Circulating cell-free DNA, peripheral lymphocyte subsets alterations and neutrophil lymphocyte ratio in assessment of COVID-19 severity

Hammad, Reham; Eldosoky, Mona A; Fouad, Shaimaa H; Elgendy, Abd-Elaleem Abd-Elaleem; Tawfeik, Amany M; Alboraie, Mohamed; Abdelmaksoud, Mariam Fathy

doi:10.1177/1753425921995577

Cited by 28 publications

(27 citation statements)

References 40 publications

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“…The diagnosis of COVID-19 was confirmed in all cases. The studies were conducted in China [ 8 – 13 , 15 , 16 , 18 , 19 , 21 – 23 , 25 , 31 – 34 ], Pakistan [ 28 ], Argentina [ 20 ], Turkey [ 14 , 17 , 33 , 35 ], Saudi Arabia [ 24 ], Iran [ 27 , 36 ], and Egypt [ 29 , 30 ]. The studies were conducted at a single center, with the exception of two multicenter studies [ 12 , 13 , 24 , 34 ].…”

Section: Resultsmentioning

confidence: 99%

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Value of the Neutrophil-Lymphocyte Ratio in Predicting COVID-19 Severity: A Meta-analysis

Wang

Zhao²,

Yang³

et al. 2021

Disease Markers

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Background. Coronavirus disease 2019 (COVID-19) is highly contagious and continues to spread rapidly. However, there are no simple and timely laboratory techniques to determine the severity of COVID-19. In this meta-analysis, we assessed the potential of the neutrophil-lymphocyte ratio (NLR) as an indicator of severe versus nonsevere COVID-19 cases. Methods. A search for studies on the NLR in severe and nonsevere COVID-19 cases published from January 1, 2020, to July 1, 2021, was conducted on the PubMed, EMBASE, and Cochrane Library databases. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and area under the curve (AUC) analyses were done on Stata 14.0 and Meta-disc 1.4 to assess the performance of the NLR. Results. Thirty studies, including 5570 patients, were analyzed. Of these, 1603 and 3967 patients had severe and nonsevere COVID-19, respectively. The overall sensitivity and specificity were 0.82 (95% confidence interval (CI), 0.77-0.87) and 0.77 (95% CI, 0.70-0.83), respectively; positive and negative correlation ratios were 3.6 (95% CI, 2.7-4.7) and 0.23 (95% CI, 0.17-0.30), respectively; DOR was 16 (95% CI, 10-24), and the AUC was 0.87 (95% CI, 0.84-0.90). Conclusion. The NLR could accurately determine the severity of COVID-19 and can be used to identify patients with severe disease to guide clinical decision-making.

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Section: Resultsmentioning

confidence: 99%

“…The studies were conducted at a single center, with the exception of two multicenter studies [ 12 , 13 , 24 , 34 ]. Two studies were prospective [ 11 , 26 ], two were cross-sectional [ 28 , 29 ], and the rest were retrospective studies.…”

Section: Resultsmentioning

confidence: 99%

Value of the Neutrophil-Lymphocyte Ratio in Predicting COVID-19 Severity: A Meta-analysis

Wang

Zhao²,

Yang³

et al. 2021

Disease Markers

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“…In another study that set out to examine a means to discern severe cases, the NLR, WBC, NEU, LYM, CRP, and ferritin AUC was 0.831, 0.693, 0.765, 0.737, 0.816, and 0.752, respectively [24]. Other researchers observed an AUC for NLR and LYM of 0.98 and 0.092, respectively [25]. We found that the IG and IGLR values could reliably discriminate severe COVID-19 cases.…”

