The Neutrophil-to-Monocyte Ratio and Lymphocyte-to-Neutrophil Ratio at Admission Predict In-Hospital Mortality in Mexican Patients with Severe SARS-CoV-2 Infection (Covid-19)

Rizo-Téllez, Salma A.; Méndez-García, Lucía A.; Flores-Rebollo, Cruz; Alba-Flores, Fernando; Alcántara-Suárez, Raúl; Manjarrez-Reyna, Aarón N.; Baltazar‐López, Neyla; Hernández-Guzmán, Verónica Alejandra; León-Pedroza, José Israel; Zapata-Arenas, Rogelio; González-Chávez, Antonio; Hernández-Ruiz, Joselín; Carrillo-Ruíz, José Damián; Serrano-Loyola, Raúl; Guerrero‐Avendaño, Guadalupe; Escobedo, Galileo

doi:10.3390/microorganisms8101560

Cited by 65 publications

(78 citation statements)

References 44 publications

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“…Of note, in that study, the impact of these markers on in-hospital mortality was not assessed and comparisons were made between SARS-CoV-2 positive and negative patients [ 42 ]. In a cohort of 54 Mexican adult patients with COVID-19, an LNR lower than 0.088 and an NMR greater than 17.75 measured at the time of hospital admission were independent risk factors for in-hospital mortality in patients with severe COVID-19 [ 43 ]. As mentioned early, several studies have reported impaired clinical outcomes, including more intensive care unit (ICU) admissions and increased mortality among CKD patients with COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Elevated Monocyte to Lymphocyte Ratio and Increased Mortality among Patients with Chronic Kidney Disease Hospitalized for COVID-19

Dávila-Collado¹,

Jarquín-Durán²,

Solís-Vallejo³

et al. 2021

JPM

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Chronic kidney disease (CKD) constitutes a major health problem and one of the leading causes of death worldwide. Patients with CKD have impaired immune functions that predispose them to an increased risk of infections, as well as virus-associated cancers and a diminished vaccine response. In this study, we aimed to identify clinical and laboratory parameters associated with in-hospital mortality in patients evaluated in the department of emergency (ER) and admitted with the diagnosis of severe acute respiratory syndrome (SARS) caused by coronavirus disease 2019 (COVID-19) at the Baptist Hospital of Nicaragua (BHN). There were 37 patients with CKD, mean age 58.3 ± 14.1 years, admitted to BHN due to COVID-19, and among them, 24 (65.7%) were males (p = 0.016). During hospitalization, 23 patients with CKD (62.1%) died of complications associated with COVID-19 disease, which was a higher proportion (odds ratio (OR) 5.6, confidence interval (CI) 2.1–15.7, p = 0.001) compared to a group of 70 patients (64.8% males, mean age 57.5 ± 13.7 years) without CKD admitted during the same period in whom 28.5% died of COVID-19. In the entire cohort, the majority of patients presented with bilateral pneumonia, and the most common symptoms at admission were dyspnea, cough, and fever. Serum levels of D-dimer, ferritin and procalcitonin were significantly higher in patients with CKD compared with those without CKD. Multivariate analysis revealed that CKD, age (>60 years), and hypoxia measured in the ER were factors associated with increased in-hospital mortality. Among patients with CKD but not in those without CKD (OR 36.8, CI 1.5–88.3, p = 0.026), an increased monocytes-to-lymphocyte ratio (MLR) was associated with higher mortality and remained statistically significant after adjusting for confounders. The MLR measured in the ER may be useful for predicting in-hospital mortality in patients with CKD and COVID-19 and could contribute to early risk stratification in this group.

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Section: Discussionmentioning

confidence: 99%

Elevated Monocyte to Lymphocyte Ratio and Increased Mortality among Patients with Chronic Kidney Disease Hospitalized for COVID-19

Dávila-Collado¹,

Jarquín-Durán²,

Solís-Vallejo³

et al. 2021

JPM

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“…However, only the neutrophil-to-monocyte ratio remained a significant independent predictor of the primary outcome in the multivariate competing risk regression model. It has been observed that lymphocyte and monocyte populations decrease while neutrophil counts increase in COVID-19 ( Zhao et al, 2020 ), and more recent research showed a link between neutrophil-to-monocyte ratio and COVID-19 in-hospital mortality ( Rizo-Téllez et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Admission levels of Soluble Urokinase Plasminogen Activator Receptor (suPAR) are Associated with the Development of Severe Complications in Hospitalised COVID-19 Patients: A Prospective Cohort Study

