Neutrophil Count Percentage and Neutrophil–Lymphocyte Ratio as Prognostic Markers in Patients Hospitalized for Community-Acquired Pneumonia

Curbelo, José; Rajas, Olga; Arnalich, Belén; Galván-Román, José María; Luquero-Bueno, Sergio; Ortega-Gómez, Mara; Lancho, A.; Roy, E.; Azofra, Ana Sánchez; Jiménez, Gloria Mateo; Gómez, Manuel; Moldenhauer, Fernando; Aspa, Javier

doi:10.1016/j.arbr.2019.07.002

Cited by 28 publications

(26 citation statements)

References 25 publications

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“…As it is known, the human immune system plays a major role in putting out viral infections. The NLR reflects that the high systemic inflammatory response is associated with the poor prognosis of infectious diseases [9][10][11][12]. Several studies have manifested that severe cases (including dead patients) of COVID-19 were more likely to have higher neutrophil counts and lower lymphocyte counts, when compared with non-severe cases.…”

Section: Discussionmentioning

confidence: 99%

“…The neutrophil-tolymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are novel biomarkers that provide important information about the systemic inflammation status, and these are easily available from routine laboratory studies. The elevated NLR and PLR are significantly associated with the mortality of patients with infectious diseases [9][10][11][12]. Therefore, recent studies have suggested that NLR is an effective predictor for the mortality of patients with COVID-19 [4,13,14].…”

Section: Introductionmentioning

confidence: 99%

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Ratios of neutrophil-to-lymphocyte and platelet-to-lymphocyte predict all-cause mortality in inpatients with coronavirus disease 2019 (COVID-19): a retrospective cohort study in a single medical centre

Wang

Shang³

et al. 2020

Epidemiol. Infect.

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The Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a public health emergency of international concern. The current study aims to explore whether the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are associated with the development of death in patients with COVID-19. A total of 131 patients diagnosed with COVID-19 from 13 February 2020 to 14 March 2020 in a hospital in Wuhan designated for treating COVID-19 were enrolled in the current study. These 131 patients had a median age of 64 years old (interquartile range: 56–71 years old). Furthermore, among these patients, 111 (91.8%) patients were discharged and 12 (9.2%) patients died in the hospital. The pooled analysis revealed that the NLR at admission was significantly elevated for non-survivors, when compared to survivors (P < 0.001). The NLR of 3.338 was associated with all-cause mortality, with a sensitivity of 100.0% and a specificity of 84.0% (area under the curve (AUC): 0.963, 95% confidence interval (CI) 0.911–1.000; P < 0.001). In view of the small number of deaths (n = 12) in the current study, NLR of 2.306 might have potential value for helping clinicians to identify patients with severe COVID-19, with a sensitivity of 100.0% and a specificity of 56.7% (AUC: 0.729, 95% CI 0.563–0.892; P = 0.063). The NLR was significantly associated with the development of death in patients with COVID-19. Hence, NLR is a useful biomarker to predict the all-cause mortality of COVID-19.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ratios of neutrophil-to-lymphocyte and platelet-to-lymphocyte predict all-cause mortality in inpatients with coronavirus disease 2019 (COVID-19): a retrospective cohort study in a single medical centre

Wang

Shang³

et al. 2020

Epidemiol. Infect.

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“…Neutrophil-to-lymphocyte ratio (NLR) is an easily acquired, non-invasive, and inexpensive marker, which can be used routinely to indicate systematic in ammatory status in clinical work that has been studied as a predictor of bacterial infection, showing a superior predictive value than those of conventional in ammatory markers. In addition, the NLR has displayed good predictive power for pneumonia (8), as well as dose-response information relating to the burden of community-acquired pneumonia (8,9). NLR has been demonstrated to predict the prognosis in cerebral infarction and cerebral hemorrhage (10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Increased neutrophil-to-lymphocyte ratio after thrombolysis better predicts 3-month stroke outcome

