
  Faculty of Medicine, Iran University of Medical Sciences (IUMS),
  Tehran, Iran. shivarhp@gmail.com
\item
  Faculty of Medicine, Iran University of Medical Sciences (IUMS),
  Tehran, Iran. drmiladgholizadeh@gmail.com; gholizadeh.mi@iums.ac.ir
\item
  Students' scientific research center, Tehran university of medical
  sciences (TUMS), Tehran, Iran. sheikhyali@yahoo.com
\item
  Students' scientific research center, Tehran university of medical
  sciences (TUMS), Tehran, Iran. m.mehdi.khademR@gmail.com
\item
  Students' scientific research center, Tehran university of medical
  sciences (TUMS), Tehran, Iran. Amin.khadem75@gmail.com
\item
  Students' scientific research center, Tehran university of medical
  sciences (TUMS), Tehran, Iran. Mohamad.em76@gmail.com
\item
  Students' scientific research center, Tehran university of medical
  sciences (TUMS), Tehran, Iran. taramahmoodi@yahoo.com
\item
  Sina Hospital, Tehran University of Medical Sciences (TUMS), Tehran,
  Iran. behnaz.inanloo@yahoo.com
\end{enumerate}

*Correspondence to: Milad Gholizadeh Mesgarha

\textbf{Affiliation} : Faculty of Medicine, Iran University of Medical
Sciences (IUMS), Tehran, Iran

\textbf{Email}
:\emph{drmiladgholizadeh@gmail.com},\emph{gholizadeh.mi@iums.ac.ir}

\textbf{Address} : Rasool-E-Akram Medical Center, Niayesh St.,
Sattarkhan Ave., Tehran, Iran.

\textbf{Telephone Number} : +989128142523



\textbf{ABSTRACT}

\textbf{Background:} Pulmonary thromboembolism (PTE) is a common
complication of SARS-CoV-2, which raises the COVID-19 disease's fatality
rate from 3\% to 45\%. Nevertheless, due to fairly indistinguishable
clinical symptoms and a lack of validated clinical prediction models,
PTE diagnosis in COVID-19 patients is challenging. This study aims to
investigate the applicability of hematological indices to predict PTE
incidence and its severity in SARS-CoV-2 patients.

\textbf{Methods:} A retrospective cohort study was conducted on
hospitalized patients with a confirmed diagnosis of SARS-CoV-2 infection
who underwent CT angiography to assess probable PTE in them. The
correlation between CBC parameters one day prior to CT angiography and
CT angiography outcomes, and simplified Pulmonary Embolism Severity
Index (s-PESI) was investigated.

\textbf{Results:} We discovered that among individuals with a probable
PTE, males and those with higher platelet-to-lymphocyte (PLR) and
neutrophil-to-lymphocyte (NLR) ratios had a greater likelihood of PTE
incidence. PLR was a significant and independent predictor of PTE.
Moreover, a higher neutrophil count was associated with a higher s-PESI
score in COVID-19 patients developing PTE.

\textbf{Conclusions:}Among haematological indices, NLR and more
precisely PLR are cost-effective and simply calculable markers that can
assist physicians in determining whether or not COVID-19 patients with
clinically probable PTE require CT angiography and the higher neutrophil
count can be employed as an indicator of PTE severity in COVID-19
patients. Further large multicenter and prospective studies are
warranted to corroborate these observations.

\textbf{KEYWORDS:} Pulmonary thromboembolism; SARS-CoV-2;
Neutrophil-to-lymphocyte ratio; Platelet-to-lymphocyte ratio; PESI score

\textbf{INTRODUCTION}

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
outbreak that began in Wuhan, China, in December 2019 rapidly spread
worldwide, insofar as the World Health Organization has declared
COVID-19 to be a pandemic and a public health emergency of international
concern (1-4). Although the disease is typically associated with
respiratory tract involvement, the virus also can affect other systems
including hematological and cardiovascular systems through different
hypothesized mechanisms (5, 6). One of the most important underlying
mechanisms is an increased level of inflammatory mediators (7). This
inflammatory process is accompanied by thrombotic events, including
pulmonary thromboembolism (PTE), in COVID-19 patients (8-10).

Pulmonary thromboembolism is a cause of mortality among COVID-19
complications. While the case fatality rate for COVID-19 ranges from 2\%
to 3\%, the mortality rate for COVID-19 patients who develop PTE is
45.1\% (11). This remarkable complication is reported in 15.3 percent of
COVID-19 cases (12). Due to the high mortality and incidence of PTE, as
well as the fact that prompt treatment is highly effective and has been
shown to significantly impact clinical outcomes, early diagnosis of PTE
is crucial (12, 13).

