The neutrophil to lymphocyte ratio is an independent predictor for severe COVID-19

Abstract

Summary Purpose The aim of this study was to determine whether the neutrophil to lymphocyte ratio (NLR) can predict severe Coronavirus disease 2019 (COVID-19). Patients and methods A multicenter case-control study was conducted to investigate whether the NLR can help predict the severity of COVID-19. Patients confirmed to have COVID-19 between 16 January 2020 and 15 March 2020 were enrolled. Furthermore, meta-analyses were conducted based on both previous studies and our case-control study. Results In the case-control study, 213 patients (severe: 81) were included. The results suggested that the NLR was an independent risk factor (odds ratio [OR], 1.155, 95% confidence interval [95% CI]: 1.043–1.279, P = 0.006) and a great predictor (the area under the ROC curve was 0.728, 95% CI: 0.656–0.800) for severe COVID-19. In total, 18 datasets from 16 studies combined with our case-control study (severe: 1211; non-severe: 5838) were included in the meta-analyses and the results showed that the NLR of the severe COVID-19 group was significantly higher than that of the non-severe group (SMD = 1.10, 95% CI: 0.90–1.31, P < 0.001). Based on the 2 × 2 data from 6 studies, the SROC of NLR for predicting severe COVID-19 was 0.802, with a sensitivity of 0.67 (95% CI: 0.61–0.72) and a specificity of 0.75 (95% CI: 0.73–0.78). Conclusion Based on a multicenter case-control study and a meta-analysis, we found that the initial NLR was a great predictor of severe COVID-19.

The Relationship Between BMI And Neutrophil/Lymphocyte Ratio in Non-critical Hospitalized Patients With Coronavirus Disease 2019

“…We did not find any significant association of any clinical features with the BMI category. A previous study from Bangladesh did not find any significant association between different BMI categories with patients categorized based on symptoms 12 .…”

“…Neutrophilia along with lymphopenia which is the elevated neutrophils/lymphocytes ratio is one of the independent risk factors of severe COVID-19 and poor outcome 12,13 . Around 75% of deceased Bangladeshi hospitalized COVID-19 patients had also high NLR (e"5) 14 .…”

Evaluation of hematological changes and immune response biomarkers as a prognostic factor in critical patients with COVID-19

“…According to a recent meta-analysis conducted by Cheng et al (2021), which analyzed 17 studies and 7,049 COVID-19 patients, it was found that the NLR (neutrophil-to-lymphocyte ratio) was significantly higher in patients with severe COVID-19 compared to those with non-severe COVID-19 [ 44 ]. This study reinforces that the initial NLR can be a reliable predictor of severe COVID-19.…”

Study of neutrophil to lymphocyte ratio as a prognostic marker in COVID-19 infection-our experience at teritary care hospital

“…The baseline characteristics of the non-ARDS group and ARDS group are listed.The cut off value of NLR for moderate-severe ARDS is 11.The high NLR group (NLR > 9.8) showed a higher incidence of ARDS (P= 0.005) and higher rate of non-invasive (P= 0.002) and invasive (P= 0.048)mechanical ventilation. InWenjing Ye1et al study27 they studied the dynamic changes in NLR in 349 patients at the time of joining in the hospital and few days after the admission they found that association between clinical deterioration and changes in NLR values as follows Initial NLR in survivors 2.88(1.79-6.74), in dead patients it is about 14.96(8.52-26.58) with P-value <0.001. Peak NLR changes as follows in survivors 4.14(2.11-12.32), in dead patients it is about 46.58(27.95-87.29) with p-VALUE <0.001.…”