ROLE OF LEUKOCYTE PARAMETERS IN ASSESSING SEVERITY OF INFECTIOUS GASTROENTERITIS

Abstract

Infectious gastroenteritis remains a significant cause of morbidity worldwide and continues to pose a substantial burden on healthcare systems, particularly in low- and middle-income countries. Early and accurate assessment of disease severity is essential for guiding timely clinical management, preventing complications, and optimizing resource utilization. Although clinical scoring systems are widely used, their reliance on subjective assessment limits their predictive accuracy. In recent years, routine hematological parameters have gained attention as objective, rapid, and cost-effective tools for evaluating inflammatory response and disease severity. The present study aimed to assess the role of leukocyte parameters in determining the severity of infectious gastroenteritis among adult patients presenting to a tertiary care hospital. A hospital-based observational cross-sectional study was conducted at a Tertiary Care Hospital, Karachi, involving 200 adult patients aged 18–65 years with clinically diagnosed acute infectious gastroenteritis of less than 14 days’ duration. Patients with chronic gastrointestinal, hematological, immunological, or systemic diseases were excluded to minimize confounding effects. Demographic and clinical data were recorded at presentation, and disease severity was categorized into mild, moderate, and severe based on clinical features and hydration status. Venous blood samples were collected prior to treatment, and complete blood counts were analyzed to obtain total white blood cell count, absolute neutrophil count, absolute lymphocyte count, and neutrophil-to-lymphocyte ratio. Statistical analysis was performed to compare leukocyte parameters across severity groups. Quantitative analysis revealed a significant stepwise increase in total white blood cell count with increasing disease severity, with mean values of 8.4 ± 2.1 ×10⁹/L in mild cases, 11.2 ± 3.4 ×10⁹/L in moderate cases, and 14.6 ± 4.2 ×10⁹/L in severe cases (p < 0.001). Absolute neutrophil count also rose significantly across severity categories, while absolute lymphocyte count demonstrated a declining trend, indicating relative lymphopenia in severe disease (p = 0.002). The neutrophil-to-lymphocyte ratio showed the strongest association with severity, increasing from a mean of 2.4 ± 0.9 in mild cases to 7.8 ± 2.6 in severe cases (p < 0.001). These findings suggest that leukocyte parameters, particularly neutrophil count and neutrophil-to-lymphocyte ratio, are strongly associated with clinical severity in infectious gastroenteritis and may serve as valuable adjuncts to clinical assessment.