Nevertheless, PTE diagnosis in COVID-19 is challenging for a variety of
reasons. First, PTE and COVID-19 clinical manifestations may overlap
(14). Second, hospital overcrowding during the resurgence of the
COVID-19 epidemic, costs, and lack of availability in all centers make
chest CT angiography inaccessible for all patients with probable PTE
(15). Third, available clinical prediction models for PTE do not apply
to COVID-19 patients. Therefore, their use as the sole diagnostic
screening tool in clinical practice is not recommended. New clinical
probability models for PTE that have been validated in COVID-19 patients
are consequently required (16).

As previously stated, thrombotic events accompany the inflammatory
process in patients with COVID-19 (8-10). Notably, hematological ratios
are one of the valuable, inexpensive, and widely-examined markers of
inflammation (17). In addition, circulating biomarkers of inflammation,
such as Neutrophil-to-Lymphocyte ratio (NLR) and Platelet-to-Lymphocyte
ratio (PLR), have been proposed as reliable prognosticators for both
COVID-19 and PTE patients (18-20). Despite the importance of the
aforementioned hematologic markers, there are very few studies focusing
on the prediction of PTE occurrence or PTE severity in COVID-19 patients
with probable PTE, accordingly, we conducted an exploratory analysis to
evaluate the potential role of these parameters as predictors of
thromboembolism in COVID-19 patients and the correlation of CBC
parameters with the simplified-PESI score as an indicator of PTE
severity.

\textbf{METHOD}

\textbf{2.1. Participants and Study Design}

On the routine basis in the hospital, COVID-19 patients with probable
PTE due to changes in their clinical condition who were patients with
poor response to treatment, hemoptysis, and spontaneous deterioration,
comprising sudden respiratory distress, tachycardia, sudden drop in
blood pressure, or O2 saturation, underwent Chest CT angiography (CTA)
immediately after diagnostic doubt (21). All these patients received
prophylactic anticoagulant and every patient who was diagnosed with PTE
was treated by the standard protocol of PTE treatment. Among these
above-mentioned patients, cases with a confirmed diagnosis of SARS-CoV-2
infection based on positive chest CT scan findings or positive
nasopharyngeal reverse transcriptase-polymerase chain reaction (RT-PCR)
test at the general ward \& ICU of Sina hospital, Tehran, Iran, between
``March- 2019'' and ``July- 2022'', were enrolled in this observational,
analytical, retrospective cohort study and based on the results of CTA,
they were divided into the PTE and non-PTE groups.

Subsequently, patients meeting exclusion criteria consist of 1. Previous
history of deep vein thrombosis (DVT) or PTE, 2. Severe sepsis, 3.
End-stage renal disease, 4. Cirrhosis, 5. Hemoglobinopathies (e.g.
Thalassemia), 6. Platelet disorders (e.g. Immune thrombocytopenia,
Thrombotic thrombocytopenic purpura), 7. Haematological malignancies
(e.g. ALL, CLL, lymphoma), 8. Immunosuppressive drugs use, and 9. Blood
products transfusion within 48 hours of blood sampling were excluded,
and the remaining patients were included in the final sample.

\textbf{2.2.} \textbf{Data Collection}

COVID-19 patients data were collected during two years of the pandemic
in Iran which encompassed six peaks of disease and various subtypes of
SARS-CoV-2 infections. Patients' blood samples were checked for complete
blood count (CBC) (including white blood cell (WBC) count and
differentials (Neutrophil and Lymphocyte), platelets count , Hemoglobin
(Hb), red cell distribution width (RDW), mean platelet volume (MPV)),
D-dimer, C-reactive protein (CRP), and ferritin, then NLR and PLR
calculated and analysis was performed on the laboratory results of 24
hours prior to CTA. Moreover, the simplified pulmonary embolism severity
index score (simplified PESI score) was estimated for the patients with
confirmed PTE on the day of its diagnosis.

\textbf{Ethics}

The study was conducted in accordance with the Declaration of Helsinki
and national and institutional standards.

\textbf{Statistical Analysis}

Statistical analysis was done on the aforementioned laboratory data,
simplified PESI score in addition to patients' age, and gender in each
PTE and non-PTE group. All the collected data were entered into IBM SPSS
Statistics for Windows, version 22.0 (Armonk, NY: IBM Corp.)) and R
version 4.0.3 (Vienna, Austria) for analysis.

