Neutrophil-to-Lymphocyte Ratio and Outcomes in Louisiana COVID-19 Patients

Tatum, Danielle; Taghavi, Sharven; Houghton, August; Stover, Jacob; Toraih, Eman A.; Duchesne, Juan

doi:10.1097/shk.0000000000001585

Cited by 128 publications

(160 citation statements)

References 24 publications

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“…To date, six retrospective clinical studies examining the potential use of NLR as a prognostic marker for severe Covid-19 have been published; none in Mexican patients until now [ 22 , 23 , 24 , 25 , 26 , 27 ]. All these clinical studies consistently conclude that NLR is an independent risk factor of mortality in critically ill patients with Covid-19.…”

Section: Discussionmentioning

confidence: 99%

The Neutrophil-to-Monocyte Ratio and Lymphocyte-to-Neutrophil Ratio at Admission Predict In-Hospital Mortality in Mexican Patients with Severe SARS-CoV-2 Infection (Covid-19)

et al. 2020

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There is a deep need for mortality predictors that allow clinicians to quickly triage patients with severe coronavirus disease 2019 (Covid-19) into intensive care units at the time of hospital admission. Thus, we examined the efficacy of the lymphocyte-to-neutrophil ratio (LNR) and neutrophil-to-monocyte ratio (NMR) as predictors of in-hospital death at admission in patients with severe Covid-19. A total of 54 Mexican adult patients with Covid-19 that met hospitalization criteria were retrospectively enrolled, followed-up daily until hospital discharge or death, and then assigned to survival or non-survival groups. Clinical, demographic, and laboratory parameters were recorded at admission. A total of 20 patients with severe Covid-19 died, and 75% of them were men older than 62.90 ± 14.18 years on average. Type 2 diabetes, hypertension, and coronary heart disease were more prevalent in non-survivors. As compared to survivors, LNR was significantly fourfold decreased while NMR was twofold increased. LNR ≤ 0.088 predicted in-hospital mortality with a sensitivity of 85.00% and a specificity of 74.19%. NMR ≥ 17.75 was a better independent risk factor for mortality with a sensitivity of 89.47% and a specificity of 80.00%. This study demonstrates for the first time that NMR and LNR are accurate predictors of in-hospital mortality at admission in patients with severe Covid-19.

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Section: Discussionmentioning

confidence: 99%

The Neutrophil-to-Monocyte Ratio and Lymphocyte-to-Neutrophil Ratio at Admission Predict In-Hospital Mortality in Mexican Patients with Severe SARS-CoV-2 Infection (Covid-19)

et al. 2020

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“…The remaining 42 studies were further scrutinized by reading the full text. Finally, only 19 studies were included in this meta-analysis, of which 9 reported the predictive value on disease severity [26][27][28][29][30][31][32][33][34], 6 reported the predictive value on mortality [35][36][37][38][39][40], and 4 reported the predictive value on both disease severity and mortality [41][42][43][44].…”

Section: Selection and Characteristics Of Studiesmentioning

confidence: 99%

Predictive values of neutrophil-to-lymphocyte ratio on disease severity and mortality in COVID-19 patients: a systematic review and meta-analysis

