The clinical implication of dynamic neutrophil to lymphocyte ratio and D-dimer in COVID-19: A retrospective study in Suzhou China

Fu, Jianhong; Kong, Jindan; Wang, Wei; M, Wu; Yao, Lin; Wang, Zhaoyue; Jin, Jun; Wu, Depei; Yu, Xin

doi:10.1016/j.thromres.2020.05.006

Cited by 245 publications

(268 citation statements)

References 21 publications

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“…While after balancing the confounding factors, the logistic regression showed that D-dimer > 0.83 µg/ml could not be used as an independent predictor of disease risk in this study (OR = 1.209; 95%CI = 0.626-2.334; p = 0.571). In a dynamic study of hematological parameters in patients with COVID-19, the D-dimer of the severe group was higher than the non-severe group on days 1, 7 and 14 (p < 0.05) [24]. This suggests that due to different admission times, the ability of D-dimer to predict disease risk may be weakened.…”

Section: Evaluation Of Multi-parameter Modelmentioning

confidence: 98%

Prognostic Value of Neutrophil-To-Lymphocyte Ratio, Lactate Dehydrogenase, D-Dimer and CT Score in Patients with COVID-19

Cai¹,

Zhang²,

Zeng³

et al. 2020

Preprint

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Background: To explore the significance of neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), D-dimer and CT score in evaluating the severity and prognosis of coronavirus disease – 2019 (COVID-19) in two centers of Hubei, China.Methods: A total of 432 patients with laboratory confirmed COVID-19 were retrospectively enrolled and divided into non-severe and severe groups. The baseline data, laboratory findings, chest computed tomography (CT) results evaluating by CT score on admission, and clinical outcomes were collected and compared. The logistic regression was used to assess the independent relationship between the baseline level of four indicators (NLR, LDH, D-dimer, CT score) on admission and the severity of COVID-19, respectively.Results: Among 432 patients, 125 (28.94%) cases were divided into severe group, the remaining (n = 307, 71.06%) were in non-severe group. In multivariate logistic regression, the high level of NLR, LDH were independent predictor in the early classification of patients with COVID-19 (OR = 2.163; 95%CI = 1.162–4.026; p = 0.015 for NLR > 3.82; OR = 2.298; 95%CI = 1.327–3.979; p = 0.003 for LDH > 246U/L). Furthermore, combining NLR > 3.82 and LDH > 246U/L could increase the sensitivity of diagnosis in severe patients (NLR > 3.82 [50.40%] vs. Combined diagnosis [72.80%]; p = 0.0007; LDH > 246 [59.2%] vs. Combined diagnosis [72.80%]; p < 0.0001).Conclusions: The high levels of NLR and LDH in serum have potential value in the early identification of severe patients with COVID-19. The combination of LDH and NLR can improve the sensitivity of diagnosis.Importance: COVID-19 has been a global pandemic. The mortality rate is range from 3.5-6.0%. In order to predict the risk factors of severity of COVID-19. we explore the significance of neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), D-dimer and CT score in evaluating the severity and prognosis of coronavirus disease – 2019 (COVID-19) in two centers of Hubei, China. We found that the high levels of NLR and LDH in serum have potential value in the early identification of severe patients with COVID-19. The combination of LDH and NLR can improve the sensitivity of diagnosis.

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Section: Evaluation Of Multi-parameter Modelmentioning

confidence: 98%

Prognostic Value of Neutrophil-To-Lymphocyte Ratio, Lactate Dehydrogenase, D-Dimer and CT Score in Patients with COVID-19

Cai¹,

Zhang²,

Zeng³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…pattients [6][7][8][9][10][11]. In this study, ROC curve analysis revealed that the optimal cut-off value of D-dimer at 2.145 µg/L had 75.0% sensitivity and 78.3% speci city, and the AUC of D-dimer was 0.818.…”

Section: Discussionmentioning

confidence: 55%

“…Huang and colleagues showed D-dimer levels on admission were higher in patients needing critical care support than those who did not require it [9]. Similarly, Fu and colleagues retrospectively analyzed 75 con rmed COVID-19 adult patients in Suzhou and found that D-dimer levels of the severe group was higher than the mild/moderate on days 1, 4 and 14 [7]. Guan and colleagues analyzed 1099 patients with laboratory-con rmed Covid-19 from over 550 hospitals in China, and found the non-survivors had a signi cantly higher D-dimer than that of survivors [10].…”

Section: Discussionmentioning

confidence: 99%

The Predictive Value of D-Dimer and DPR for in-Hospital Mortality in Patients with COVID-19