Qualitative data were described as absolute frequencies and percentages,
and quantitative data were reported as mean and standard deviation or
median and interquartile range according to their distribution. The
normality of the variables was assessed using histogram charts as well
as central tendency and dispersion measures. The qualitative variables
were compared between the `non-PTE' and `PTE' groups applying the
chi-square test, and the quantitative variables were compared between
the two above-mentioned groups using T-test for normally distributed and
Mann--Whitney U test for skewed distributed variables.

The univariate effect of covariates on PTE was assessed by the
``Logistic regression'' model and reported as an Odds ratio (OR) with
95\% confidence interval (95\% CI). Covariates with P values less than
0.1 in the univariate Logistic regression analyses were entered into
multivariate Logistic regression analysis. The backward elimination
method was considered for multivariate Logistic regression analysis to
locate predictors of PTE.

Receiver operator characteristic (ROC) curves were generated to estimate
the accuracy of each covariate in predicting PTE. The area under each
ROC curve (AUC) was calculated to identify an accurate prognostic
covariate.

\textbf{RESULT}

\textbf{Study population}

Among 464 COVID-19 patients who underwent CTA, 28 patients were excluded
from the study according to inclusion and exclusion criteria. Of these
excluded patients, nine patients were diagnosed with PTE. The
demographic and characteristics of included patients are shown
in\textbf{Table 1} . In brief, male gender were significantly correlated
with PTE occurrence in patients with underlying COVID-19 (81.7\% vs.
41.6\%, P-Value\textless{}0.001). The median age had no significant
differences between two groups. Except for NLR and PLR, other lab data
including MPV had no significant differences between two studied groups.
NLR was significantly higher in PTE group (235.50 vs. 205.50, P-Value:
0.027). Comparably, PLR was significantly higher in COVID patients which
led to PTE (13.65 vs. 9.94, P-Value:0.037).

\textbf{Stepwise logistic regression analyses of the disease
determinants}

All variables with a p-value [?]0.1 in univariate analyses (\textbf{Table
2} ) were included in stepwise logistic regression (\textbf{Table 3} ).
According to the univariate analysis, patients with higher Neutrophil
percentage, PLR, and NLR 24 hours prior to CTA had a higher risk of PTE
incidence; however, they were not statistically significant except PLR.
The OR was estimated as 1.01 (0.99-1.03) for Neutrophil percentage, 1.01
(1.00-1,02) for PLR, and 1.01 (1.00-1.02) for NLR. In contrast, patients
with higher lymphocyte percentage had a lower chance of PTE although it
was not statistically significant. The OR for mentioned protective
factor was estimated as 0.98 (0.96-1.00). In the multivariate analysis,
PLR and NLR 24 hours prior to CTA were revealed as potential
determinants of PTE (OR:1.001 (1.000-1.002) and OR:1.006 (0.998- 1.018),
respectively).

\textbf{Receiver Operating Characteristic (ROC) curve analysis}

The performance of PLR and NLR is shown in \textbf{Figure 1} .
Discrimination at the PTE was poor overall (0.5\textless{} AUC
\textless{} 0.6), although there were significant indicators. The area
under the curve for PLR was estimated as 0.559 (P-Value:0.001) and for
NLR as 0.567 (P-Value\textless{}0.001). The threshold for PLR was
estimated as 120.5 as the best cut-off point, moreover, the ideal
cut-off for the NLR was estimated as 3.5 \textbf{(Table 4)} .

\textbf{Linear regression analyses for simplified PESI-score
determinants in PTE patients}

In the linear regression analysis, higher neutrophil count in 24 hours
prior to CTA was identified as a potential indicator of PTE severity
based on the simplified PESI-score (Beta coefficient: 0.149, P-Value:
0.038) \textbf{(Table 5)} \textbf{(Figure 2)} .

\textbf{DISCUSSION}

Our study indicated that PLR significantly and independently predicts
PTE occurrence in hospitalized COVID-19 patients. Furthermore, the
bivariate test revealed an association between NLR and PTE incidence in
these patients, notwithstanding regression analysis revealed that the
correlation was not independently significant. Additionally, a greater
neutrophil count was shown to be a marker that is associated with a
higher PTE severity (higher simplified-PESI score).

