Neutrophil/Lymphocyte Ratio – A Marker of COVID-19 Pneumonia Severity

Imran, Muhammad; Ahmed, Umair; Usman, Umar; Ali, Majid; Shaukat, Aamir; Gul, Noor

doi:10.22541/au.159969693.39051590

Cited by 12 publications

(20 citation statements)

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“…Various other researchers around the globe have concluded that NLR and PLR can be used to stratify COVID-19 patients and high NLR at admission has been associated with poor outcome. 11 , 29 – 31 Our study prospectively validates the findings of previous studies and demonstrates that NLR can be used as a tool to predict disease deterioration and serious clinical outcomes. In further analyzing the data for the overall mortality, the NLR1 and NLR3 ratios were found to be significantly high in the patients with death than in survivors.…”

Section: Discussionsupporting

confidence: 83%

Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio as Markers for Predicting the Severity in COVID-19 Patients: A Prospective Observational Study

Singh

Singh²,

Rudravaram

et al. 2021

Indian Journal of Critical Care Medicine

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Background: Coronavirus disease-2019 (COVID-19) pandemic has shown unpredictable course in individual patients. Few patients develop severe disease with progression after admission to a healthcare facility. Multiple parameters have been investigated to identify a marker to predict disease progression. Neutrophil-to-lymphocyte ratio (NLR) or platelet-to-lymphocyte (PLR) ratio has shown some promise. The current investigation explores the role of NLR and PLR to predict the disease progression. Materials and methods: After obtaining ethics committee approval, 608 patients were screened for inclusion in the prospective observational study, and 201 patients were included in the final analysis. The NLR and PLR were derived from routinely obtained complete blood count analysis. The patients were followed to determine the development of severity of the disease during the course. The NLR and PLR were analyzed in both univariate and multivariable models to assess the association and prediction. Results: In nonsevere (NS) group, the mean age of patients was 50.9 ± 16.3 years, and 66 (61.2%) were male, while in severe group (S), the mean age of patients was 53.7 ± 16.4 years, and 65 (69.89%) were male. NLR at day 1 and day 3 was significantly lower in survivors as compared to nonsurvivors, while the relation of PLR in both the groups was not statistically significant. The NLR is better in predicting the severity of disease as well as mortality than PLR. Conclusion: The NLR calculated at the time of admission has high predictive value for disease deterioration and adverse clinical outcome. How to cite this article: Singh Y, Singh A, Rudravaram S, Soni KD, Aggarwal R, Patel N, et al. Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio as Markers for Predicting the Severity in COVID-19 Patients: A Prospective Observational Study. Indian J Crit Care Med 2021;25(8):847–852.

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Section: Discussionsupporting

confidence: 83%

Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio as Markers for Predicting the Severity in COVID-19 Patients: A Prospective Observational Study

Singh

Singh²,

Rudravaram

et al. 2021

Indian Journal of Critical Care Medicine

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“…In severe асute resрirаtоry syndrоme соrоnаvirus 2 (SARS‐CoV‐2) risk assessment, ferritin can be used as a biomarker to assess severity and mortality 1,2 . In SARS‐CoV‐2 infection, cytokine storms are interlinked with elevated levels of ferritin.…”

Section: Intrоduсtiоnmentioning

confidence: 99%

Ferritin level: A predictor of severity and mortality in hospitalized COVID‐19 patients

Alroomi

Rajan

Omar³

et al. 2021

Immunity Inflam & Disease

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Аbstrасt Introduction This study aims to investigate in‐hоsрitаl mоrtаlity in severe асute resрirаtоry syndrоme соrоnаvirus 2 раtients strаtified by serum ferritin levels. Methods Patients were stratified based on ferritin levels (ferritin levels ≤ 1000 or >1000). Results Approximately 89% (118) of the patients with ferritin levels > 1000 had pneumonia, and 51% (67) had hypertension. Fever (97, 73.5%) and shortness of breath (80, 61%) were two major symptoms among the patients in this group. Logistic regression analysis indicated that ferritin level (odds ratio [OR] = 0.36, 95% confidence interval [CI] = 0.21–0.62; p < .001), male sex (OR = 2.63, 95% CI = 1.43–5.06; p = .003), hypertension (OR = 4.16, 95% CI = 2.42–7.36; p < .001) and pneumonia (OR = 8.48, 95% CI = 3.02–35.45; p < .001) had significance in predicting in‐hospital mortality. Additionally, the Cox proportional hazards analysis and Kaplan–Meier survival probability plot showed a higher mortality rate among patients with ferritin levels > 1000. Conclusion In this study, higher levels of serum ferritin were found to be an independent predictor of in‐hоsрitаl mоrtаlity.

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“…The Neutrophil: Lymphocyte ratio is a biomarker that can easily be derived by dividing the total number of neutrophils by the total number of lymphocytes (Imran et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Retrospective Analysis of Hematological Parameters in Covid Positive Pregnancy

Maharajan

Amthul

Sumaldha

2021

ijrps

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The newly identified SARS-CoV-2 virus and its ongoing implicated COVID-19 pandemic started off as pneumonia of unknown aetiology in Wuhan, China, in December 2019. Certain laboratory values that may be considered deranged in non pregnant states are normal physiological changes in pregnancy. An understanding of the normal haematological and immunologic parameters in pregnancy is necessary for the interpretation of COVID-19 severity. Considering the COVID-19 infection is still new, little is known about the clinical course of the disease in pregnancy. This is a retrospective observational study undertaken in the Department of Obstetrics and Gynaecology, Saveetha Medical College Hospital, Chennai, India, from April to November 2020. Out of the 50 women in the study, 19 women were anaemic with haemoglobin <11, accounting for 38% of the study population. A neutrophil to lymphocyte ratio greater than 4.5 was observed in 44% of the population. Thrombocytopenia was present in 12% of the population. D-dimer greater than 1000 was found in 12% of the study population. All of our patients were asymptomatic, had good maternal and fetal outcomes even though derangement of inflammatory markers were noted. The immunological changes of pregnancy make pregnant women more susceptible to pathogens. Though our patients had instances suggestive of critical prognosis like an increased neutrophil-lymphocyte-ratio and affirmative acute phase reactants and inflammatory markers, they were asymptomatic (category BNH) and stable in room air. However, further analysis of laboratory parameters and their correlation to clinical scenarios in the second wave of COVID19 infection is warranted.

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Neutrophil/Lymphocyte Ratio – A Marker of COVID-19 Pneumonia Severity

Cited by 12 publications

References 0 publications

Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio as Markers for Predicting the Severity in COVID-19 Patients: A Prospective Observational Study

Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio as Markers for Predicting the Severity in COVID-19 Patients: A Prospective Observational Study

Ferritin level: A predictor of severity and mortality in hospitalized COVID‐19 patients

Retrospective Analysis of Hematological Parameters in Covid Positive Pregnancy

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