Hematological Markers: An Early Road to Recovery in Sepsis

Abstract

Objective: To investigate the clinical value of hematological parameters neutrophil NEUT-X, NEUT-Y, and NEUT-Z and monocyte MONO-X, MONO-Y, and MONO-Z in the detection of sepsis and compare their values with that of C-reactive protein (CRP).

Methodology: This is a cross-sectional study that was conducted at Chughtai Institute of Pathology and Mayo Hospital, Lahore, from October 2025 to January 2026. A total of 175 patients, both male and female, were recruited in the study. The normal group consisted of 65 individuals (30 males, 35 females; age range 14–85 years) who underwent routine physical examination and showed no evidence of illness or inflammation. The sepsis group consisted of 110 individuals (70 males, 40 females; age range 14–95 years). Their SOFA score was calculated. The CRP and NEUT-X, NEUT-Y, NEUT-Z, MONO-X, MONO-Y, and MONO-Z were analyzed for everyone using the analyzers, Sysmex XN-9000 (for hematology parameters) and Abott Alinity C (for CRP with cut-off >5 mg/L). The cut-off for total leukocyte counts 10x109/L was taken. The data was analyzed using SPSS. The median and Interquartile range for all parameters were calculated. Mann-Whitney U test and Shapiro-Wilk test were used to assess the data. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance (including sensitivity and specificity) of these parameters in distinguishing between septic and non-septic patients along with overall model quality to help in predictability.

Results: Median values of NEUT-X, NEUT-Y, NEUT-Z, MONO-X, MONO-Y, MONO-Z, and CRP in the sepsis group were significantly higher than those in the normal group. The area under the receiver operating characteristic curve (AUC) of NEUT-X, NEUT-Y, NEUT-Z, MONO-X, MONO-Z, and CRP for the diagnosis of sepsis was 0.719 (sensitivity 92.7%, specificity 20.0%), 0.856 (97.3%, 27.7%), 0.854 (98.2%, 40.0%), 0.922 (83.6%, 89.2%), 0.616 (87.3%, 18.5%), and 0.965 (94.5%, 81.5%), respectively. While the area under the receiver operating characteristic curve (AUC) of MON-Y 0.140 showed low predictability.

Conclusion: The findings collectively indicate that while MONO-Y is not discriminative, neutrophil-related variables (NEUT-X, NEUT-Y, NEUT-Z) and monocyte variables (MONO-X, MONO-Z) may be sepsis biomarkers.