\textbf{NLR and PLR predictive value in COVID-19 infection and its
pulmonary embolism complication}

A systematic review and meta-analysis demonstrated that NLR has adequate
predictive values on disease severity and mortality in patients
developing COVID-19 infection. In severe or non-survival patients with
COVID-19, the lymphocytes count decreases progressively, while the
neutrophils count gradually increases (18). This may be due to excessive
inflammation and immune suppression caused by SARS-CoV-2 infection. On
the one hand, neutrophils are generally regarded as pro-inflammatory
cells with a range of antimicrobial activities, which can be triggered
by virus-related inflammatory factors, such as interleukin-6 and
interleukin-8. On the other hand, systematic inflammation triggered by
SARS-CoV-2 significantly depresses cellular immunity, leading to a
decrease in CD3 + T cells, CD4 + T cells, and CD8 + T cells. In
addition, SARS-CoV-2-infected T cells may also cause cytopathic effects
on T cells. Therefore, the ratio of neutrophils to lymphocytes increases
(18, 22). Even though the etiopathogenesis of PTE in COVID-19 is not
completely understood, factors related to the acute inflammatory
response to the disease may be contributing to a dysregulation of the
equilibrium of procoagulant and anticoagulant mechanisms. Accordingly,
it could reasonably be predicted that higher NLR values were also found
in COVID-19 patients with PTE when compared to patients with non-PTE. A
Single-center prospective cohort study by Castillejo et al. indicated
higher baseline, peak, and prior-to-CTPA NLR values in PTE groups which
were statistically significant compared to the non-PTE group (14). This
observation was consistent with our bivariate analysis of NLR and PTE
incidence; however, regression analysis did not show this significance.

A systematic review and meta-analysis which investigated the prognostic
role of PLR in COVID-19 noted that a higher level of PLR on admission in
COVID-19 patients is correlated with increased morbidity and mortality
but evidence regarding this issue has low quality (23), but another
systematic review and meta-analysis focusing on the association between
haematological indices and COVID-19 progression and mortality found that
PLR had no significant correlation with progression and fatality of the
disease (24). Based on this review of the literature, it can be
concluded that NLR is better at predicting the severity and mortality of
COVID-19 disease than PLR (25). On the contrary, our study showed PLR
but not NLR significantly and independently predicts PTE incidence in
hospitalized COVID-19 patients. PLR was shown to be positively
correlated with CT pulmonary artery obstruction index which suggests
that higher PLR is associated with escalated thrombus burden (26).
Consequently, we could postulate that for thrombotic complications of
COVID-19 like PTE, PLR has a more precise predictive value.

Considering the cut-off point for the predictive power of NLR and PLR,
ROC curve analysis in our study showed a threshold of 3.5 for NLR with
81.4\% sensitivity and 29.9\% specificity and a threshold of 120.5 for
PLR with 76.8\% sensitivity and 35.3\% specificity. Another
observational, analytical, retrospective cohort study demonstrated a
threshold of 13.67 for NLR with 67.7\% sensitivity and 81\% specificity
and a threshold of 207.06 with 74.2\% sensitivity and 61.3\% specificity
to predict the occurrence of acute PTE in COVID-19 patients (27). The
difference between our cut-off values and the study by Muresan et al.
can be ascribed to the various time of laboratory data acquisition. In
our study, we utilized laboratory results 24 hours before CTA but
Muresan et al. used their first laboratory analyses. Nonetheless, it may
be concluded from these results that earlier NLR and PLR calculations,
with fairly acceptable specificity for NLR and fairly acceptable
sensitivity for PLR in the COVID-19 disease course, could predict the
incidence of PTE with higher cut-off values; in comparison, later NLR
and PLR calculation could also predict PTE incidence with to some extent
acceptable sensitivity but very low specificity with lower cut-off
values.

\textbf{Association between} \textbf{haematological indices and
pulmonary embolism severity (s-PESI score) in COVID-19 patients}

The Pulmonary Embolism Severity Index (PESI) was developed to estimate
30-day mortality in patients with acute PTE. The simplified PESI
(s-PESI) showed similar prognostic accuracy, clinical utility, and more
convenience in use compared with the original PESI (28). An increased
s-PESI was shown to be associated with a worse PTE prognosis in COVID-19
patients (29). We found that a higher neutrophil count 24 hours before
PTE diagnosis via CTA is correlated with a higher s-PESI score. Hence,
we postulate that neutrophil count could be a prognostic factor of PTE
severity in COVID-19 patients.