Deng

Xie

et al. 2020

Preprint

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Background: The aim of this study was to explore the predictive value of D-dimer and D-dimer to platelet ratio (DPR) on admission in COVID-19 patients. Methods: This is a retrospective cohort study of confirmed COVID-19 patients that were admitted to the Renmin Hospital of Wuhan University from January 30, 2020 to February 15, 2020. The baseline clinical and laboratory parameters were collected.Results: 264 COVID-19 patients were enrolled in this study, of whom 52 died during hospitalization and 212 were discharged from the hospital. Receiver operating characteristic (ROC) curve analysis demonstrated that the area under curve (AUC) of D-dimer was 0.818 with a sensitivity of 75.0% and a specificity of 78.3%, and the AUC of DPR was 0.847 with a sensitivity of 84.6% and a specificity of 75.5% for the prediction of in-hospital mortality on admission. Patients with higher D-dimer or DPR levels were associated with higher mortality risk, compared to those who lower levels. The multivariable Cox regression indicated that in-hospital mortality was associated with age (hazard ratio (HR) 1.034, 95% confidence interval (CI) 1.011-1.058, P=0.003), gender (HR 0.553, 95% CI 0.313-0.976; P=0.041), coronary heart disease (HR 2.315, 95% CI 1.276-4.200; P=0.006), elevated D-dimer (HR 6.111, 95% CI 3.095-12.068; P<0.001), and elevated DPR (HR 7.158, 95% CI 3.633-14.101; P<0.001). Conclusions: DPR levels seem to be slightly better at predicting mortality than D-dimer, and elevated D-dimer and DPR can both be considered independent risk factors of the death in COVID-19 patients.

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“…While after balancing the confounding factors, the logistic regression showed that D-dimer > 0.83 µg/ml could not be used as an independent predictor of disease risk in this study (OR = 1.209; 95%CI = 0.626-2.334; p = 0.571). In a dynamic study of hematological parameters in patients with COVID-19, the D-dimer of the severe group was higher than the non-severe group on days 1, 7 and 14 (p < 0.05) (24). This suggests that due to different admission times, the ability of D-dimer to predict disease risk may be COVID-19 patients have lung involvement with imaging changes (10,26).…”

Section: Evaluation Of Multi-parameter Modelmentioning

confidence: 97%

Prognostic value of neutrophil-to-lymphocyte ratio, lactate dehydrogenase, D-dimer and CT score in patients with COVID-19

Cai

Zeng

Zhang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background To explore the significance of neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), D-dimer and CT score in evaluating the severity and prognosis of coronavirus disease – 2019 (COVID-19). Methods Patients with laboratory confirmed COVID-19 were retrospectively enrolled. The baseline data, laboratory findings, chest computed tomography (CT) results evaluating by CT score on admission, and clinical outcomes were collected and compared. The logistic regression was used to assess the independent relationship between the baseline level of four indicators (NLR, LDH, D-dimer, CT score) and the severity of COVID-19. Results Among 432 patients, 125 (28.94%) cases were divided into severe group, the remaining (n = 307, 71.06%) were in non-severe group. In multivariate logistic regression, high level of NLR, LDH were independent predictor of the severe group in COVID-19 (OR = 2.163; 95%CI = 1.162–4.026; p = 0.015 for NLR > 3.82; OR = 2.298; 95%CI = 1.327–3.979; p = 0.003 for LDH > 246U/L). Combining NLR > 3.82 and LDH > 246U/L increased the sensitivity of diagnosis in severe patients (NLR > 3.82 [50.40%] vs. Combined diagnosis [72.80%]; p = 0.0007; LDH > 246 [59.2%] vs. Combined diagnosis [72.80%]; p < 0.0001). Conclusions High levels of NLR and LDH in serum have potential value in the early identification of severe patients with COVID-19. The combination of LDH and NLR can improve the sensitivity of diagnosis.

show abstract

The clinical implication of dynamic neutrophil to lymphocyte ratio and D-dimer in COVID-19: A retrospective study in Suzhou China

Cited by 245 publications

References 21 publications

Prognostic Value of Neutrophil-To-Lymphocyte Ratio, Lactate Dehydrogenase, D-Dimer and CT Score in Patients with COVID-19

Prognostic Value of Neutrophil-To-Lymphocyte Ratio, Lactate Dehydrogenase, D-Dimer and CT Score in Patients with COVID-19

The Predictive Value of D-Dimer and DPR for in-Hospital Mortality in Patients with COVID-19

Prognostic value of neutrophil-to-lymphocyte ratio, lactate dehydrogenase, D-dimer and CT score in patients with COVID-19

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