Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as diagnostic markers for pneumonia severity

Lee, Jong Han; Song, Sungwook; Yoon, Soo Young; Lim, Chae Seung; Song, Jae Woo; Kim, Hyun Sook

doi:10.1080/09674845.2016.1209898

Cited by 39 publications

(40 citation statements)

References 16 publications

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“…The neutrophil-to-lymphocyte ratio (NLR: approximately 1.5 in health, greater in inflammatory disease) and platelet-to-lymphocyte ratio (PLR: approximately 100 in health, also higher in inflammatory disease) are indices easily and cheaply obtained from a full blood count and may be useful in a number of clinical situations [10,11]. Lee et al [12] measured these ratios in patients presenting to hospital with pneumonia, finding that the NLR, but not the PLR or inflammation marker CRP was the preferred index for predicted those sufficiently ill to warrant entering an intensive care unit. The ease with which these ratios can be determined is a powerful factor in their adoption as routine clinical markers.…”

Section: Immunologymentioning

confidence: 99%

British Journal of Biomedical Science in 2016. What have we learned?

Blann

2017

British Journal of Biomedical Science

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In 2016, the British Journal of Biomedical Science published 36 reports outlining specific advances in each of the various disciplines within biomedical science. These were one review, 25 original articles, 9 'In Brief' reports and one letter to the Editor. Of these, the majority were in blood science (5 in biochemistry, 7 in haematology and 2 in immunology) and infection science (8 in microbiology, 2 in virology) with a smaller number in cellular sciences (6 in cellular pathology and 2 in cytopathology). Three reports considered both biochemistry and immunology, while another reported an advance in the identification of chromosomal abnormalities. The present report will summarise key aspects of these publications that are of greatest relevance to laboratory scientists.

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Section: Immunologymentioning

confidence: 99%

British Journal of Biomedical Science in 2016. What have we learned?

Blann

2017

British Journal of Biomedical Science

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“…Firstly, NLR and PLR were calculated from the results of the blood tests in the patients who were initially admitted. Secondly, the CT features of patients were included in our study, but not in the study by Lee et al [13] and Liu et al [9].…”

Section: Discussionmentioning

confidence: 97%

“…NLR was a widely used marker for the assessment of the severity of bacterial infections [9,[iii]]. Platelet-to-lymphocyte ratio (PLR) has been described as a novel in ammatory marker, which may be used in many diseases for predicting in ammation and mortality [13]. Lee et al [13] reported that NLR and PLR might be useful parameters in determining the severity of pneumonia.…”

Section: Discussionmentioning

confidence: 99%

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Nomogram to identify severe Coronavirus Disease 2019 (COVID-19) based on initial clinical and CT characteristics: a multi-center study

Wang

et al. 2020

Preprint

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Background: To develop and validate a nomogram for early identification of severe coronavirus disease 2019 (COVID-19) based on initial clinical and CT characteristics. Methods: The initial clinical and CT imaging data of 217 patients with COVID-19 were analyzed retrospectively from January to March 2020. 217 patients with 146 mild cases and 71 severe cases were randomly divided into training and validation cohorts. Independent risk factors were selected to construct the nomogram for predicting severe COVID-19. Nomogram performance in terms of discrimination and calibration ability was evaluated using the area under the curve (AUC), calibration curve, decision curve, clinical impact curve and risk chart.Results: In the training cohort, the severity score of lung in the severe group (7, interquartile range [IQR]:5-9) was significantly higher than that of the mild group (4, IQR:2-5) (P < 0.001). Age, density, mosaic perfusion sign and severity score of lung were independent risk factors for severe COVID-19. The nomogram had a AUC of 0.929 (95% CI, 0.889-0.969), sensitivity of 84.0% and specificity of 86.3%, in the training cohort, and a AUC of 0.936 (95% CI, 0.867-1.000), sensitivity of 90.5% and specificity of 88.6% in the validation cohort. The calibration curve, decision curve, clinical impact curve and risk chart showed that nomogram had high accuracy and superior net benefit in predicting severe COVID-19.Conclusion: The nomogram incorporating initial clinical and CT characteristics may help to identify the severe patients with COVID-19 in the early stage.

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“…Therefore, NLCR was more sensitive than any of them alone. NLCR was used as a marker to predict the prognosis of pneumonia [13,14] and the risk of death from bacterial infection [15] had been reported. When NLCR was elevated, it might be associated with a poor clinical prognosis or an increased risk of death.…”

Section: Discussionmentioning

confidence: 99%

An emerging marker predicting the severity of COVID-19: Neutrophil-Lymphocyte Count Ratio

Zhang

Xiao²,

Liu

et al. 2020

Preprint

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Background: To analyze clinical features and laboratory indicators and identify the markers of exacerbation in COVID-19. Methods: We reviewed clinical histories of 177 patients with confirmed COVID-19. The patients were categorized into mild group (153 patients) and severe group (24 patients). The baseline demographic and laboratory indicators of all patients were collected, including the neutrophil-lymphocyte count ratio (NLCR) and C-reactive protein to albumin ratio (CAR). Receiver operating characteristic curve (ROC) analysis was performed to search for indicators predicting exacerbation in COVID-19 patients, and acquiring the area under the curves (AUCs), sensitivity, specificity and cut-off value. Results: The age of the severe group were significantly older than those of the mild group (P <0.01). Fever was the typical symptom in all COVID-19 patients. Cough and fatigue were manifested in mild group, yet severe patients were more prominent in dyspnea. The laboratory indicators showing that the mild group mainly had an elevated C-reactive protein; the severe group had a decreased lymphocyte count and lymphocyte ratio. WBC, neutrophil count, neutrophil ratio, D-dimer, AST, ALT, LDH, BUN, CRP levels increased. Furthermore, compared to mild group, WBC, neutrophil count, neutrophil ratio (Neut%), D-dimer, total bilirubin, albumin, AST, ALT, LDH, BUN, creatine kinase, CRP, CAR, NLCR were significantly higher, the lymphocyte count, lymphocyte ratio, and APTT were significantly lower in severe group (P<0.05). The ROC indicating that NLCR, Neut%, CAR, CRP, and LDH were better at distinguishing mild and severe patients. The AUCs of NLCR was larger than others (NLCR>Neut%>CAR>CRP>LDH: 0.939>0.925>0.908>0.895>0.873), which suggested that NLCR was the optimal maker; a cut-off value for NLCR of 6.15 had 87.5% sensitivity and 97.6% specificity for predicting exacerbation in COVID-19 patients. Conclusions: The different types of COVID-19 had significant differences in age, clinical symptoms and laboratory indicators, and severe patients might be easier to suffer from the multiple organ damage. An elevated NLCR may indicate that the disease was progressing towards exacerbation. It was essential to dynamically monitor the serum NLCR levels which contributed to evaluate the patient's condition and efficacy. NLCR could be used as a novel, highly specific and sensitive marker for predicting severity of COVID-19 patients.

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Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as diagnostic markers for pneumonia severity

Cited by 39 publications

References 16 publications

British Journal of Biomedical Science in 2016. What have we learned?

British Journal of Biomedical Science in 2016. What have we learned?

Nomogram to identify severe Coronavirus Disease 2019 (COVID-19) based on initial clinical and CT characteristics: a multi-center study

An emerging marker predicting the severity of COVID-19: Neutrophil-Lymphocyte Count Ratio

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