Thoreau et al. study demonstrated that a neutrophil count of more than
7.0 G/L is associated with an increased risk of PTE and also the
composite criterion combining a D-dimer level of more than 2000 ng/mL
and neutrophils count of more than 7.0 G/L was associated with an
increased risk of death, ICU transfer, and longer hospital stay,
nevertheless they found PTE occurrence did not affect time to ICU
transfer or death, nor did it influence time to hospital discharge (30).
Although they observed PTE occurrence does not correlate with worse
outcomes, PTE severity as higher neutrophil count could indicate it
might have led to a worse prognosis in their patient population which
was not assessed in this study.

In another study by Strazzulla et al., the neutrophil count was
associated with the diagnosis of acute PTE while no CBC parameters,
including neutrophil, were associated with mortality at day seven (15).
This disparity between our findings and this study may be attributable
to the differing follow-up duration as the s-PESI score estimates 30-day
mortality in PTE patients but Strazzulla et al. considered 7-day
mortality in their statistical analysis.

\textbf{Study limitation}

There were some limitations inherent to this study. Firstly, the
retrospective design of the study was implicated in the development of
some biases and hidden confounders. Selection bias might have occurred
as the patient data were collected only after a set of requisites became
accessible. Secondly, we conducted a monocentric study; consequently,
our results are not fully applicable to various COVID-19 patients
population. Thirdly, the number of patients included in the study was
restricted due to partial loss of information which was inevitable
because of the study design. Fourthly, the data on the antiviral and
anti-inflammatory medications received by the patients during
hospitalization was not available. Therefore, the effect of these drugs
on the incidence of PTE and changes in CBC parameters in our COVID-19
patients could not be assessed as confounders. Lastly, any statistics
regarding the COVID-19 vaccination of our subjects were not obtainable;
thus, this study could not differentiate the effect of SARS-CoV-2
vaccines on the PTE occurrence.

\textbf{Conclusion}

Among haematological indices, NLR and more precisely PLR are
cost-effective and simply calculable markers that can assist physicians
in determining whether or not COVID-19 patients with clinically probable
PTE require CT angiography and the higher neutrophil count can be
employed as an indicator of PTE severity in COVID-19 patients. Further
large multicenter and prospective studies are warranted to support these
findings and distinguish the effect of SARS-CoV-2 variants, anti-viral
and anti-inflammatory medications, and COVID-19 vaccination on the
predictive value of CBC parameters for PTE incidence in COVID-19
patients.

\textbf{Table-Legend 1:} Patients baseline characteristics and lab data.

\textbf{Table-Legend 2:} Univariate models for PTE: odds ratios (OR) and
95\% confidence intervals (95\%-CI).

\textbf{Table-Legend 3:} Final model for PTE -- results from stepwise
logistic regression. Variables are listed in the order of inclusion into
the model.

\textbf{Table-Legend 4:} ROC analysis of predictive variables.

\textbf{Table-Legend 5:} Linear regression analyses for PESI score in
PTE patients.

\textbf{Figure-Legend 1:} The ROC curves of PTE determinants (A. PLR and
B. NLR).

\textbf{Figure-Legend 2:} Correlation between simplified PESI-score and
Neutrophil count.

\par\null

\textbf{Acknowledgement}

\textbf{Conflict Of Interest:} The authors declare that they have no
conflict of interest.

\textbf{Funds:} No Funding was received and authors do not have any
financial relationship with the organization that sponsored this
research.

\textbf{Data Availability Statement:} The data that support the findings
of this study are available from the corresponding author, M.GH, upon
reasonable request.



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mortality of pulmonary embolism in COVID-19: a systematic review and
meta-analysis. Critical Care. 2020;24(1):464.

13. Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing G-J,
Harjola V-P, et al. 2019 ESC Guidelines for the diagnosis and management
of acute pulmonary embolism developed in collaboration with the European
Respiratory Society (ERS): The Task Force for the diagnosis and
management of acute pulmonary embolism of the European Society of
Cardiology (ESC). European Heart Journal. 2019;41(4):543-603.

14. Suarez Castillejo C, Toledo-Pons N, Calvo N, Ramon-Clar L, Mart\selectlanguage{ngerman}ínez
J, Hermoso de Mendoza S, et al. A Prospective Study Evaluating
Cumulative Incidence and a Specific Prediction Rule in Pulmonary
Embolism in COVID-19. Front Med (Lausanne). 2022;9:936816.

15. Strazzulla A, Abroug Ben Halima S, Chouchane I, Rezek M, Pinto
Stiebler M, Hamrouni S, et al. The Predictive Value of Cell Blood Count
Parameters to Diagnose Pulmonary Embolism in Patients with SARS-CoV-2
Infection: A Case Control Study. Antibiotics {[}Internet{]}. 2022;
11(1).