Liu

Mao

et al. 2020

Preprint

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Background：Coronavirus disease 2019 (COVID-19), a highly infectious disease, has been rapidly spreading all over the world and posted a great threat to global public health. Patients diagnosed with severe or critical cases have a poor prognosis. Hence, it is crucial for us to identify potential severe or critical cases early, and give timely treatments for the targeted patients. In the clinical practice of treating COVID-19 patients, we have observed that the neutrophil-to-lymphocyte ratio (NLR) of severe patients is higher than that in mild patients. We performed this systematic review and meta-analysis to evaluate the predictive values of NLR on disease severity and mortality in COVID-19 patients. Methods: We searched PubMed, EMBASE, China National Knowledge Infrastructure (CNKI) and Wanfang databases to identify eligible studies (up to August 11, 2020). Two authors independently screened studies and extracted data. The methodological quality of the included studies was assessed by Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2).Results: Thirteen studies involving 1579 patients reported the predictive value of NLR on disease severity. The pooled sensitivity (SEN), specificity (SPE) and area under curve (AUC) were 0.78 (95% CI 0.70-0.84), 0.78 (95% CI 0.73-0.83) and 0.85 (95% CI 0.81-0.88), respectively. Ten studies involving 2967 patients reported the predictive value of NLR on mortality. The pooled SEN, SPE and AUC were 0.83 (95% CI 0.75-0.89), 0.83 (95% CI 0.74-0.89) and 0.90 (95% CI 0.87-0.92), respectively. Conclusions: NLR has good predictive values on disease severity and mortality in COVID-19 patients. Evaluating NLR can help clinicians identify potentially severe cases early, conduct early triage and initiate effective management in time, which may reduce the overall mortality of COVID-19. Moreover, we can better allocate scarce medical resources in this unprecedented time. Trial registration: This meta-analysis was prospectively registered on PROSPERO database (Registration number: CRD42020203612).

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“…Neutrophil to Lymphocyte ratio (NLR) has been explored as a prognostic marker for COVID-19, with high level of NLR associated with severity of the disease 43,44 or with higher mortality rates 45,46 . More specific subsets of the Lymphocytes, especially the CD4 + and CD8 + T-cell counts are found to be depleted in severe COVID-19 patients 17,47 .…”

Section: Relationship With Immune Cellsmentioning

confidence: 99%

IL-6 and IL-10 as predictors of disease severity in COVID-19 patients: results from meta-analysis and regression

Dhar¹,

Vishnupriyan²,

Damodar³

et al. 2020

Preprint

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Objectives: SARS-CoV-2, an infectious agent behind the ongoing COVID-19 pandemic, induces high levels of cytokines in patients contributing to the disease patho-physiology. Nonetheless, exact association and contribution of particular cytokines towards COVID-19 pathology remains poorly understood. This study performed a comprehensive meta-analysis to establish association between induced cytokines and COVID-19 disease severity to help in prognosis and clinical management. Methods: Scientific literature was searched to identify 18 clinical studies. Standardized mean difference (SMD) for cytokines IL-2, IL-4, IL-6, IL-10, TNF-α and IFN-γ between severe and non-severe COVID-19 patient groups were summarized using random effects model. A classifier was built using logistic regression model with cytokines having significant SMD as covariates. Results: Out of the 6 cytokines, IL-6 and IL-10 showed statistically significant SMD across the studies synthesized. Classifier with mean values of both IL-6 and IL-10 as covariates performed well with accuracy of ~ 92% that was significantly higher than accuracy reported in literature with IL-6 and IL-10 as individual covariates. Conclusions: Simple panel proposed by us with only two cytokine markers can be used as predictors for fast diagnosis of patients with higher risk of COVID-19 disease deterioration and thus can be managed well for a favourable prognosis.

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Neutrophil-to-Lymphocyte Ratio and Outcomes in Louisiana COVID-19 Patients

Cited by 128 publications

References 24 publications

The Neutrophil-to-Monocyte Ratio and Lymphocyte-to-Neutrophil Ratio at Admission Predict In-Hospital Mortality in Mexican Patients with Severe SARS-CoV-2 Infection (Covid-19)

The Neutrophil-to-Monocyte Ratio and Lymphocyte-to-Neutrophil Ratio at Admission Predict In-Hospital Mortality in Mexican Patients with Severe SARS-CoV-2 Infection (Covid-19)

Predictive values of neutrophil-to-lymphocyte ratio on disease severity and mortality in COVID-19 patients: a systematic review and meta-analysis

IL-6 and IL-10 as predictors of disease severity in COVID-19 patients: results from meta-analysis and regression

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