C-reactive protein and neutrophil–lymphocyte ratio as predictors of mortality in coronavirus disease 2019

Abstract

OBJECTIVE: This study investigates whether C-reactive protein, platelet-lymphocyte ratio, and neutrophil-lymphocyte ratio could be useful to predict mortality in COVID-19.METHODS: Data of 635 patients with COVID-19 followed up in Sinop Ataturk State Hospital from February to May 2020 were evaluated retrospectively. Diagnosis of COVID-19 was made according to the interim guidance of the World Health Organization. Patients were grouped into two groups based on mortality as survived and non-survived patients. Age, gender, neutrophil-lymphocyte ratio, plateletlymphocyte ratio, and C-reactive protein of the groups were investigated and compared. RESULTS:The mean age of the participants was 55.8±22.3 years. Among the patients, 584 survived and 51 patients died. Age was significantly different between the groups, 54.2±22.3 in the survived group and 75.6±11.1 in the dead group (p=0.000). In addition, neutrophil, C-reactive protein, and neutrophil-lymphocyte ratio values were significantly higher in the dead group (p=0.000). plateletlymphocyte ratio was slightly higher in the dead group, but this difference was not significant (p=0.42). The area under the curve values for age, lymphocyte, platelet, C-reactive protein, and neutrophil-lymphocyte ratio are 0.797, 0.424, 0.485, 0.778, and 0.729, respectively. CONCLUSIONS: Our results showed that neutrophil-lymphocyte ratio and C-reactive protein are significantly higher in patients leading to death and could be effective biomarkers in predicting COVID-19 fatality. Furthermore, C-reactive protein could be used as an independent biomarker to predict death in patients with COVID-19, regardless of gender and age (p=0.000).

Multi-inflammatory Index as a Novel Mortality Predictor in Critically Ill COVID-19 Patients

“…Elevated CRP levels were related with poor prognosis and mortality. 5 Our study also showed that CRP levels were significantly increased in mortal COVID-19 cases compared with survived ones.…”

“…In addition to this new finding, we also found in our study that advanced age and increased NLR level were the other independent mortality predictors as in agreement with the previous literature. 5 …”

“…As the neutrophil count usually increases and lymphocyte count decreases in COVID-19, elevated NLR predicts disease severity and mortality. 5 Apart from NLR, many other inflammatory parameters showing systemic inflammation were found to be useful in predicting mortality in COVID-19 patients. 19 – 29 The common mechanism of the effect of these parameters to the disease mortality is that systemic inflammation has a crucial role in the pathogenesis and mortality of COVID-19.…”

“…Previous studies showed that CRP levels seriously increase in critical situations such as cancers and critical infections as well as COVID-19. 4 , 5 …”

Covi̇d-19 Hastalarinin Ri̇sk Siniflamasinda Enflamatuvar İndeksleri̇n Prognosti̇k Rolü

“…Diğer taraftan nötrofil, lenfosit trombosit sayısı ve CRP düzeyleri kullanılarak türetilen ve kolayca rutin kullanıma uygulanabilecek enflamatuvar indekslerin kanser, sepsis, pulmoner emboli gibi enflamasyonla ilişkili çeşitli hastalıklarda prognoz öngörüsü ve hastalık şiddetinin belirlenmesinde yardımcı olabileceğini bildiren çalışmalar bulunmaktadır (14)(15)(16). Bu indekslerden nötrofil-lenfosit oranı (NLR), platelet-lenfosit oranı (PLR), sistemik immün-enflamatuvar indeksi (SII) gibi bazılarının Covid-19'un ciddiyeti ile ilişkili olduğu bildirilmiştir (17)(18)(19).…”