16. Franco-Moreno AI, Bustamante-Fermosel A, Ruiz-Giardin JM,
Muñoz-Rivas N, Torres-Macho J, Brown-Lavalle D. Utilidad de las escalas
de predicción diagnósticas de embolia de pulmón en pacientes con
infección por SARS-CoV-2: una revisión sistemática. Revista Clínica
Española. 2023;223(1):40-9.

17. Aly MM, Meshref TS, Abdelhameid MA, Ahmed SA, Shaltout AS,
Abdel-Moniem AE, et al. Can Hematological Ratios Predict Outcome of
COVID-19 Patients? A Multicentric Study. J Blood Med. 2021;12:505-15.

18. Li X, Liu C, Mao Z, Xiao M, Wang L, Qi S, et al. Predictive values
of neutrophil-to-lymphocyte ratio on disease severity and mortality in
COVID-19 patients: a systematic review and meta-analysis. Critical Care.
2020;24(1):647.

19. Ayalew G, Mulugeta B, Haimanot Y, Adane T, Bayleyegn B, Abere A.
Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Can
Predict the Severity in COVID-19 Patients from Ethiopia: A Retrospective
Study. Int J Gen Med. 2022;15:7701-8.

20. Wang Q, Ma J, Jiang Z, Ming L. Prognostic value of
neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in acute
pulmonary embolism: a systematic review and meta-analysis. Int Angiol.
2018;37(1):4-11.

21. Katsios CM, Donadini M, Meade M, Mehta S, Hall R, Granton J, et al.
Prediction Scores Do Not Correlate with Clinically Adjudicated
Categories of Pulmonary Embolism in Critically Ill Patients. Canadian
Respiratory Journal. 2014;21:296161.

22. Higaki A, Okayama H, Homma Y, Sano T, Kitai T, Yonetsu T, et al.
Predictive value of neutrophil-to-lymphocyte ratio for the fatality of
COVID-19 patients complicated with cardiovascular diseases and/or risk
factors. Sci Rep. 2022;12(1):13606.

23. Sarkar S, Kannan S, Khanna P, Singh AK. Role of
platelet-to-lymphocyte count ratio (PLR), as a prognostic indicator in
COVID-19: A systematic review and meta-analysis. J Med Virol.
2022;94(1):211-21.

24. Zinellu A, Mangoni AA. A systematic review and meta-analysis of the
association between the neutrophil, lymphocyte, and platelet count,
neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio and
COVID-19 progression and mortality. Expert Rev Clin Immunol.
2022;18(11):1187-202.

25. Singh Y, Singh A, Rudravaram S, Soni KD, Aggarwal R, Patel N, et al.
Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio as
Markers for Predicting the Severity in COVID-19 Patients: A Prospective
Observational Study. Indian J Crit Care Med. 2021;25(8):847-52.

26. Phan T, Brailovsky Y, Fareed J, Hoppensteadt D, Iqbal O, Darki A.
Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios Predict
All-Cause Mortality in Acute Pulmonary Embolism. Clin Appl Thromb
Hemost. 2020;26:1076029619900549.

27. Mure\selectlanguage{romanian}șan AV, H\selectlanguage{polish}ă\selectlanguage{english}lmaciu I, Arb\selectlanguage{polish}ă\selectlanguage{english}na\selectlanguage{romanian}și EM, Kaller R, Arb\selectlanguage{polish}ă\selectlanguage{english}na\selectlanguage{romanian}și EM, Budișc\selectlanguage{polish}ă
\selectlanguage{english}OA, et al. Prognostic Nutritional Index, Controlling Nutritional Status
(CONUT) Score, and Inflammatory Biomarkers as Predictors of Deep Vein
Thrombosis, Acute Pulmonary Embolism, and Mortality in COVID-19
Patients. Diagnostics (Basel). 2022;12(11).

28. Jim\selectlanguage{ngerman}énez D, Aujesky D, Moores L, Gómez V, Lobo JL, Uresandi F, et al.
Simplification of the Pulmonary Embolism Severity Index for
Prognostication in Patients With Acute Symptomatic Pulmonary Embolism.
Archives of Internal Medicine. 2010;170(15):1383-9.

29. Miró Ò, Jiménez S, Llorens P, Roussel M, Gorlicki J,
García-Lamberechts EJ, et al. Pulmonary embolism severity and
in-hospital mortality: An international comparative study between
COVID-19 and non-COVID patients. Eur J Intern Med. 2022;98:69-76.

