The utility of peripheral blood leucocyte ratios as biomarkers in infectious diseases: A systematic review and meta-analysis

Russell, Clark D; Parajuli, Arun; Gale, Hugo; Bulteel, Naomi; Schuetz, Philipp; Jager, Cornelis P.C. de; Loonen, Anne J. M.; Μερεκούλιας, Γεώργιος; Baillie, J Kenneth

doi:10.1016/j.jinf.2019.02.006

Cited by 203 publications

(172 citation statements)

References 59 publications

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“…The neutrophil-to-lymphocyte ratio (NLR) can be calculated by dividing the absolute number of neutrophils by the absolute number of lymphocytes from a simple blood test. The NLR has been shown to be effective in predicting the prognosis of cancer 13 , cardiovascular disease 14 , and cerebrovascular disease 15 as well as infection 16 . In addition, a significant increase in NLR was reported in patients with Alzheimer's disease 17 , although its clinical importance has not yet been elucidated 18 .…”

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confidence: 99%

High neutrophil-to-lymphocyte ratio predicts short survival duration in amyotrophic lateral sclerosis

Choi

Hong

Kim

et al. 2020

Sci Rep

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the present study aimed to investigate the prognostic importance of the neutrophil-to-lymphocyte ratio (NLR) in patients with amyotrophic lateral sclerosis (ALS). Among 322 patients diagnosed as having definite, probable, or possible ALS at a single tertiary hospital, 194 patients were included in the final analysis. Patients were divided into three groups (T1, T2, and T3) according to the tertile of their NLR. Survival rate was significantly lower in T3 compared to the other groups (log-rank test; T1 vs. T3, p = 0.009; T2 vs. T3, p = 0.008). Median survival duration was 37. 0 (24.0-56.0), 32.5 (19.5-51.2), and 22.0 (17.0-38.0) months in T1, T2, and T3, respectively. In a multivariable Cox proportional hazards regression analysis, the hazard ratio of age at onset, bulbar-onset, and NLR (T3/T1) was 1. 04 (1.02-1.06, p < 0.001), 1.68 (1.10-2.57, p = 0.015), and 1.60 (1.01-2.51, p = 0.041), respectively. A high baseline NLR may serve as a useful indicator for short survival duration in patients with ALS.

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confidence: 99%

High neutrophil-to-lymphocyte ratio predicts short survival duration in amyotrophic lateral sclerosis

Choi

Hong

Kim

et al. 2020

Sci Rep

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“…In the present study, almost all patients who complained of respiratory symptoms, such as cough and dyspnea, were confirmed suffering varying degree of lung infection in high-resolution computed tomography. Theoretically, serum infectious indicators in these patients, like WBC and neutrophil/lymphocyte ratio (NLR), would increase [30].…”

Section: Discussionmentioning

confidence: 99%

AST/ALT ratio as a predictor of mortality and future exacerbations of PM/DM-ILD——a retrospective cohort study with 522 cases

Li¹,

Zhu²,

Wang³

et al. 2020

Preprint

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ObjectiveTo assess the associations between aspartate transaminase/alanine transaminase ratio (DRR) and mortality in patients with Polymyositis/dermatomyositis associated interstitial lung disease (PM/DM-ILD).Patients and MethodsThis was a retrospective cohort study, which included 522 patients with PM/DM-ILD whose DRR on admission were tested at West China Hospital of Sichuan University during the period from January 1, 2008 to December 31, 2018. Cox regression models were used to estimate hazard ratios for mortality in four predefined DRR strata (≤ 0.91, 0.91–1.26, 1.26–1.73 and > 1.73), after adjusting for age, sex, DRR stratum, diagnosis, overlap syndrome, hemoglobin, platelet count, white blood cell count, the percentage of neutrophils, neutrophil/lymphocyte ratio, albumin, creatine kinase, uric acid/creatinine ratio, triglycerides or low density lipoprotein.ResultsHigher DRR (> 1.73) was an independent predictor of 1-year mortality in multivariate Cox regression analysis (hazard ratio 3.423, 95% CI 1.481–7.911, p = .004). Patients with higher DRR more often required use of mechanical ventilation and readmission for acute exacerbation of PM/DM-ILD at 1-year follow-up.ConclusionHigher DRR on admission for PM/DM-ILD patients are associated with increased mortality, risk of mechanical ventilation and hospitalization in 1-year follow-up. This low-cost, easy-to-obtain, rapidly measured biomarker may be useful in the identification of high-risk PM/DM-ILD patients that could benefit from intensive management.

