Neutrophil-to-Monocyte-Plus-Lymphocyte Ratio as a Potential Marker for Discriminating Pulmonary Tuberculosis from Nontuberculosis Infectious Lung Diseases

Jeon, You La; Lee, Wooin; Kang, So Young; Kim, Myeong Hee

doi:10.1093/labmed/lmy083

Cited by 28 publications

(41 citation statements)

References 19 publications

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“…NLR is an indicator of systemic inflammation [28], mainly seen in tumor-related diseases, autoimmune diseases, bacterial infectious pneumonia and tuberculosis [29][30][31][32]. It was reported that COVID-19 infection-triggered inflammation increased NLR and the increase in NLR was significantly associated with poor clinical outcomes of COVID-19 patients [33].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Analysis of COVID-19 Patients with ARDS and Prediction Based on Machine Learning

Xu¹,

Sun²,

Gao

et al. 2020

Preprint

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COVID-19 is a newly emerging infectious disease, which is generally susceptible to human beings and has caused huge losses to people's health. Acute respiratory distress syndrome (ARDS) is one of the common clinical manifestations of severe COVID-19 and it is also responsible for the current shortage of ventilators worldwide. This study aims to analyze the clinical characteristics of COVID-19 ARDS patients and establish a diagnostic system based on artificial intelligence (AI) method to predict the probability of ARDS in COVID-19 patients. We collected clinical data of 659 COVID-19 patients from 11 regions in China. The clinical characteristics of the two groups were elaborately compared and both traditional machine learning algorithms and deep learning-based methods were used to build the prediction models. Results indicated the median age of ARDS patients was 56.5 years old, which was significantly older than those with non-ARDS by 7.5 years. Male and patients with BMI>25 were more likely to develop ARDS. The clinical features of ARDS patients included cough (80.3%), polypnea (59.2%), lung consolidation (53.9%), secondary bacterial infection (30.3%), and comorbidities such as hypertension (48.7%). Abnormal biochemical indicators such as lymphocyte count, leukocyte counting, CK, NLR, AST, LDH, and CRP were all strongly related to the aggravation of ARDS. Furthermore, through various AI methods for modeling and prediction effect evaluation based on the above risk factors, decision tree achieved the best AUC, sensitivity, and specificity in identifying the mild patients who were easy to develop ARDS, which undoubtedly helps to optimize the treatment strategy, reduce mortality, and relieve the medical pressure.

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Section: Discussionmentioning

confidence: 99%

Risk Factors Analysis of COVID-19 Patients with ARDS and Prediction Based on Machine Learning

Xu¹,

Sun²,

Gao

et al. 2020

Preprint

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“…A number of prior studies have evaluated CBC-derived ratios (MLR, NLR, and/or PLR) in the context of symptomatic TB disease, speci cally related to either predicting subsequent TB disease development, diagnosing TB disease, or monitoring disease response to antimicrobial therapy (5)(6)(7)(8)(9)(10)(11)(12)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). These studies were heterogeneous with respect to the geographic region from which participants originated, presence of comorbidities (such as HIV), age, concurrent use of TB therapy, and choice of control groups, making comparisons challenging.…”

Section: Discussionmentioning

confidence: 99%

“…Third, because MLR, NLR, and PLR are hypothesized to represent non-speci c markers of in ammation, inclusion of other controls groups, such as individuals with other chronic infections (e.g., HIV) or chronic in ammatory conditions, would have been potentially bene cial. However, our study was designed primarily as a TB vaccine trial and therefore did not include such groups, although others have considered similar controls in prior studies (18)(19)(20)23,24).…”

Section: Discussionmentioning

confidence: 99%

“…The CBC ratios described here are hypothesized to represent markers of non-speci c in ammation, and have been evaluated in the context of TB disease (5)(6)(7)(8)(9)(10)(11)(12)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25), malignancy (26)(27)(28)(29)(30), and several other conditions that are hypothesized to have a pro-in ammatory component (31)(32)(33). Through the analysis of paired CBC and IGRA assays, we are able to report on the utility of baseline MLR, NLR, and PLR, as well as other CBC components, for predicting future development of asymptomatic TB infection and on the effect of incident TB infection on concurrent CBC values.…”

Section: Introductionmentioning

confidence: 99%

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The potential of CBC-derived ratios (Monocyte-to-lymphocyte, neutrophil-to-lymphocyte, and platelet-to-lymphocyte) to predict or diagnose incident TB infection in Tanzanian adolescents 

