Prognostic Role of Neutrophil-to-Lymphocyte Ratio in Patients with COVID-19

Piovani, Daniele; Tsantes, Andreas G.; Bonovas, Stefanos

doi:10.3390/jcm11164688

Cited by 3 publications

(4 citation statements)

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“…It has been reported that an elevated NLR is often observed in conditions that involve tissue damage and activate the systemic inflammatory response, such as bacterial and fungal infections, sepsis, acute stroke, atherosclerosis, myocardial infarction, severe trauma, and cancer [27,28]. Recently, studies revealed that NLR can predict clinical outcomes and plays as an easyto-obtain biomarker to evaluate severity for Covid-19 patients [29,30]. A multicenter retrospective cohort study from France investigated the prognostic value of the NLR for disease severity and mortality in 1035 COVID-19 patients [31].…”

Section: Discussionmentioning

confidence: 99%

“…The PCR results contains nucleocapsid protein (N) gene and open reading frame (ORF) gene. N gene Ct value was 30 (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34), and ORF gene was 33 (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36).The median of total lung volume was 3088ml (1055-3809ml), GGO pattern was 833ml (392-1047ml) and its corresponding ratio to total lung was 30.3% (8.1%-40.3%); while the consolidation pattern was 186ml (63-316ml), the ratio was 7.2% (1.7%-11.4%); the affected lung was 1045ml (482-1359ml), and the ratio was 39% (10%-55%). ROC test results showed the area under the curve (AUC) for N gene, ORF gene, leukomonocyte count, N gene + leukomonocyte count, and ORF gene + leukomonocyte count were 0.562, 0.567, 0.703, and 0.582, respectively when adjusted with age, gender, and C reaction protein level (p <0.05 results are shown in Fig.…”

Section: (Table 1 Set Here)mentioning

confidence: 99%

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Quantitative Chest CT Analysis in Relationships between CT Patterns, Virus Load, and Pathophysiological States in SARS-CoV-2 infected Patients: A Cross-Sectional Observational Study

Yan,

Haining,

Sumei

et al. 2023

Preprint

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CT imaging is often used to confirm COVID-19, playing a crucial role in the diagnosis and assessment due to its high sensitivity. The purpose of this study is to investigate results of quantitative CT analysis for CT patterns in SARS-CoV-2 infected patients, and how these relate to viral load and pathophysiological states. We recruited patients who had confirmed SARS-CoV-2 infection and undergone chest CT within 24 hours of confirmation. By quantitative CT analysis, and collecting clinical data, we explored correlations between those variables. Our research included 253 patients, after screening by exclusion criteria, 171 patients were included in final cohort. The incidence of SARS-CoV-2 associated pneumonia was 74.3%. The ROC test results showed AUCs for leukomonocyte count, and virus genes were 0.703, 0.562, 0.567, and 0.582, respectively. GGO pattern in CT was correlated PaO /FiO ratio. Multiple linear regression results indicated GGO was associated with PaO /FiO . Meanwhile, the consolidation was correlated with PaCO level. Additionally, consolidation was also associated with neutrophil–lymphocyte ratio. Conclusion: Lymphocyte count may be a potential marker for predicting SARS-CoV-2 pneumonia, independent of virus load. Additionally, GGO is correlated with hypoxia, while consolidation is associated with PaCO levels and inflammation, which may affect aeration in the lungs.

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Section: Discussionmentioning

confidence: 99%

Section: (Table 1 Set Here)mentioning

confidence: 99%

Quantitative Chest CT Analysis in Relationships between CT Patterns, Virus Load, and Pathophysiological States in SARS-CoV-2 infected Patients: A Cross-Sectional Observational Study

Yan,

Haining,

Sumei

et al. 2023

Preprint

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“…In total, 13 studies have been published this year alone (2022) that independently showed that higher NLR in COVID-19 patients entering the hospital was a strong predictor of in-hospital worsening or death [ 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. Chart review showed this to be the case also at our ICU, independently of whether dapsone was given or not.…”

Section: Discussionmentioning

confidence: 99%

Dapsone Lowers Neutrophil to Lymphocyte Ratio and Mortality in COVID-19 Patients Admitted to the ICU