Hou¹,

Wang²,

Ye³

et al. 2020

Preprint

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Background-Thrombolysis has become an effective therapy for acute cerebral infarction (AIS) within 4.5 hours. Thrombolysis improves prognosis by increasing perfusion of the ischemic penumbra. Inflammation as one of the mechanisms of cerebral infarction, the role of thrombolysis is the topic of our exploration. Methods-From August 1, 2017 and September 1, 2019, 493 consecutive patients with AIS were prospectively enrolled in this cohort. 170 patients received thrombolytic therapy and 323 patients did not have thrombolysis. Clinical evaluation, laboratory data before and after thrombolysis and 3-month modified Rankin scale (mRS) scores were compared. Neutrophil-to-lymphocyte ratio (NLR), which represents inflammatory response, was divided into quartiles for comparison. Multivariate regression analysis was used to determine independent factors of 3-month prognosis. The receiver operating characteristic curve was used to evaluate the predictability of NLR for good prognosis that was defined as 3-month mRS scores < 3. Results-The NLR after thrombolysis was higher than that before thrombolysis (p < 0.001) and in non-thrombolytic patients (p < 0.001). NLR after thrombolysis is an independent predictor of 3-month functional outcome (odds ratio (OR) = 1.20, 95% confidence interval (CI), 1.01–1.42, p = 0.03). Also, a cutoff value of 4.51 for NLR was detected in predicting post-thrombolysis 3-month functional outcome with a sensitivity of 65.7% and a specificity of 73.1% (area under curve [AUC], 0.85; 95% CI, 0.77–0.92). We also found a significant difference (62% vs 88%, p < 0.001) in the proportion of good 3 months prognosis between the higher and lower group. Conclusions-This study showed that NLR increase after thrombolysis better predict post-thrombolytic unfavorable functional outcome in AIS patients. Clinical Trial Registration-URL: http://www.chictr.org.cn/index.aspx, Unique identifier: ChiCTR1800018315. URL: http://www.chictr.org.cn/index.aspx, Unique identifier: ChiCTR1800019615.

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“…Neutrophil lymphocyte count ration (NLCR) has been introduced by Zahorec as a rapid, easy-applicable and cost-effective parameter of in ammation and stress in patients of critical conditions [1]. Until recently, the diagnostic and prognostic value of NLCR on myriad medical situations such as bacteremia [2], sepsis [3], myocardial infarction [4], aneurysmal subarachnoid hemorrhage [5], community acquired pneumonia [6], acute kidney injury [7], liver transplantation [8] and even colorectal cancer, remains a hot topic of investigation [9]. Systemic in ammation is an indispensable process of critical disease, and its severity can be generally associated with the short-and long-term outcomes of critical patients [10].…”

Section: Introductionmentioning

confidence: 99%

Neutrophil-Lymphocyte Count Ratio Better Predict Prognosis than Conventional Markers in Critical Patients? A Multiple-Centered Retrospective Cohort Study

Zheng

Zhu

et al. 2020

Preprint

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Background: Neutrophil-lymphocyte count ratio (NLCR) has been reported as better indicator of bacteremia than procalcitonin (PCT), and better predictor of mortality than C-reactive protein (CRP) in various medical conditions. However, large controversy remains upon this topic. We compared the efficiency of NLCR with conventional inflammatory markers in predicting the prognosis of critical illness. Methods: We performed a multiple-centered retrospective cohort study consisting of 536 ICU patients with outcomes of survival, 28- and 7-day mortality. NLCR was compared with conventional inflammatory markers such as PCT, C-reactive protein (CRP), serum lactate (LAC), white blood cell, neutrophil and severity score APACHE II (Acute Physiology and Chronic Health Evaluation II) to evaluate the predictive value on outcomes of critical illness. Then receiver operating characteristics (ROC) curves were constructed to assess and compare each marker’s sensitivity and specificity respectively. Results: NLCR values were not differential among survival and mortality groups. Meanwhile remarkable differences were observed upon APACHE II score, CRP, PCT and LAC levels among survival and death groups. ROC analysis revealed that NLCR was not competent to predict prognosis of critical illness. The AUROCs of conventional markers such as CRP, PCT, LAC and APACHE II score were more significant in predicting 28- and 7-day mortality. Conclusions: NLCR is not competent and less reliable than conventional markers CRP, PCT, LAC and APACHE II score in assessing severity and in predicting outcomes of critical illness.

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Neutrophil Count Percentage and Neutrophil–Lymphocyte Ratio as Prognostic Markers in Patients Hospitalized for Community-Acquired Pneumonia

Cited by 28 publications

References 25 publications

Ratios of neutrophil-to-lymphocyte and platelet-to-lymphocyte predict all-cause mortality in inpatients with coronavirus disease 2019 (COVID-19): a retrospective cohort study in a single medical centre

Ratios of neutrophil-to-lymphocyte and platelet-to-lymphocyte predict all-cause mortality in inpatients with coronavirus disease 2019 (COVID-19): a retrospective cohort study in a single medical centre

Increased neutrophil-to-lymphocyte ratio after thrombolysis better predicts 3-month stroke outcome

Neutrophil-Lymphocyte Count Ratio Better Predict Prognosis than Conventional Markers in Critical Patients? A Multiple-Centered Retrospective Cohort Study

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