Neutrophil‐To‐Lymphocyte Ratio: An Emerging Marker Predicting Prognosis in Elderly Adults with Community‐Acquired Pneumonia

Cataudella, Emanuela; Giraffa, Chiara M.; Marca, Salvatore Di; Pulvirenti, Alfredo; Alaimo, Salvatore; Pisano, Marcella; Terranova, V.; Corriere, Thea; Ronsisvalle, Maria L.; Quattro, R. Di; Stancanelli, Benedetta; Giordano, Mauro; Vancheri, Carlo; Malatino, Lorenzo

doi:10.1111/jgs.14894

Cited by 169 publications

(157 citation statements)

References 30 publications

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“…Data presented as mean (range), mean ±standard deviation, or n(%), BMI, body mass index distress syndrome, community-acquired pneumonia and sarcoidosis and tuberculosis. [13][14][15][16][17] In this study, NLR has been found to be statistically significantly higher in silicosis patients with profusion categories 2 and 3 when compared to the control group. The NLR in patients with profusion category 1 was also higher than controls; however, the difference was not significant.…”

Section: Discussionsupporting

confidence: 50%

“…NLR has been shown to be an independent prognostic factor in several types of tumours, including colorectal, lung, breast, pancreatic, gastric and ovarian cancer . Studies have also shown a correlation between the NLR and the prognosis and severity of the clinical course in pulmonary diseases such as chronic obstructive pulmonary disease, acute respiratory distress syndrome, community‐acquired pneumonia and sarcoidosis and tuberculosis . In this study, NLR has been found to be statistically significantly higher in silicosis patients with profusion categories 2 and 3 when compared to the control group.…”

Section: Discussionsupporting

confidence: 49%

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Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as haematological indices of inflammatory response in ceramic workers’ silicosis

Karataş¹,

Gündüzöz

Öziş³

et al. 2019

Clinical Respiratory J

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Introduction Occupational exposure to crystalline silica over time may result in silicosis: a fatal, irreversible occupational disease leading to lung function impairment. A complex inflammatory process, excessive accumulation of mesenchymal cells and collagen production are the primary mechanisms underlying silicosis. Neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR) have emerged as representative indices of systemic inflammation. Objectives The purpose of the present study was to investigate the relationship between NLR, PLR and silicosis. Methods We retrospectively analysed the demographic and laboratory data of ceramic workers who were referred to our Hospital between 2010 and 2018. Five hundred and seventy‐three patients with silicosis and 222 ceramic workers without silicosis (controls) were included in the study. Results The radiographic ILO classification of silicosis patients was as follows: category 1 (71.5%), category 2 (19.2%), category 3 (7.5%). NLR and PLR in categories 2 and 3 were significantly higher when compared with the control group (P < .005). FEV1, FEV1%, FVC, FVC % and PEF were significantly lower in all silicosis patients and also in patients with subcategories (all P < .005). NLR showed a poor positive correlation with CRP (r = 0.095, P < .05) and ESR (r = 0.207, P = .000) while PLR only with ESR (r = 0.317, P = .000) in patients with silicosis. NLR and PLR showed negative correlations with FEV1, FVC and PEF (all P < .005). Conclusion We conclude that NLR and PLR have significant but poor correlations with pulmonary functions and severity of silicosis, especially in late radiographic profusion categories.

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Section: Discussionsupporting

confidence: 50%

Section: Discussionsupporting

confidence: 49%

Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as haematological indices of inflammatory response in ceramic workers’ silicosis

Karataş¹,

Gündüzöz

Öziş³

et al. 2019

Clinical Respiratory J

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“…Some studies proposed the neutrophil to lymphocyte ratio (NLR) as simple and inexpensive indicators of systemic inflammation and infection. An Italian study [43] explored the performance of the NLR to predict prognosis in a cohort of 195 elderly adults with CAP. NLR predicted 30-day mortality and performed better than PSI, CURB65, CRP and white cell count to predict prognosis in the studied population.…”