Rees

PINEROS

Amour

et al. 2020

Preprint

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Background: Ratios of different immune cell populations (i.e., monocyte-to-lymphocyte, neutrophil-to-lymphocyte, and platelet-to-lymphocyte ratios) have been studied as a means of predicting future tuberculosis (TB) disease risk or to assist in the diagnosis of incident TB disease. No studies to-date, however, have evaluated the potential of these ratios to predict or assist in the diagnosis of incident TB infection - the first step in the natural history of TB disease. Methods: In this prospective study, we evaluated the complete blood count (CBC)-derived metrics of monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) as predictors of future TB infection risk or aids in the diagnosis of TB infection among 145 Tanzanian adolescents enrolled in the DAR-901 vaccine trial, using paired CBCs and interferon-gamma release assays (IGRAs) obtained at 0, 60 and 720 days after study enrollment.Results: At baseline, there were no significant differences between study participants who remained persistently IGRA negative throughout the study period and those who subsequently converted to IGRA positive with respect to MLR (0.18 vs 0.17, p=0.10), NLR (0.88 vs 1.02, p=0.08), or PLR (115 vs 120, p=0.28). Similarly, no significant differences were noted with respect to MLR, NLR, and PLR between IGRA converters and time-matched negative controls at the time of IGRA conversion. With respect to other blood cell measures, however, there were modest but significant differences between IGRA negatives and IGRA converters with respect to red blood cell count (4.8 vs 4.6 × 106 cells/mcL, p=0.008), hemoglobin (12.6 vs 12.3 g/dL, p=0.01), and hematocrit (38.8 vs 37.8 %, p=0.005).Conclusions: In contrast to prior studies that have suggested that the ratios of different immune cell populations are associated with development of TB disease, our present findings do not demonstrate an association between these ratios and the development of TB infection. However, decreased red blood cell measures were associated with the subsequent development of TB infection, suggesting either that dysregulation of iron metabolism may play a role in TB pathogenesis or that following TB infection, iron dysregulation may precede IGRA positivity. Trial Registration: Clinicaltrials.gov NCT02712424. Date of registration: March 14, 2016.

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“…The CBC ratios described here are hypothesized to represent markers of non-specific inflammation, and have been evaluated in the context of TB disease [5][6][7][8][9][10][11][12][15][16][17][18][19][20][21][22][23][24][25], malignancy [26][27][28][29][30], and several other conditions that are hypothesized to have a pro-inflammatory component [31][32][33]. Through the analysis of paired CBC and IGRA assays, we are able to report on the utility of baseline MLR, NLR, and PLR, as well as other CBC components, for predicting future development of asymptomatic TB infection and on the effect of incident TB infection on concurrent CBC values.…”

Section: Introductionmentioning

confidence: 99%

The potential of CBC-derived ratios (monocyte-to-lymphocyte, neutrophil-to-lymphocyte, and platelet-to-lymphocyte) to predict or diagnose incident TB infection in Tanzanian adolescents

et al. 2020

View full text Add to dashboard Cite

Background: Ratios of different immune cell populations (i.e., monocyte-to-lymphocyte, neutrophil-to-lymphocyte, and platelet-to-lymphocyte ratios) have been studied as a means of predicting future tuberculosis (TB) disease risk or to assist in the diagnosis of incident TB disease. No studies to-date, however, have evaluated the potential of these ratios to predict or assist in the diagnosis of incident TB infection-the first step in the natural history of TB disease. Methods: In this prospective study, we evaluated the complete blood count (CBC)-derived metrics of monocyte-tolymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) as predictors of future TB infection risk or aids in the diagnosis of TB infection among 145 Tanzanian adolescents enrolled in the DAR-901 vaccine trial, using paired CBCs and interferon-gamma release assays (IGRAs) obtained at 0, 60 and 720 days after study enrollment. Results: At baseline, there were no significant differences between study participants who remained persistently IGRA negative throughout the study period and those who subsequently converted to IGRA positive with respect to MLR (0.18 vs 0.17, p = 0.10), NLR (0.88 vs 1.02, p = 0.08), or PLR (115 vs 120, p = 0.28). Similarly, no significant differences were noted with respect to MLR, NLR, and PLR between IGRA converters and time-matched negative controls at the time of IGRA conversion. With respect to other blood cell measures, however, there were modest but significant differences between IGRA negatives and IGRA converters with respect to red blood cell count (4.8 vs 4.6 × 10 6 cells/mcL, p = 0.008), hemoglobin (12.6 vs 12.3 g/dL, p = 0.01), and hematocrit (38.8 vs 37.8%, p = 0.005).

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Neutrophil-to-Monocyte-Plus-Lymphocyte Ratio as a Potential Marker for Discriminating Pulmonary Tuberculosis from Nontuberculosis Infectious Lung Diseases

Cited by 28 publications

References 19 publications

Risk Factors Analysis of COVID-19 Patients with ARDS and Prediction Based on Machine Learning

Risk Factors Analysis of COVID-19 Patients with ARDS and Prediction Based on Machine Learning

The potential of CBC-derived ratios (Monocyte-to-lymphocyte, neutrophil-to-lymphocyte, and platelet-to-lymphocyte) to predict or diagnose incident TB infection in Tanzanian adolescents

The potential of CBC-derived ratios (monocyte-to-lymphocyte, neutrophil-to-lymphocyte, and platelet-to-lymphocyte) to predict or diagnose incident TB infection in Tanzanian adolescents

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Neutrophil-to-Monocyte-Plus-Lymphocyte Ratio as a Potential Marker for Discriminating Pulmonary Tuberculosis from Nontuberculosis Infectious Lung Diseases

Cited by 28 publications

References 19 publications

Risk Factors Analysis of COVID-19 Patients with ARDS and Prediction Based on Machine Learning

Risk Factors Analysis of COVID-19 Patients with ARDS and Prediction Based on Machine Learning

The potential of CBC-derived ratios (Monocyte-to-lymphocyte, neutrophil-to-lymphocyte, and platelet-to-lymphocyte) to predict or diagnose incident TB infection in Tanzanian adolescents&nbsp;

The potential of CBC-derived ratios (monocyte-to-lymphocyte, neutrophil-to-lymphocyte, and platelet-to-lymphocyte) to predict or diagnose incident TB infection in Tanzanian adolescents

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The potential of CBC-derived ratios (Monocyte-to-lymphocyte, neutrophil-to-lymphocyte, and platelet-to-lymphocyte) to predict or diagnose incident TB infection in Tanzanian adolescents