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“…Early detection of patients whose condition is likely to worsen may aid in delivering proper care and optimizing use of limited resources [2]. NLR of the peripheral blood is related to the systemic in ammatory state and disease activity and shows its prognostic value in cardiovascular diseases, autoimmune diseases, malignant tumors and infectious diseases [11][12][13][14], For patients with COVID-19, besides severe lung lesions, the prominent derangement of the lymph hematopoietic system was noted [15]. An elevated NLR may re ect the severity of the COVID-19 and the immune status of the patients.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Neutrophil to Lymphocyte Ratio for Disease Deterioration and Serious Adverse Outcomes in Patients with COVID-19: A Prospective Cohort Study

Zeng

Chen

2020

Preprint

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Background: Early identification of patients who are at high risk of poor clinical outcomes is of great important in saving lives for patients with the novel corona virus disease 2019 (COVID-19) in context of limited medical resources. Objective: To evaluate value of the neutrophil to lymphocyte ratio (NLR), calculated at hospital admission and in isolation, for prediction of the subsequent presence of disease aggravation and serious clinical outcomes (e.g., shock, death).Methods: We designed a prospective cohort study of 352 hospitalized patients with COVID-19 between January 9 and February 26, 2020 in Yichang city, Hubei province. Patients with a NLR equal to and higher than the cutoff value derived from the receiver operating characteristic curve method were classified as the exposure group. The primary outcome was disease deterioration, defined as promotion of clinical classifications of the disease during hospitalization (e.g., moderate to severe/critical; severe to critical,). The secondary outcomes were shock and death occurred during the treatment.Results: During the follow up, 51 (14.5%) patients’ condition deteriorated, 15 patients (4.3%) complicated septic shock, and 15 patients (4.3%) died. NLR was higher in patients with deterioration than those without (median: 5.33 vs. 2.14, P <0.001), as well as between patients with and without serious clinical outcomes (shock vs. no shock: 6.19 vs. 2.25, P <0.001; death vs. survival: 7.19 vs. 2.25, P <0.001). NLR measured at hospital admission had high value in predicting subsequent disease deterioration, shock and death (all the areas under the curve > 0.80). The sensitivity of ≥ 2.6937 for the NLR in predicting subsequent disease deterioration, shock and death were 82.0% (95% confidence interval, 69.0 to 91.0), 93.3% (68.0 to 100), and 92.9% (66.0 to 100); and the corresponding negative predictive values were 95.7% (93.0 to 99.2), 99.5% (98.6 to 100) and 99.5% (98.6 to 100), respectively. Conclusions: The NLR measured at admission and in isolation can be used to effectively predict subsequent presence of disease deterioration and serious clinical outcomes for patients with COVID-19.

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The utility of peripheral blood leucocyte ratios as biomarkers in infectious diseases: A systematic review and meta-analysis

Cited by 203 publications

References 59 publications

High neutrophil-to-lymphocyte ratio predicts short survival duration in amyotrophic lateral sclerosis

High neutrophil-to-lymphocyte ratio predicts short survival duration in amyotrophic lateral sclerosis

AST/ALT ratio as a predictor of mortality and future exacerbations of PM/DM-ILD——a retrospective cohort study with 522 cases

Predictive Value of Neutrophil to Lymphocyte Ratio for Disease Deterioration and Serious Adverse Outcomes in Patients with COVID-19: A Prospective Cohort Study

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