30. Thoreau B, Galland J, Delrue M, Neuwirth M, Stepanian A, Chauvin A,
et al. D-Dimer Level and Neutrophils Count as Predictive and Prognostic
Factors of Pulmonary Embolism in Severe Non-ICU COVID-19 Patients.
Viruses. 2021;13(5).



\textbf{Table 1.}\selectlanguage{english}
\begin{longtable}[]{@{}lllll@{}}
\toprule
\begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
No-PTE (N= 250)\strut
\end{minipage} & \begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
PTE (N= 186)\strut
\end{minipage} & \begin{minipage}[b]{0.19\columnwidth}\raggedright\strut
P-value\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Sex\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Male\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
104 (41.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
152 (81.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Female\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
146 (58.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
34 (18.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Age\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Age\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
55 {[}54-57{]}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
57 {[}54-59{]}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.842\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Hemoglobin\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Hemoglobin\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
12.71 \selectlanguage{ngerman}± 0.35\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
12.63 \selectlanguage{ngerman}± 0.17\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.821\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Platelet\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Platelet\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
257.41 \selectlanguage{ngerman}± 6.88\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
256.05 \selectlanguage{ngerman}± 8.40\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.900\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
WBC\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
WBC\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
11.76 \selectlanguage{ngerman}± 0.48\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
10.01 \selectlanguage{ngerman}± 1.01\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.197\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Neutrophil \%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Neutrophil \%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
78.34 \selectlanguage{ngerman}± 0.77\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
80.43 \selectlanguage{ngerman}± 0.92\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.083\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Lymphocyte \%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Lymphocyte \%\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
14.00 \selectlanguage{ngerman}± 0.59\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
12.30 \selectlanguage{ngerman}± 0.65\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.063\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
RDW\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
RDW\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
14.84 \selectlanguage{ngerman}± 0.14\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
14.60 \selectlanguage{ngerman}± 0.20\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.539\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
MPV\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
MPV\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
10.72 \selectlanguage{ngerman}± 0.26\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
10.44 \selectlanguage{ngerman}± 0.08\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.408\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Ferritin\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
Ferritin\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
523.40 {[}455.90- 623.69{]}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
588.15 {[}496.20- 736.00{]}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.460\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
D-dimer\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
D-dimer\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
763.00 {[}681.00- 952.00{]}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
1059.00 {[}780.00- 1471.00{]}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.106\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
CRP\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
CRP\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
37.40 {[}30.90- 51.30{]}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
36.20 {[}28.10- 48.00{]}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
0.712\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
PLR\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
PLR\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
205.50 {[}183.00- 222.00{]}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
235.50 {[}198.00- 295.11{]}\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{0.027}\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
NLR\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
NLR\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
9.94 \selectlanguage{ngerman}± 0.93\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
13.65 \selectlanguage{ngerman}± 1.70\strut
\end{minipage} & \begin{minipage}[t]{0.17\columnwidth}\raggedright\strut
\textbf{0.037}\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

WBC: White blood cell, RDW: Red cell distribution width, MPV: Mean
platelet volume, CRP: C-reactive protein, PLR: Platelet/ Lymphocyte
ratio, NLR: Neutrophil/ Lymphocyte ratio

\textbf{Table 2.}\selectlanguage{english}
\begin{longtable}[]{@{}llll@{}}
\toprule
Variable & OR & 95\%-CI & P-value\tabularnewline
\midrule
\endhead
WBC & 1.00 & 0.99-1.01 & 0.552\tabularnewline
Neutrophil percentage & 1.01 & 0.99-1.03 & \textbf{0.092}\tabularnewline
Lymphocyte percentage & 0.98 & 0.96-1.00 & \textbf{0.065}\tabularnewline
Hemoglobin & 0.99 & 0.96-1.04 & 0.852\tabularnewline
RDW & 0.98 & 0.90-1.05 & 0.526\tabularnewline
MPV & 0.96 & 0.86-1.08 & 0.489\tabularnewline
Platelet count & 1.00 & 0.99-1.00 & 0.901\tabularnewline
Platelet/ Lymphocyte ratio (PLR) & 1.01 & 1.00-1.02 &
\textbf{0.008}\tabularnewline
Neutrophil/ Lymphocyte ratio (NLR) & 1.01 & 1.00-1.02 &
\textbf{0.062}\tabularnewline
CRP & 0.99 & 0.99-1.00 & 0.711\tabularnewline
Ferritin & 1.00 & 0.99-1.01 & 0.492\tabularnewline
\bottomrule
\end{longtable}

