An Easy Parameter That Can Predict Intensive Care Unit Admission in Patients with COVID-19 in the Early Stage: Neutrophil to Lymphocyte Ratio

Abstract

Background: The COVID-19 pandemic has caused more than 60 million confirmed cases and approximately 1.5 million deaths all over the world as of December 1st, 2020. So it’s important to predict the clinical course of infected patients and to prevent the disease course from worsening with early intervention.
 Aim: This study aimed to evaluate the new generation inflammation markers such as NLR, MPV and RDW in predicting the need for intensive care of COVID-19 patients.
 Methods: The retrospective cross-sectional study included 112 patients whose hemogram parameters were checked simultaneously with the diagnosis of COVID-19, hospitalized in public hospitals in Antalya province between March 16th and June 15th, 2020. Patients treated in the intensive care unit and treated only in the ward were compared according to laboratory data, and the predictive effect of study parameters on the need for intensive care was investigated.
 Results: Of the patients 43.8% were female and 56.3% were male. The average age was 49.48 ± 17.12 years. The percentage of patients admitted to the intensive care unit was 19.6% and, died was 5.4%. While MPV was found to be statistically significantly lower in COVID-19 patients who need intensive care, NLR and RDW were found to be statistically significantly higher. Decreased MPV and increased NLR were determined as independent risk factors for ICU admission. In addition, the optimal cut-off value was calculated as ≤ 10.4 for MPV (with 77.27% sensitivity and 66.67% specificity) and > 5.3 for NLR (with 72.73% sensitivity and 91.11% specificity) in predicting ICU admission.
 Conclusion: NLR, which is checked at the first admission in patients with suspected COVID-19, is an easy, fast, cheap and very valuable test in determining the severity of SARS-CoV2 infection and predicting the need for intensive care.