Oulhaj¹,

Alsuwaidi²,

Suliman³

et al. 2021

International Journal of Infectious Diseases

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Objective To examine the association between plasma levels of the soluble urokinase plasminogen activator receptor (suPAR) and the incidence of severe complications of COVID-19. Methods 403 RT-PCR-confirmed COVID-19 patients were recruited and prospectively followed-up at a major hospital in the United Arab Emirates. The primary endpoint was time from admission until the development of a composite outcome, including acute respiratory distress syndrome (ARDS), intensive care unit (ICU) admission, or death from any cause. Patients discharged alive were considered as competing events to the primary outcome. Competing risk regression was used to quantify the association between suPAR and the incidence of the primary outcome. Results 6.2% of patients experienced ARDS or ICU admission, but none died. Taking into account competing risk, the incidence of the primary outcome was 11.5% (95% confidence interval [CI], 6.7–16.3) in patients with suPAR levels >3.91 ng/mL compared to 2.9% (95% CI, 0.4–5.5) in those with suPAR ≤3.91 ng/mL. Also, an increase by 1 ng/mL in baseline suPAR resulted in 58% rise in the hazard of developing the primary outcome (hazard ratio 1.6, 95% CI, 1.2–2.1, p = 0.003). Conclusion suPAR has an excellent prognostic utility in predicting severe complications in hospitalised COVID-19 patients.

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“…The 15 most frequent tests corresponding to 38 biomarkers were selected for analysis based on the availability of data. Five biomarkers WBC count, neutrophil lymphocyte ratio (NLR), lymphocyte monocyte ration (LMR), neutrophil monocyte ratio (NMR), platelet to lymphocyte ratio (PLR) were manually calculated from various blood cell counts available owing their reported importance in predicting mortality due to COVID [21, 22]. 209 unique co-morbid conditions were observed in patients in our study.…”

Section: Methodsmentioning

confidence: 99%

COVID-19 Risk Stratification and Mortality Prediction in Hospitalized Indian Patients

Alle

Siddiqui

Kanakan

et al. 2020

Preprint

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The clinical course of coronavirus disease 2019 (COVID-19) infection is highly variable with the vast majority recovering uneventfully but a small fraction progressing to severe disease and death. Appropriate and timely supportive care can reduce mortality and it is critical to evolve better patient risk stratification based on simple clinical data, so as to perform effective triage during strains on the healthcare infrastructure. This study presents risk stratification and mortality prediction models based on usual clinical data from 544 COVID-19 patients from New Delhi, India using machine learning methods. An XGboost classifier yielded the best performance on risk stratification (F1 score of 0.81). A logistic regression model yielded the best performance on mortality prediction (F1 score of 0.71). Significant biomarkers for predicting risk and mortality were identified. Examination of the data in comparison to a similar dataset with a Wuhan cohort of 375 patients was undertaken to understand the much lower mortality rates in India and the possible reasons thereof. The comparison indicated higher survival rate in the Delhi cohort even when patients had similar parameters as the Wuhan patients who died. Steroid administration was very frequent in Delhi patients, especially in surviving patients whose biomarkers indicated severe disease. This study helps in identifying the high-risk patient population and suggests treatment protocols that may be useful in countries with high mortality rates.

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The Neutrophil-to-Monocyte Ratio and Lymphocyte-to-Neutrophil Ratio at Admission Predict In-Hospital Mortality in Mexican Patients with Severe SARS-CoV-2 Infection (Covid-19)

Cited by 65 publications

References 44 publications

Elevated Monocyte to Lymphocyte Ratio and Increased Mortality among Patients with Chronic Kidney Disease Hospitalized for COVID-19

Elevated Monocyte to Lymphocyte Ratio and Increased Mortality among Patients with Chronic Kidney Disease Hospitalized for COVID-19

Admission levels of Soluble Urokinase Plasminogen Activator Receptor (suPAR) are Associated with the Development of Severe Complications in Hospitalised COVID-19 Patients: A Prospective Cohort Study

COVID-19 Risk Stratification and Mortality Prediction in Hospitalized Indian Patients

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