Section: Discussionmentioning

confidence: 96%

Predictive values of immature granulocyte and other inflammatory parameters on disease severity of COVID‐19 patients

alisik¹

2021

Int J Med Biochem

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Predictive value of immature granulocyte count and other inflammatory parameters for disease severity in COVID-19 patients C oronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection, was declared a pandemic by the World Health Organization in March 2020 [1]. Since the first case, identified in late 2019, COVID-19 has affected over 145.2 million people around the world and caused more than 3.08 million deaths as of April 24, 2021 [2]. COVID-19 infection may be asymptomatic or have clinical manifestations that range from mild to severe, but understanding the signs upon presentation remains complex [3]. Greater disease severity is associated with poor outcomes and Objectives: This study was designed to compare the immature granulocyte (IG) count, IG-to-lymphocyte ratio (IGLR), complete blood count (CBC) values, and inflammatory parameters of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP), ferritin level, and CRP-to-albumin ratio (CAR) measured at hospital admission in patients with coronavirus disease 2019 (COVID-19) and non-COVID-19 patients and to compare these parameters between subgroups according to disease severity. In addition, these parameters were evaluated for predictive value related to the severity of COVID-19. Methods: The data of adult patients admitted with a suspected COVID-19 infection confirmed with real-time polymerase chain reaction testing of nasal and pharyngeal swab specimens were included in this retrospective study. Outpatient COVID-19-positive patients were enrolled in the mild group, hospitalized patients were classified in the moderate group, and patients admitted to the intensive care unit were categorized in the severe group. Results: A total of 1213 COVID-19-positive patients and 1034 COVID-19-negative patients were included in the study. The IGLR, NLR, PLR, CRP, CAR, and ferritin levels were significantly higher, and the leukocyte, IG, neutrophil, lymphocyte, monocyte, basophil, and eosinophil levels were significantly lower in the COVID-19-positive group than the COVID-19-negative group (p<0.05 for all). The severe group had higher median IG, IGLR, neutrophil, NLR, PLR levels than the mild, moderate, and COVID-19-negative groups (p<0.05 for all). Receiver operating characteristic analysis revealed an area under the curve value for IGLR, CAR, CRP, IG, NLR, and ferritin of 0.868, 0.860, 0.834, 0.848, 0.845, 0.841, and 0.827, respectively, which differentiated severe COVID-19 patients from mild and moderate COVID-19 patients. Conclusion:The results suggest that the IGLR may be useful to distinguish severe COVID-19 patients at the time of admission. Further exploration is warranted to fully determine the potential value of the IGLR in disease monitoring.

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“…One study demonstrated that patients with severe COVID-19 infections had greater increases in cfDNA than those with milder disease; this may in large part be related to a correlation between intensity of inflammation and the magnitude of cfDNA increase. 16 The assay used in our study is specific for host ncfDNA and unlike other fluorometric or spectrophotometry based DNA quantification methods is not affected by DNA derived from exogenous sources such as bacteria, viruses or fungus. Increasing evidence suggests that cfDNA itself may be an actively released component of the damage-associated molecular pattern (DAMP) signaling pathway.…”

Section: Discussionmentioning

confidence: 99%

Increase in nuclear cell‐free DNA is associated with major adverse events in adult and pediatric heart transplant recipients

Zangwill

Deshpande

Simpson

et al. 2021

Clinical Transplantation

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Background: Cell-free DNA is an emerging biomarker. While donor fraction may detect graft events in heart transplant recipients, the prognostic value of total nuclear cellfree DNA (ncfDNA) itself is largely unexplored.Objective: Explore the relationship between ncfDNA and clinical events in heart transplant recipients. Methods:We conducted a multi-center prospective study to investigate the value of cell-free DNA in non-invasive monitoring following heart transplantation. Over 4000

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Circulating cell-free DNA, peripheral lymphocyte subsets alterations and neutrophil lymphocyte ratio in assessment of COVID-19 severity

Cited by 28 publications

References 40 publications

Value of the Neutrophil-Lymphocyte Ratio in Predicting COVID-19 Severity: A Meta-analysis

Value of the Neutrophil-Lymphocyte Ratio in Predicting COVID-19 Severity: A Meta-analysis

Predictive values of immature granulocyte and other inflammatory parameters on disease severity of COVID‐19 patients

Increase in nuclear cell‐free DNA is associated with major adverse events in adult and pediatric heart transplant recipients

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