Article ; Online: Prognostic implications of neutrophil-lymphocyte ratio in COVID-19.
European journal of clinical investigation
2020 Volume 51, Issue 1, Page(s) e13404
Abstract: Background: The clinical presentation of COVID-19 ranges from a mild, self-limiting disease, to multiple organ failure and death. Most severe COVID-19 cases present low lymphocytes counts and high leukocytes counts, and accumulated evidence suggests ... ...
| Abstract | Background: The clinical presentation of COVID-19 ranges from a mild, self-limiting disease, to multiple organ failure and death. Most severe COVID-19 cases present low lymphocytes counts and high leukocytes counts, and accumulated evidence suggests that in a subgroup of patients presenting severe COVID-19, there may be a hyperinflammatory response driving a severe hypercytokinaemia which may be, at least in part, signalling the presence of an underlying endothelial dysfunction. In this context, available data suggest a prognostic role of neutrophil-lymphocyte ratio (NLR) in various inflammatory diseases and oncological processes. Following this rationale, we hypothesized that NLR, as a marker of endothelial dysfunction, may be useful in identifying patients with a poor prognosis in hospitalized COVID-19 cases. Design: A retrospective observational study performed at Hospital Universitario HM Puerta del Sur, Madrid, Spain, which included 119 patients with COVID-19 from 1 March to 31 March 2020. Patients were categorized according to WHO R&D Expert Group. Results: Forty-five (12.1%) patients experienced severe acute respiratory failure requiring respiratory support. Forty-seven (12.6%) patients died. Those with worse outcomes were older (P = .002) and presented significantly higher NLR at admission (P = .001), greater increase in Peak NLR (P < .001) and higher increasing speed of NLR (P = .003) compared with follow-up patients. In a multivariable logistic regression, age, cardiovascular disease and C-reactive protein at admission and Peak NLR were significantly associated with death. Conclusions: NLR is an easily measurable, available, cost-effective and reliable parameter, which continuous monitoring could be useful for the diagnosis and treatment of COVID-19. |
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| MeSH term(s) | Age Factors ; Aged ; Aged, 80 and over ; C-Reactive Protein/immunology ; COVID-19/blood ; COVID-19/immunology ; COVID-19/mortality ; Cardiovascular Diseases/epidemiology ; Comorbidity ; Diabetes Mellitus/epidemiology ; Endothelium, Vascular/physiopathology ; Female ; Hospital Mortality ; Humans ; Hypertension/epidemiology ; L-Lactate Dehydrogenase/blood ; Leukocyte Count ; Leukocytosis/blood ; Leukocytosis/immunology ; Logistic Models ; Lymphocyte Count ; Lymphocytes ; Lymphopenia/blood ; Lymphopenia/immunology ; Male ; Middle Aged ; Multivariate Analysis ; Neutrophils ; Prognosis ; Pulmonary Disease, Chronic Obstructive/epidemiology ; Retrospective Studies ; SARS-CoV-2 ; Severity of Illness Index ; Spain/epidemiology |
| Chemical Substances | C-Reactive Protein (9007-41-4) ; L-Lactate Dehydrogenase (EC 1.1.1.27) |
| Keywords | covid19 |
| Language | English |
| Publishing date | 2020-09-25 |
| Publishing country | England |
| Document type | Journal Article ; Observational Study |
| ZDB-ID | 186196-7 |
| ISSN | 1365-2362 ; 0014-2972 ; 0960-135X |
| ISSN (online) | 1365-2362 |
| ISSN | 0014-2972 ; 0960-135X |
| DOI | 10.1111/eci.13404 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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