Section: Biomarkers For Community-acquired Pneumonia Prognosismentioning

confidence: 99%

Community-acquired pneumonia as an emergency condition

Cillóniz

Dominedò

García-Vidal

2018

Current Opinion in Critical Care

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Purpose of review Despite the improvements in its management, community-acquired pneumonia (CAP) still exhibits high global morbidity and mortality rates, especially in elderly patients. This review focuses on the most recent findings on the epidemiology, cause, diagnosis and management of CAP. Recent findings There is consistent evidence that the trend in CAP mortality has declined over time. However, the mortality of pneumococcal CAP has not changed in the last two decades, with an increase in the rate of hospitalization and more severe forms of CAP. Streptococcus pneumoniae remains the most frequent cause of CAP in all settings, age groups and regardless of comorbidities. However, the implementation of molecular diagnostic tests in the last years has identified respiratory viruses as a common cause of CAP too. The emergency of multidrug-resistance pathogens is a worldwide concern. An improvement in our ability to promptly identify the causative cause of CAP is required in order to provide pathogen-directed antibiotic therapy, improve antibiotic stewardship programs and implement appropriate vaccine strategies. Summary It is time to apply all the knowledge generated in the last decade in order to optimize the management of CAP.

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“…Therefore, NLCR was more sensitive than any of them alone. NLCR was used as a marker to predict the prognosis of pneumonia [13,14] and the risk of death from bacterial infection [15] had been reported. When NLCR was elevated, it might be associated with a poor clinical prognosis or an increased risk of death.…”

Section: Discussionmentioning

confidence: 99%

An emerging marker predicting the severity of COVID-19: Neutrophil-Lymphocyte Count Ratio

Zhang

Xiao²,

Liu

et al. 2020

Preprint

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Background: To analyze clinical features and laboratory indicators and identify the markers of exacerbation in COVID-19. Methods: We reviewed clinical histories of 177 patients with confirmed COVID-19. The patients were categorized into mild group (153 patients) and severe group (24 patients). The baseline demographic and laboratory indicators of all patients were collected, including the neutrophil-lymphocyte count ratio (NLCR) and C-reactive protein to albumin ratio (CAR). Receiver operating characteristic curve (ROC) analysis was performed to search for indicators predicting exacerbation in COVID-19 patients, and acquiring the area under the curves (AUCs), sensitivity, specificity and cut-off value. Results: The age of the severe group were significantly older than those of the mild group (P <0.01). Fever was the typical symptom in all COVID-19 patients. Cough and fatigue were manifested in mild group, yet severe patients were more prominent in dyspnea. The laboratory indicators showing that the mild group mainly had an elevated C-reactive protein; the severe group had a decreased lymphocyte count and lymphocyte ratio. WBC, neutrophil count, neutrophil ratio, D-dimer, AST, ALT, LDH, BUN, CRP levels increased. Furthermore, compared to mild group, WBC, neutrophil count, neutrophil ratio (Neut%), D-dimer, total bilirubin, albumin, AST, ALT, LDH, BUN, creatine kinase, CRP, CAR, NLCR were significantly higher, the lymphocyte count, lymphocyte ratio, and APTT were significantly lower in severe group (P<0.05). The ROC indicating that NLCR, Neut%, CAR, CRP, and LDH were better at distinguishing mild and severe patients. The AUCs of NLCR was larger than others (NLCR>Neut%>CAR>CRP>LDH: 0.939>0.925>0.908>0.895>0.873), which suggested that NLCR was the optimal maker; a cut-off value for NLCR of 6.15 had 87.5% sensitivity and 97.6% specificity for predicting exacerbation in COVID-19 patients. Conclusions: The different types of COVID-19 had significant differences in age, clinical symptoms and laboratory indicators, and severe patients might be easier to suffer from the multiple organ damage. An elevated NLCR may indicate that the disease was progressing towards exacerbation. It was essential to dynamically monitor the serum NLCR levels which contributed to evaluate the patient's condition and efficacy. NLCR could be used as a novel, highly specific and sensitive marker for predicting severity of COVID-19 patients.

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Neutrophil‐To‐Lymphocyte Ratio: An Emerging Marker Predicting Prognosis in Elderly Adults with Community‐Acquired Pneumonia

Cited by 169 publications

References 30 publications

Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as haematological indices of inflammatory response in ceramic workers’ silicosis

Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as haematological indices of inflammatory response in ceramic workers’ silicosis

Community-acquired pneumonia as an emergency condition

An emerging marker predicting the severity of COVID-19: Neutrophil-Lymphocyte Count Ratio

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