WBC: White blood cell, RDW: Red cell distribution width, MPV: Mean
platelet volume, CRP: C-reactive protein

\textbf{Table 3.}\selectlanguage{english}
\begin{longtable}[]{@{}llll@{}}
\toprule
& OR & 95\%-CI & \emph{P-value}\tabularnewline
\midrule
\endhead
Platelet/ Lymphocyte ratio (PLR) & 1.001 & 1.000-1.002 &
\textbf{0.045}\tabularnewline
Neutrophil/ Lymphocyte ratio (NLR) & 1.006 & 0.998-1.018 &
\textbf{0.053}\tabularnewline
\bottomrule
\end{longtable}

\textbf{Table 4.}\selectlanguage{english}
\begin{longtable}[]{@{}lllll@{}}
\toprule
Covariate & AUC/ P- value & Thresholds & Specificity &
Sensitivity\tabularnewline
\midrule
\endhead
Platelet/ Lymphocyte ratio (PLR) & 0.559/ 0.001 & 120.5 & 29.94\%
(25.15\%- 34.73\%) & 81.46\% (75.28\%- 87.08\%)\tabularnewline
Neutrophil/ Lymphocyte ratio (NLR) & 0.567/ \textless{}0.001 & 3.5 &
35.33\% (29.94\%- 40.42\%) & 76.88\% (70.97\%- 82.80\%)\tabularnewline
\bottomrule
\end{longtable}

\textbf{Table 5.}\selectlanguage{english}
\begin{longtable}[]{@{}llllll@{}}
\toprule
\begin{minipage}[b]{0.16\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[b]{0.16\columnwidth}\raggedright\strut
\textbf{Unstandardized coefficients}\strut
\end{minipage} & \begin{minipage}[b]{0.16\columnwidth}\raggedright\strut
\textbf{Unstandardized coefficients}\strut
\end{minipage} & \begin{minipage}[b]{0.16\columnwidth}\raggedright\strut
\textbf{Standardized} \textbf{coefficients} \selectlanguage{greek}\textbf{(β)}\selectlanguage{english}\strut
\end{minipage} & \begin{minipage}[b]{0.16\columnwidth}\raggedright\strut
\textbf{P value}\strut
\end{minipage} & \begin{minipage}[b]{0.16\columnwidth}\raggedright\strut
\textbf{95\% CI}\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textbf{B}\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textbf{SE}\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
WBC\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.001\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.003\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.027\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.721\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.006, 0.004\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Neutrophil percentage\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.453\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.259\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.131\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.082\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.058, .964\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Lymphocyte percentage\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.321\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.365\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.066\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.380\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-1.041, 0.399\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Neutrophil count\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.001\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.001\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.149\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textbf{0.038}\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.001, 0.003\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Lymphocyte count\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.003\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.004\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.063\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.396\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.010, 0.004\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Hemoglobulin\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-1.786\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1.383\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.097\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.198\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-4.515, 0.943\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
RDW\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1.331\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1.210\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.083\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.273\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-1.057, 3.719\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
MPV\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-2.974\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
2.839\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.079\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.296\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-8.576, 2.628\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Platelet count\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.029\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.029\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.077\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.311\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.086, 0.027\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Platelet/ Lymphocyte ratio (PLR)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.007\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.013\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.042\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.579\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.032, 0.018\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Neutrophil/ Lymphocyte ratio (NLR)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.004\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.133\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.002\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.978\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.276, 0.259\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
CRP\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.043\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.068\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.053\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.525\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.091, 0.177\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Ferritin\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.005\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.008\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.057\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.563\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
-0.011, 0.021\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

WBC: White blood cell, RDW: Red cell distribution width, MPV: Mean
platelet volume, CRP: C-reactive protein, PLR: Platelet/ Lymphocyte
ratio, NLR: Neutrophil/ Lymphocyte ratio

\textbf{Hosted file}

\verb`Figure 1.docx`  available at \url{https://authorea.com/users/723747/articles/708172-predictive-value-of-haematological-indices-on-incidence-and-severity-of-pulmonary-embolism-in-covid-19-patients}

\textbf{Hosted file}

\verb`Figure 2.docx`  available at \url{https://authorea.com/users/723747/articles/708172-predictive-value-of-haematological-indices-on-incidence-and-severity-of-pulmonary-embolism-in-covid-19-patients}

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\end{document}

