Neutrophil-to-Lymphocyte Ratio Improves the Accuracy and Sensitivity of Pneumonia Severity Index in Predicting 30-Day Mortality of CAP Patients

Zhang, Hai F; Ge, Yan L; Wang, Hong Y; Zhang, Qian; Li, Wen Q; Chen, Yi; Chen, Qian C; Jin, Jing J; Xu, Jing; Zhang, Shuang; Xu, Tian T; Zhang, Xue; Yu, Hua; Zhu, Xiao Jun; Liu, Cong H; Jing, Bai; Zhang, Jia B; Xie, Bao Q; Wang, Yuan; Fu, Ai S; Zhang, Pan P

doi:10.7754/clin.lab.2019.190226

Cited by 27 publications

(29 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…was a widely used marker for the assessment of the severity of bacterial infections and the prognosis of patients with pneumonia and tumors. [17][18][19] In our study, we also found the increase of NLR in COVID-19 patients, and it was positively related to the disease severity.…”

Section: Discussionsupporting

confidence: 75%

COVID-19 early warning score: a multi-parameter screening tool to identify highly suspected patients

Song

et al. 2020

Preprint

153

174

View full text Add to dashboard Cite

BACKGROUND Corona Virus Disease 2019 (COVID-19) is spreading worldwide.Effective screening for patients is important to limit the epidemic. However, some defects make the currently applied diagnosis methods are still not very ideal for early warning of patients. We aimed to develop a diagnostic model that allows for the quick screening of highly suspected patients using easy-to-get variables. METHODSA total of 1,311 patients receiving severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleicacid detection were included, whom with a positive result were classified into COVID-19 group. Multivariate logistic regression analyses were performed to construct the diagnostic model. Receiver operating characteristic (ROC) curve analysis were used for model validation. RESULTS After analysis, signs of pneumonia on CT, history of close contact, fever, neutrophil-to-lymphocyte ratio (NLR), Tmax and sex were included in the diagnostic model. Age and meaningful respiratory symptoms were enrolled into COVID-19 early warning score (COVID-19 EWS). The areas under the ROC curve (AUROC) indicated that both of the diagnostic model (training dataset 0.956 [95%CI 0.935-0.977, P < 0.001]; validation dataset 0.960 [95%CI 0.919-1.0, P < 0.001] ) and COVID-19 EWS (training dataset 0.956 [95%CI 0.934-0.978, P < 0.001] ; validate dataset 0.966 [95%CI 0.929-1, P< 0.001]) had good discrimination capacity. In addition, we also obtained the cut-off values of disease severity predictors, such as CT score, CD8 + T cell count, CD4 + T cell count, and so on. CONCLUSIONSThe new developed COVID-19 EWS was a considerable tool for early and relatively accurately warning of SARS-CoV-2 infected patients.

show abstract

Section: Discussionsupporting

confidence: 75%

COVID-19 early warning score: a multi-parameter screening tool to identify highly suspected patients

Song

et al. 2020

Preprint

153

174

View full text Add to dashboard Cite

show abstract

“…The increase of NLR indicated poor clinical prognosis. [8][9][10][11][12][13][14] The results indicated that 2019-nCoV may act on T lymphocytes, and T lymphocyte damage is an important factor that causes patients to deteriorate 13 . In addition, patients with severe illness might have bacterial infection due to low immune function.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-to-Lymphocyte Ratio Predicts Severe Illness Patients with 2019 Novel Coronavirus in the Early Stage

Liu

Pan

et al. 2020

Preprint

287

292

View full text Add to dashboard Cite

Background: Severe ill patients with 2019 novel coronavirus (2019-nCoV) infection progressed rapidly to acute respiratory failure. We aimed to select the most useful prognostic factor for severe illness incidence.Methods: The study prospectively included 61 patients with 2019-nCoV infection treated at Beijing Ditan Hospital from January 13, 2020 to January 31, 2020. Prognostic factor of severe illness was selected by the LASSO COX regression analyses, to predict the severe illness probability of 2019-CoV pneumonia. The predictive accuracy was evaluated by concordance index, calibration curve, decision curve and clinical impact curve.Results: The neutrophil-to-lymphocyte ratio (NLR) was identified as the independent risk factor for severe illness in patients with 2019-nCoV infection. The NLR had a cindex of 0.807 (95% confidence interval, 0.676-0.38), the calibration curves fitted well, All rights reserved. No reuse allowed without permission. the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

show abstract

“…In addition, a high leukocyte count is common in critically ill patients because damaged cells induce innate inflammation in the lungs, which is largely mediated by proinflammatory macrophages and granulocytes [22]. The NLR was a widely used marker for the assessment of the severity of bacterial infections and the prognosis of patients with pneumonia and tumors [21,[23][24][25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage

et al. 2020

View full text Add to dashboard Cite

Background: Patients with critical illness due to infection with the 2019 coronavirus disease (COVID-19) show rapid disease progression to acute respiratory failure. The study aimed to screen the most useful predictive factor for critical illness caused by COVID-19. Methods: The study prospectively involved 61 patients with COVID-19 infection as a derivation cohort, and 54 patients as a validation cohort. The predictive factor for critical illness was selected using LASSO regression analysis. A nomogram based on non-specific laboratory indicators was built to predict the probability of critical illness. Results: The neutrophil-to-lymphocyte ratio (NLR) was identified as an independent risk factor for critical illness in patients with COVID-19 infection. The NLR had an area under receiver operating characteristic of 0.849 (95% confidence interval [CI], 0.707 to 0.991) in the derivation cohort and 0.867 (95% CI 0.747 to 0.944) in the validation cohort, the calibration curves fitted well, and the decision and clinical impact curves showed that the NLR had high standardized net benefit. In addition, the incidence of critical illness was 9.1% (1/11) for patients aged ≥ 50 and having an NLR < 3.13, and 50% (7/14) patients with age ≥ 50 and NLR ≥ 3.13 were predicted to develop critical illness. Based on the risk stratification of NLR according to age, this study has developed a COVID-19 pneumonia management process. Conclusions: We found that NLR is a predictive factor for early-stage prediction of patients infected with COVID-19 who are likely to develop critical illness. Patients aged ≥ 50 and having an NLR ≥ 3.13 are predicted to develop critical illness, and they should thus have rapid access to an intensive care unit if necessary.

show abstract

Neutrophil-to-Lymphocyte Ratio Improves the Accuracy and Sensitivity of Pneumonia Severity Index in Predicting 30-Day Mortality of CAP Patients

Cited by 27 publications

References 0 publications

COVID-19 early warning score: a multi-parameter screening tool to identify highly suspected patients

COVID-19 early warning score: a multi-parameter screening tool to identify highly suspected patients

Neutrophil-to-Lymphocyte Ratio Predicts Severe Illness Patients with 2019 Novel Coronavirus in the Early Stage

Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage

Contact Info

Product

Resources

About