Neutrophil to Lymphocyte Ratio as a Predictor of Adverse Outcome in Patients with Decompensated Liver Cirrhosis

Луньков, В. Д.; Маевская, М. В.; Tsvetaeva, E. K.; Mendez, A.; Zharkova, Maria; Ткаченко, П. Е.; Ивашкин, В. Т.

doi:10.22416/1382-4376-2019-29-1-47-61

Cited by 6 publications

(2 citation statements)

References 27 publications

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“…ст. [52,25; 82,41], HCO 3 22,06 ммоль/л [17,82; 26,30], pH 7,11 [7,[3][4][5][6][7]19]. Несмотря на комплексную терапию, включающую внутривенные антибиотики, противовирусную терапию, кислородотерапию, терапию сопутствующего заболевания и др., состояние пациентов прогрессивно ухудшалось, приведя к летальному исходу.…”

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“…Наши результаты показывают, что у пациентов с тяжелым и неблагоприятным течением SARS-CoV-2-инфекции с большей вероятностью выявляется лимфопения (р ≤ 0,001), лейкоцитоз, повышенный уровень нейтрофилов (р ≤ 0,05) и значения нейтрофильно-лимфоцитарного индекса, а также тенденция к тромбоцитопении. Известно, что лимфоциты играют решающую роль в поддержании иммунного гомеостаза организма человека, а соотношение нейтрофилов и лимфоцитов рассматривается в качестве прогностического воспалительного маркера и потенциального предиктора прогноза выживаемости у пациентов с различными нозологическими формами [5,6]. В нашем исследовании лимфопения и увеличение нейтрофильно-лимфоцитарного отношения отражают тяжесть течения заболевания пациентов с коронавирусной инфекцией.…”

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Clinical Traits of SARS-CoV-2 Infection

Зольникова

Джахая

Поцхверашвили

et al. 2020

Rossijskij žurnal gastroènterologii, gepatologii, koloproktolog

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Aim. Analysis of clinical manifestations, laboratory and instrumental examination data in SARS-CoV-2 patients with taking into account the disease severity and outcome.Materials and methods. The study included 92 patients with conﬁrmed coronavirus infection, including 15 lethal cases, hospitalised at the Vasilenko Clinic of Internal Disease Propaedeutics, Gastroenterology and Hepatology of the Sechenov University in April 2020. The analysis included demographic data, the presence of concomitant diseases, chest computed tomography (CT) results, laboratory tests (including SARS-CoV-2-diagnostic PCR, general and metabolic blood panels, coagulogram) and the duration of disease.Results. Patients infected with SARS-CoV-2 usually exhibit lymphopenia (p ≤ 0.001), leucocytosis, the elevated neutrophils (p ≤ 0.05), neutrophil-lymphocyte ratio (p ≤0,05), C-reactive protein (p ≤ 0.05), ferritin (p ≤ 0.05), D-dimer (p ≤ 0.05) and ﬁbrinogen (p ≤ 0.05), altered prothrombin time (p ≤ 0.05) and INR (p ≤ 0.05). In a critical coronavirus infection, the pulmonary lesion exceeds 50% (corresponds to CT3 — CT4). The risk of critical SARS-CoV-2 infection increases with elder age (p ≤ 0.001), associates with the male gender and presence of concomitant diseases, such as obesity (p < 0.01), diabetes mellitus (p < 0.001), hypertension (p ≤ 0.001), CHD (p ≤ 0.001) and atrial ﬁbrillation (p <0.05).Conclusion. The risk of severe and adverse coronavirus infection is signiﬁcantly higher in elder comorbid patients.

