Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio and Their Role as Predictors of Disease Severity of Coronavirus Disease 2019 (COVID-19)

Jain, Rajendra Singh; Gopal, Arun; Pathak, Basant Kumar; Mohakuda, Sourya Sourabh; Tilak, Tvsvgk; Singh, Anchit Raj

doi:10.1055/s-0041-1723057

Cited by 14 publications

(11 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the findings were consistent with previous studies that state an increase in PLR as an independent indicator of COVID-19 infection in the general population [Chan AS, Rout, A., 2020]. Moreover, several studies related to the severity indicator of COVID-19 stated that PLR was positively corresponds to the severity of the sufferer [Goh BKP et al, 2016;Chan AS, Rout, A., 2020;Jain R et al, 2021].…”

Section: Demographic Characteristics Of the Patientssupporting

confidence: 90%

The explorat ion of inflammat ory and coagulation biomarkers between pregnantwomen with andwithout COVID-19

Wardhana

Tumangger

Juwono

et al. 2022

NAMJ

View full text Add to dashboard Cite

Objectives: to assess the effect-related inflammatory and coagulation biomarkers in pregnancy and their connection with the coronavirus disease of 2019 (COVID-19). Methods: A prospective case-control study was carried out among normal third-trimester pregnant women admitted to the labor room of Dr. Soetomo General Academic Hospital between January until June 2021. Two classified groups of patients were established in accordance with the result of the RT-PCR test. Demographic, clinical and laboratory results data of the two groups were collected and compared. Results: Platelet-to-lymphocyte ratio (PLR) was shown to be the only significant biomarkers found in the expectant with COVID-19, which was 35.8% higher compared to the ones free of COVID-19 [212.25 (157.57-269.37) vs 156.29 (128.55-195.3), p=0.048]. Logistic regression analysis of PLR between groups showed that the level of PLR was an independent factor in pregnant women with COVID-19 (OR 4.483, 95%CI 1.262-15.926). The ROC analysis showed that the PLR cut-off among the expectant was 171.335, with both sensitivity and specificity were 66.7% (p=0.021). The result shows no significant differences in leukocyte count, absolute neutrophils – lymphocyte count and percentage, neutrophil-to-lymphocyte ratio (NLR) and D-Dimer level between pregnant women infected with COVID-19 and free of the virus (p>0.05). Conclusion: Intriguingly, physiological adaptation during the course of the third trimester of pregnancy found no difference in most inflammation and coagulation markers, both in the condition of infected COVID-19 or not. The evidence from this single-centre study supports the viewpoint that elevated PLR was associated with independent biomarkers and thereby might be helpful to detect expectant with COVID-19.

show abstract

Section: Demographic Characteristics Of the Patientssupporting

confidence: 90%

The explorat ion of inflammat ory and coagulation biomarkers between pregnantwomen with andwithout COVID-19

Wardhana

Tumangger

Juwono

et al. 2022

NAMJ

View full text Add to dashboard Cite

show abstract

“…An AUC of 0.779, with a larger OR of 1.237 and a cut-off of 4.1 showed 69% sensitivity and 78% specificity in predicting severe disease. The cut-off for PLR was 115.3, which showed 79% sensitivity and 62% specificity in predicting severe disease [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Platelet Indices and Platelet to Lymphocyte Ratio (PLR) as Markers for Predicting COVID-19 Infection Severity

Ravindra¹,

Ramamurthy²,

Shaikh³

et al. 2022

Cureus

View full text Add to dashboard Cite

BackgroundNovel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (or coronavirus disease 2019; has caused a large number of infections across the globe. Numerous markers are being used to predict the severity of infection. This study was undertaken to assess the utility of platelet count, mean platelet volume (MPV), platelet distribution width (PDW), and platelet lymphocyte ratio (PLR) as markers of severity and mortality among patients with COVID-19 infection. MethodologyThis is a retrospective study conducted in a tertiary care center in India from April 2021 to June 2021. Patients admitted with COVID-19 infection were included in the study. Based on the severity, patients were categorized into the mild and severe (moderate severity included) groups. Platelet count, MPV, PDW, and PLR done at admission were studied and correlated with the disease severity and mortality. StatisticsThe independent t-test was used to compare the variables. The receiver operating characteristic (ROC) curve was done to identify the cut-off value. Statistical analysis was performed using SPSS 18 software (SPSS Inc. Released 2009. PASW Statistics for Windows, Version 18.0. Chicago: SPSS Inc). ResultsOne hundred patients admitted with COVID-19 infection were studied. 51 patients had a mild and 49 had a severe infection. The mean PLR was 141.40 among patients with mild illness and 252.6 with severe infection (P<0.001). The mean PLR among survivors was 104.4 (SD-23.56) and among nonsurvivors was 302.78 (SD-34.5) (P<0.001). There was no statistically significant difference between the two groups with respect to platelet count, MPV, and PDW. ConclusionPLR was found to be a reliable marker of severity and mortality among patients with COVID-19 illness.

