Abstract
This study aims to systematically assess the diagnostic utility of specific hematological parameters and indices in pediatric patients for the early and accurate diagnosis of COVID-19, thereby contributing to enhanced clinical management and diagnosis of children. The study evaluated the diagnostic potential of hematological and inflammatory markers in 90 pediatric patients, including 49 with COVID-19 and 41 without. It focused on complete blood counts, systemic immune-inflammatory index (SII, calculated as platelet count multiplied by neutrophil count divided by lymphocyte count), platelet to mean platelet volume ratio (PLT/MPV), neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, C-reactive protein, and procalcitonin, comparing these markers between patients with and without COVID-19. COVID-19 positive patients exhibited higher hemoglobin levels and immature granulocyte percentages, along with lower total leukocyte, neutrophil, platelet counts, and procalcitonin levels (p-values: 0.02, 0.006, 0.01, 0.002, 0.007, and 0.01, respectively). The SII and PLT/MPV ratio were significantly lower in the COVID-19 positive group (p=0.01 and p=0.006, respectively), suggesting their potential diagnostic relevance. Receiver Operating Characteristic (ROC) analysis revealed that procalcitonin, PLT/MPV, and SII had comparable diagnostic utility, with area under the curve (AUC) values indicating moderate diagnostic accuracy (procalcitonin AUC: 0.65, p=0.013; PLT/MPV AUC: 0.67, p=0.004; SII AUC: 0.65, p=0.01). Our research highlights the PLT/MPV ratio and SII as breakthrough markers for early detection of COVID-19 in children, providing a significant advance in pediatric diagnostics and enhancing our ability to meet the challenges of the pandemic.