Role of hematological parameters in the diagnosis of influenza virus infection in patients with respiratory tract infection symptoms

Han, Qingkai; Wen, Xiaomin; Wang, Lin; Xiao, Han; Shen, Yimin; Cao, Jun; Peng, Qunxin; Xu, Jie; Zhao, Lina; He, Jun; Yuan, Hong

doi:10.1002/jcla.23191

Cited by 60 publications

(61 citation statements)

References 23 publications

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“…This is consistent with previous studies showing that no single hematologic marker carried sufficient weight to confirm or refute specific respiratory virus 24,25 . In contrast, Han et al 14 reported that hematologic markers provided an adjunct diagnostic approach in the differential diagnosis of respiratory infections due to influenza virus and other respiratory viruses, but their study did not include patients infected with SARS‐CoV‐2. Thus, the diagnostic value of hematologic markers for different respiratory virus infection deserves more studies.…”

Section: Discussionsupporting

confidence: 89%

“…NLR has been demonstrated as an informative biomarker of diagnosis and disease severity in community‐acquired pneumonia and bacteremia 10,11 . MLR and PLR have also been recognized as a surrogate biological marker for the diagnosis of influenza virus infection in patients with respiratory tract infection 12‐14 . However, few studies have focused on the diagnostic value of hematologic markers for COVID‐19.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic value of peripheral hematologic markers for coronavirus disease 2019 (COVID‐19): A multicenter, cross‐sectional study

Peng

Yuan

et al. 2020

Clinical Laboratory Analysis

122

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Background To determine the diagnostic value of hematologic markers for coronavirus disease 2019 (COVID‐19) and explore their relationship with disease severity. Methods Subjects included 190 COVID‐19 patients, 190 healthy subjects, and 105 influenza pneumonia (IP) patients. COVID‐19 patients were divided into the ARDS and non‐ARDS groups. Routine blood examination, biochemistry indicator, days in hospital, body temperature, pneumonia severity index (PSI), CURB‐65, and MuLBSTA were recorded. Correlations between variables were assessed using Spearman's correlation analysis. Receiver operating characteristic (ROC) curves were used to study the accuracy of the various diagnostic tests. Results Compared with healthy subjects, COVID‐19 patients had lower white blood cell (WBC), lymphocyte, platelet, and hemoglobin levels; higher percentages of neutrophils and monocytes; lower percentages of lymphocytes and higher neutrophil‐to‐lymphocyte ratio (NLR), monocyte‐to‐lymphocyte ratio (MLR), and platelet‐to‐lymphocyte ratio (PLR) values (P < .05). COVID‐19 patients had higher WBC and neutrophil levels and lower percentages of lymphocytes compared to IP (P < .05). ROC curve analysis revealed that MLR had a high diagnostic value in differentiating COVID‐19 patients from healthy subjects, but not from IP patients. NLR showed significant positive correlations with PSI, CURB‐65, and MuLBSTA. Lymphocyte count was lower in the ARDS group and yielded a higher diagnostic value than the other variables. Conclusions Monocyte‐to‐lymphocyte ratio showed an acceptable efficiency to separate COVID‐19 patients from healthy subjects, but failed to rule out IP patients. NLR may be a reliable marker to evaluate the disease severity of COVID‐19. Lymphocyte count may be useful to establish the early diagnosis of ARDS in the COVID‐19 patients.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Diagnostic value of peripheral hematologic markers for coronavirus disease 2019 (COVID‐19): A multicenter, cross‐sectional study

Peng

Yuan

et al. 2020

Clinical Laboratory Analysis

122

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“…It has been reported that NLR has some predictive value in the diagnosis of disease and severity in patients with influenza virus and other inflammation-related diseases. [13][14][15][16] Our results showed that the NLR in the severe group was significantly higher than that in the nonsevere group. The area under the ROC curve of the NLR predicting the severity of COVID-19 was the largest.…”

Section: In Terms Of Laboratory Tests the Main Characteristics Of Comentioning

confidence: 46%

The value of clinical parameters in predicting the severity of COVID‐19

Shi

Dong

Ren

et al. 2020

Journal of Medical Virology

237

168

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To study the relationship between clinical indexes and the severity of coronavirus disease 2019 (COVID‐19), and to explore its role in predicting the severity of COVID‐19. Clinical data of 443 patients with COVID‐19 admitted to our hospital were retrospectively analyzed, which were divided into nonsevere group (n = 304) and severe group (n = 139) according to their condition. Clinical indicators were compared between different groups. The differences in sex, age, the proportion of patients with combined heart disease, leukocyte, neutrophil‐to‐lymphocyte ratio (NLR), neutrophil, lymphocyte, platelet, D‐dimer, C‐reactive protein (CRP), procalcitonin, lactate dehydrogenase, and albumin on admission between the two groups were statistically significant (P < .05). Multivariate logistic regression analysis showed NLR and CRP were independent risk factors for severe COVID‐19. Platelets were independent protective factors for severe COVID‐19. The receiver operating characteristic (ROC) curve analysis demonstrated area under the curve of NLR, platelet, CRP, and combination was 0.737, 0.634, 0.734, and 0.774, respectively. NLR, CRP, and platelets can effectively assess the severity of COVID‐19, among which NLR is the best predictor of severe COVID‐19, and the combination of three clinical indicators can further predict severe COVID‐19.

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“…In cases of other viral and bacterial pneumonia, NLR was more sensitive than individual levels of neutrophils and lymphocytes [40]. Similarly, PLR correlated well with mortality and disease severity in bacterial pneumonia [12,41].…”

Section: Discussionmentioning

confidence: 82%

Use of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in COVID-19

2020

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Background: As the pandemic of coronavirus disease 2019 (COV-ID-19) continues, prognostic markers are now being identified. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are easily accessible values that have been known to correlate with inflammation and prognosis in several conditions. We used the available data to identify the association of NLR and PLR with the severity of COVID-19. Methods: A literature search using EMBASE, MEDLINE, and Google Scholar for studies reporting the use of NLR and PLR in COVID-19 published until April 28, 2020, was performed. Random effects meta-analysis was done to estimate standard mean difference (SMD) of NLR and PLR values with 95% confidence interval (CI) between severe and non-severe COVID-19 cases. Results: A total of 20 studies with 3,508 patients were included. Nineteen studies reported NLR values, while five studies reported PLR values between severe and non-severe COVID-19 patients. Higher levels of NLR (SMD: 2.80, 95% CI: 2.12-3.48, P < 0.00001) and PLR (SMD: 1.82, 95% CI: 1.03-2.61, P < 0.00001)) were seen in patients with severe disease compared to non-severe disease. Conclusions: NLR and PLR can be used as independent prognostic markers of disease severity in COVID-19.

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Role of hematological parameters in the diagnosis of influenza virus infection in patients with respiratory tract infection symptoms

Cited by 60 publications

References 23 publications

Diagnostic value of peripheral hematologic markers for coronavirus disease 2019 (COVID‐19): A multicenter, cross‐sectional study

Diagnostic value of peripheral hematologic markers for coronavirus disease 2019 (COVID‐19): A multicenter, cross‐sectional study

The value of clinical parameters in predicting the severity of COVID‐19

Use of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in COVID-19

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