Prognostic value of neutrophil-to-lymphocyte ratio in COVID-19 compared with Influenza and respiratory syncytial virus infection

Prozan, Lior; Shusterman, Eden; Ablin, Jacob N; Mitelpunkt, Alexis; Weiss-Meilik, Ahuva; Adler, Amos; Choshen, Guy; Kehat, Orli

doi:10.1038/s41598-021-00927-x

Cited by 68 publications

(64 citation statements)

References 48 publications

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“…However, inflammation parameters (CRP, lymphopenia), LDH—as a tissue injury parameter—and CK were significantly elevated in patients with COVID-19 pneumonia, contrary to normal CXR findings. In addition, previous studies reported that the neutrophile-to-lymphocyte ratio (NLR) was an independent risk factor for COVID-19 severity [ 25 , 26 ], which we observed to be significantly higher in patients with COVID-19 pneumonia.…”

Section: Discussionsupporting

confidence: 57%

Acute Arterial Thrombosis of Lower Extremities in COVID-19 Patients

Glavinić

Marčić

Dumancic

et al. 2022

JCM

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Clinical signs and symptoms of COVID-19 varied from asymptomatic forms to severe, life-threatening conditions that required treatment in intensive care units. These severe forms of illness are connected with a hypercoagulable state due to excessive inflammation, hypoxia, immobilisation, and altered angiotensin-converting enzyme 2 (ACE-2). In total, 17 COVID-19 positive patients were diagnosed with peripheral arterial thrombosis (AT), 13 of them had COVID-19 pneumonia. Laboratory findings in patients with X-ray confirmed pneumonia showed a four times higher neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP) and three times higher lactate dehydrogenase level (LDH) than patients without confirmed pneumonia. Patients with pneumonia had significantly more bilateral occlusions of the lower extremities and a significantly higher percentage with complete occlusion of the arteries than patients without pneumonia. The rate of limb loss was 35.3%. They were all from the group with COVID-19 pneumonia. Ten out of thirteen patients with pneumonia died due to acute respiratory distress syndrome (ARDS). All patients without pneumonia were discharged from the hospital. The aim of this retrospective study was to report the incidence of arterial thrombosis of lower extremities and their complications in the acute phase of the infection among COVID-19 patients admitted to the hospital for treatment.

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Section: Discussionsupporting

confidence: 57%

Acute Arterial Thrombosis of Lower Extremities in COVID-19 Patients

Glavinić

Marčić

Dumancic

et al. 2022

JCM

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“…However, many reports have identified NLR, dNLR, MLR as independent risk factors for severe disease [ 8 , 11 , 25 , 28 , 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…NLR is related to systemic inflammatory status and disease activity and has prognostic value in cardiovascular disease, autoimmune disease, tumors, and other infectious diseases [ 33 , 34 , 35 ]. NLR is also included as a variable in a risk score to predict the occurrence of critical illness in patients with COVID-19, and some studies have identified its role in discriminating severe disease and predicting mortality [ 8 , 11 , 25 , 31 , 32 , 36 , 37 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

The Predictive Role of NLR, d-NLR, MLR, and SIRI in COVID-19 Mortality

et al. 2022

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(1) Background: Since its discovery, COVID-19 has caused more than 256 million cases, with a cumulative death toll of more than 5.1 million, worldwide. Early identification of patients at high risk of mortality is of great importance in saving the lives of COVID-19 patients. The study aims to assess the utility of various inflammatory markers in predicting mortality among hospitalized patients with COVID-19. (2) Methods: A retrospective observational study was conducted among 108 patients with laboratory-confirmed COVID-19 hospitalized between 1 May 2021 and 31 October 2021 at Municipal Emergency Clinical Hospital of Timisoara, Romania. Blood cell counts at admission were used to obtain NLR, dNLR, MLR, PLR, SII, and SIRI. The association of inflammatory index and mortality was assessed via Kaplan–Maier curves univariate Cox regression and binominal logistic regression. (3) Results: The median age was 63.31 ± 14.83, the rate of in-hospital death being 15.7%. The optimal cutoff for NLR, dNLR, MLR, and SIRI was 9.1, 9.6, 0.69, and 2.2. AUC for PLR and SII had no statistically significant discriminatory value. The binary logistic regression identified elevated NLR (aOR = 4.14), dNLR (aOR = 14.09), and MLR (aOR = 3.29), as independent factors for poor clinical outcome of COVID-19. (4) Conclusions: NLR, dNLR, MLR have significant predictive value in COVID-19 mortality.

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“…Several viruses were found to upregulate host neutrophil/lymphocyte ratio (NLR), by promoting lymphopenia, associated with both COVID-19 critical illness and AD ( Kuyumcu et al., 2012 ; Sayed et al., 2020 ; Prozan et al., 2021 ). Elevated NLR likely reflects arginase upregulation and the subsequent depletion of arginine and nitric oxide (NO).…”

Section: Cell-cell Fusion the Molecular Actorsmentioning

confidence: 99%

Virus-Induced Membrane Fusion in Neurodegenerative Disorders

Osorio

Sfera

Anton

et al. 2022

Front. Cell. Infect. Microbiol.

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A growing body of epidemiological and research data has associated neurotropic viruses with accelerated brain aging and increased risk of neurodegenerative disorders. Many viruses replicate optimally in senescent cells, as they offer a hospitable microenvironment with persistently elevated cytosolic calcium, abundant intracellular iron, and low interferon type I. As cell-cell fusion is a major driver of cellular senescence, many viruses have developed the ability to promote this phenotype by forming syncytia. Cell-cell fusion is associated with immunosuppression mediated by phosphatidylserine externalization that enable viruses to evade host defenses. In hosts, virus-induced immune dysfunction and premature cellular senescence may predispose to neurodegenerative disorders. This concept is supported by novel studies that found postinfectious cognitive dysfunction in several viral illnesses, including human immunodeficiency virus-1, herpes simplex virus-1, and SARS-CoV-2. Virus-induced pathological syncytia may provide a unified framework for conceptualizing neuronal cell cycle reentry, aneuploidy, somatic mosaicism, viral spreading of pathological Tau and elimination of viable synapses and neurons by neurotoxic astrocytes and microglia. In this narrative review, we take a closer look at cell-cell fusion and vesicular merger in the pathogenesis of neurodegenerative disorders. We present a “decentralized” information processing model that conceptualizes neurodegeneration as a systemic illness, triggered by cytoskeletal pathology. We also discuss strategies for reversing cell-cell fusion, including, TMEM16F inhibitors, calcium channel blockers, senolytics, and tubulin stabilizing agents. Finally, going beyond neurodegeneration, we examine the potential benefit of harnessing fusion as a therapeutic strategy in regenerative medicine.

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Prognostic value of neutrophil-to-lymphocyte ratio in COVID-19 compared with Influenza and respiratory syncytial virus infection

Cited by 68 publications

References 48 publications

Acute Arterial Thrombosis of Lower Extremities in COVID-19 Patients

Acute Arterial Thrombosis of Lower Extremities in COVID-19 Patients

The Predictive Role of NLR, d-NLR, MLR, and SIRI in COVID-19 Mortality

Virus-Induced Membrane Fusion in Neurodegenerative Disorders

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