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Section: Discussionunclassified

Clinical Traits of SARS-CoV-2 Infection

Зольникова

Джахая

Поцхверашвили

et al. 2020

Rossijskij žurnal gastroènterologii, gepatologii, koloproktolog

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Prognostic Markers of Acute Suppurative Lung Disease

Fetlam,

Chumachenko,

Vyazmina

et al. 2024

Obŝaâ reanimatologiâ

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The mortality rate among patients with acute suppurative lung diseases (ASLD) in the ICU reaches 30%. Early, pathogenetically relevant biomarkers are needed to ensure personiﬁcation and better eﬃcacy of ASLD treatment. Numeric variations in the counts of immune system cells in patient’s blood can be viewed as such candidate biomarkers.The aim of the study. Identiﬁcation of potential markers predicting ASLD outcome after community-acquired pneumonia and COVID-19.Materials and methods. The study included 216 in-hospital patients aged 18-87 with ASLD after community-acquired pneumonia with (N=81) and without (N=135) COVID-19 history.Results. Patients survival after COVID-19 was linked to lymphocyte count on Day 1 of hospital stay (hazard ratio, HR=5.9 95%CI 0.9–37.4; P=0.0188, log-rank test). In patients who had not have COVID-19, a diﬀerence in survival was associated with lymphocyte (HR=2.9 95%CI 1.0–8.4; P=0.0184, log-rank test; N=135), and monocyte counts (HR=2.7 95% CI 0.8–9.5; P=0.0196, log-rank test) on Day 1 of hospital stay. Patients’ survival after COVID-19 infection depended on SII (systemic immune-inﬂammation index. HR=9.3 95%CI 1.7–49.8; P=0.0124, log-rank test; N=81, SIRI (systemic inﬂammatory response index, HR=7.2 95%CI 1.4–36.6; P=0.0339, log-rank test; N=81) and NLR (neutrophil-to-lymphocyte ratio, HR=9.6 95%CI 1.8–52.0; P=0.0108; log-rank test; N=81) values on Day 1 of hospital stay. In patients who did not have COVID-19 SII values had no inﬂuence on survival.Conclusion. The lymphocyte count makes it possible to predict outcomes of pleural empyema, regardless of patient’s history of COVID-19, i. e. a decrease in the lymphocyte count below 1.2×10⁹ in 1 L is associated with fatal outcome. Monocyte count carries prognostic information for cases of pleural empyema without previous COVID-19 infection. As for the relative indicators, SIRI, SII and NLR values measured on Day 1 in the hospital were predictors of ASLD outcome only in patients after COVID-19 infection, i. e., higher values were associated with increased risk of death, with NLR index being the most informative. Overall severity of illness above 10 scores by CIRS was associated with an unfavorable ASLD outcome, regardless of patient’s history of COVID-19.

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Equivalents of the neutrophil-to-lymphocyte ratio of circulating pool of stem and immature hematopoietic cells for assessing liver transplant status

Shutko,

Gerasimova,

Marchenko

et al. 2023

RJTAO

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Objective: to study the applicability of the neutrophil-to-lymphocyte ratio (NLR) for monitoring recipient status and for possible minimization of maintenance immunosuppression in the long-term period after liver transplantation (LT).Materials and methods. Blood samples of 19 recipients with satisfactory graft function were examined by flow cytofluorometry at various time periods after LT using hematopoietic stem cell markers CD133, their CD31 derivatives, and alpha-fetoprotein (AFP), compared with the conventional NLR.Results. The use of NLR equivalents with CD133 and CD31 to assess liver transplant status is due to their high representation in liver tissue. Their values change in the long-term posttransplant period (from 1.5 to 6–7 years following LT) ≈20-fold and in different directions, but only when measuring their commissural to the liver cell fractions bearing the AFP marker.Conclusion. In contrast to the conventional NLR, maintenance of the lowest level of CD31 AFP, an NLR «equivalent», achieved at 1.5 years after LT, can be considered a criterion for the success of immunosuppressive therapy in the long-term post-LT period. The developed technique can be used to decide on whether to reduce or discontinue medication-assisted prophylaxis of graft rejection.

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Neutrophil to Lymphocyte Ratio as a Predictor of Adverse Outcome in Patients with Decompensated Liver Cirrhosis

Cited by 6 publications

References 27 publications

Clinical Traits of SARS-CoV-2 Infection

Clinical Traits of SARS-CoV-2 Infection

Prognostic Markers of Acute Suppurative Lung Disease

Equivalents of the neutrophil-to-lymphocyte ratio of circulating pool of stem and immature hematopoietic cells for assessing liver transplant status

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