show abstract

“…Severity was also predicted by NLR >4.93 (Turkey), >8.78 (Pakistan) and >5 (Iran) [8][9][10]. Different single centre studies from India suggested NLR of >3.3 predict progression of the disease, >5.2 for admission to ICU and >5.59 in severe COVID-19 disease [11][12][13]. Mechanical ventilation was required when NLR was >4.6 [14].…”

Section: Discussionmentioning

confidence: 99%

“…An initial PLR of 160 is associated with an adverse outcome which is concomitant to the study by Yang et al [ 7 ], and a peak PLR of 400 predicts mortality. Studies from other centres reveal a PLR of 180 (China and India), and 204 (India) [ 7 , 11 , 13 ]. The neutrophil and lymphocyte percentages were analysed in this study as many laboratories do not report absolute count, especially in resource-constrained areas.…”

Section: Discussionmentioning

confidence: 99%

Dynamic Profile of Prognostic Hematologic Indicators in Patient Under Intensive Care for COVID-19 Disease: A One-Year Study at a Tertiary Care Centre in South India

Balasubramanian¹,

Suman²,

Stephen³

et al. 2021

Cureus

View full text Add to dashboard Cite

Introduction Viral pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS COV-2) releases cytokines which result in neutrophils migration to the bloodstream and cytotoxic effect on lymphocytes. The ongoing pathology is reflected in the derangement of blood cells and the variations and calculations based on them that help in assessing the severity of the disease and prognosis. Aim This study aimed to compare the differences in the dynamic changes of the blood cells among survivors and non-survivors of COVID-19 disease so that cut-offs can be arrived at to aid triage at the intensive care unit (ICU) and to predict mortality. Material and methods A one-year study was conducted on patients hospitalized in the ICU. The demography and laboratory values of neutrophils and lymphocytes in percentages and absolute values, and platelet count in numbers were retrieved for eight consecutive values. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) was calculated from absolute counts. Statistical analysis was done using the Chi-Square test and Mann-Whitney test and a P-value of <0.05 is considered significant. The comparison was done between survivors and non-survivors. Result Among the 3142 patients admitted for COVID-19 disease, 7.6% required ICU care of whom 65.5% survived and 35.5% succumbed to the illness. Survivors were younger and comparable between both sexes. Though both groups had an ascending trend of neutrophils, lymphocytes, NLR, and PLR, the baseline characteristics were significantly lower in those who survived on a day-to-day basis. Neutrophilia above 80%, NLR 7.96, PLR 200 predicted the need for admission in ICU. Neutrophilia of 87% and lymphopenia of 10% were associated with adverse outcomes (mortality). Mortality can be predicted when neutrophil rises above 93% or lymphocytes fall below 5.2%. An initial NLR of 7.96 and PLR of 160 as well as peak NLR of 12.29 and peak PLR 400 predict mortality. Conclusion Serial blood counts are essential for hospitalized patients with COVID-19 for early triaging, and to assess severity and prognosis. The NLR of 6.7 and PLR of 160 require intensive care. The dynamic increase of NLR and PLR show worsening of the disease process and NLR of 40.95 and PLR of 400 predict mortality.

show abstract

Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio and Their Role as Predictors of Disease Severity of Coronavirus Disease 2019 (COVID-19)

Cited by 14 publications

References 13 publications

The explorat ion of inflammat ory and coagulation biomarkers between pregnantwomen with andwithout COVID-19

The explorat ion of inflammat ory and coagulation biomarkers between pregnantwomen with andwithout COVID-19

Platelet Indices and Platelet to Lymphocyte Ratio (PLR) as Markers for Predicting COVID-19 Infection Severity

Dynamic Profile of Prognostic Hematologic Indicators in Patient Under Intensive Care for COVID-19 Disease: A One-Year Study at a Tertiary Care Centre in South India

Contact Info

Product

Resources

About