Kanwar¹,

Khattak²,

Kast³

2022

IJMS

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Some physicians use dapsone as part of the standard treatment of severe COVID-19 patients entering the ICU, though some do not. To obtain an indication of whether dapsone is helping or not, we undertook a retrospective chart review of 29 consecutive ICU COVID-19 patients receiving dapsone and 30 not receiving dapsone. As we previously reported, of those given dapsone, 9/29 (30%) died, while of those not given dapsone, 18/30 (60%) died. We looked back on that data set to determine if there might be basic laboratory findings in these patients that might give an indication of a mechanism by which dapsone was acting. We found that the neutrophil-to-lymphocyte ratio decreased in 48% of those given dapsone and in 30% of those not given dapsone. We concluded that dapsone might be lowering that ratio. We then reviewed collected data on neutrophil related inflammation pathways on which dapsone might act as presented here. As this was not a controlled study, many variables prevent drawing any conclusions from this work; a formal, randomized controlled study of dapsone in severe COVID-19 is warranted.

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“…Some studies reported that hematological parameters such as white blood cell count (WBC), lymphocyte count, neutrophil count, eosinophil count, platelet count, hemoglobin, neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP), platelet-lymphocyte ratio (PLR), Lymphocyte-to-monocyte ratio (LMR) and C-reactive protein-to-lymphocyte ratio (CLR) are helpful in stratifying the severity of patients with COVID-19 [11][12][13][14]. However, their predictive value has not been explicitly evaluated among those severely ill.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of hematological changes and immune response biomarkers as a prognostic factor in critical patients with COVID-19

Manaças,

Amorim,

Aguila

et al. 2024

PLoS ONE

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COVID-19 disease has been a challenge for health systems worldwide due to its high transmissibility, morbidity, and mortality. Severe COVID-19 is associated with an imbalance in the immune response, resulting in a cytokine storm and a hyperinflammation state. While hematological parameters correlate with prognosis in COVID patients, their predictive value has not been evaluated specifically among those severely ill. Therefore, we aim to evaluate the role of hematological and immune response biomarkers as a prognostic factor in critically ill patients with COVID-19 admitted to the intensive care unit. From May 2020 to July 2021, a retrospective cohort study was conducted in a reference hospital in Manaus, which belongs to the Brazilian public health system. This study was carried out as single-center research. Clinical and laboratory parameters were analyzed to evaluate the association with mortality. We also evaluated the role of neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein-to-lymphocyte ratio (CLR). We gathered information from medical records, as well as from prescriptions and forms authorizing the use of antimicrobial medications. During the study period, 177 patients were included, with a mean age of 62.58 ± 14.39 years. The overall mortality rate was 61.6%. Age, mechanical ventilation (MV) requirement, leukocytosis, neutrophilia, high c-reactive protein level, NLR, and CLR showed a statistically significant association with mortality in the univariate analysis. In the multivariate logistic regression analysis, only MV (OR 35.687, 95% CI: 11.084–114.898, p< 0.001) and NLR (OR 1.026, 95% CI: 1.003–1.050, p = 0.028) remained statistically associated with the outcome of death (AUC = 0.8096). While the need for mechanical ventilation is a parameter observed throughout the hospital stay, the initial NLR can be a primary risk stratification tool to establish priorities and timely clinical intervention in patients with severe COVID-19 admitted to the ICU.

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Prognostic Role of Neutrophil-to-Lymphocyte Ratio in Patients with COVID-19

Abstract: The coronavirus disease 2019 (COVID-19) pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had a major impact on global health, continuing to put strain on healthcare systems and disrupting socioeconomic life [...]

Cited by 3 publications

References 14 publications

Quantitative Chest CT Analysis in Relationships between CT Patterns, Virus Load, and Pathophysiological States in SARS-CoV-2 infected Patients: A Cross-Sectional Observational Study

Quantitative Chest CT Analysis in Relationships between CT Patterns, Virus Load, and Pathophysiological States in SARS-CoV-2 infected Patients: A Cross-Sectional Observational Study

Dapsone Lowers Neutrophil to Lymphocyte Ratio and Mortality in COVID-19 Patients Admitted to the ICU

Evaluation of hematological changes and immune response biomarkers as a prognostic factor in critical patients with COVID-19

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