The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients

https://doi.org/10.1016/j.intimp.2020.106504Get rights and content

Highlights

  • The COVID-19 emerged in Wuhan City and rapidly spread throughout China.

  • NLR exhibited the largest area under the curve, with the highest specificity and sensitivity.

  • Elevated NLR can be considered independent biomarkers for indicating poor clinical outcomes.

Abstract

Aim

To accumulate evidence that indicated the key role played by virus-triggered inflammation in the 2019-novel coronavirus disease (COVID-19) which emerged in Wuhan City and rapidly spread throughout China.

Methods

Age, neutrophil(NEU)-to-lymphocyte (LYM) ratio (NLR), lymphocyte-to-monocyte (MON) ratio, platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP) of 93 patients with laboratory confirmed COVID-19 were investigated and compared. The receiver operating characteristic curve was applied to determine the thresholds for five bio-markers, and their prognostic values were assessed via the Kaplan–Meier curve and multivariate COX regression models.

Results

The median age was 46.4 years old, and 37cases were females. A total of 27.8% of patients had been to Wuhan, and 73.1% had contacted with people from Wuhan. Fever (83.8%) and cough (70.9%) were the two most common symptoms. Elevated NLR and age were significantly associated with illness severity. The binary logistic analysis identified elevated NLR (hazard risk [HR] 2.46, 95% confidence interval [CI] 1.98–4.57) and age (HR 2.52, 95% CI 1.65–4.83) as independent factors for poor clinical outcome of COVID-19. NLR exhibited the largest area under the curve at 0.841, with the highest specificity (63.6%) and sensitivity (88%).

Conclusions

Elevated age and NLR can be considered independent biomarkers for indicating poor clinical outcomes.

Keywords

COVID-19
Neutrophil-to-lymphocyte ratio
Platelet-to-LYM ratio
Predictive
Age

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