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C-reactive protein and neutrophil-lymphocyte ratio as predictors of mortality in coronavirus disease 2019
Hasan Ergenç1, Zeynep Ergenç1, Muharrem Dog An2
1Ayancik State Hospital, Department of Internal Medicine - Sinop, Turkey.
Insights
Neutrophil-lymphocyte ratio and C-reactive protein levels are elevated in non-survivors of COVID-19. These biomarkers, particularly C-reactive protein, show potential for predicting COVID-19 mortality.
Area of Science:
- Hematology
- Immunology
- Infectious Diseases
Background:
- COVID-19 poses a significant global health threat.
- Identifying reliable biomarkers for predicting COVID-19 mortality is crucial for patient management.
- Inflammatory markers and blood cell ratios are being investigated for their prognostic value.
Purpose of the Study:
- To evaluate the predictive value of C-reactive protein (CRP), platelet-lymphocyte ratio (PLR), and neutrophil-lymphocyte ratio (NLR) for mortality in COVID-19 patients.
- To determine if these markers can serve as effective biomarkers for COVID-19 fatality.
Main Methods:
- Retrospective analysis of 635 COVID-19 patients.
- Patients were categorized into survived and non-survived groups.
- Comparison of demographic data, CRP, PLR, and NLR between the groups.
Main Results:
- Higher levels of neutrophils, CRP, and NLR were observed in non-survivors (p=0.000).
- Age was also a significant factor differentiating survival groups (p=0.000).
- PLR showed a non-significant trend towards higher levels in non-survivors (p=0.42).
Conclusions:
- NLR and CRP are significantly elevated in non-survivors and can be effective biomarkers for predicting COVID-19 fatality.
- CRP demonstrates potential as an independent biomarker for predicting COVID-19 death, irrespective of age and gender.
- These findings highlight the utility of routine blood tests in assessing COVID-19 prognosis.
Objective:
This study investigates whether C-reactive protein, platelet-lymphocyte ratio, and neutrophil-lymphocyte ratio could be useful to predict mortality in COVID-19.
Methods:
Data of 635 patients with COVID-19 followed up in Sinop Ataturk State Hospital from February to May 2020 were evaluated retrospectively. Diagnosis of COVID-19 was made according to the interim guidance of the World Health Organization. Patients were grouped into two groups based on mortality as survived and non-survived patients. Age, gender, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and C-reactive protein of the groups were investigated and compared.
Results:
The mean age of the participants was 55.8±22.3 years. Among the patients, 584 survived and 51 patients died. Age was significantly different between the groups, 54.2±22.3 in the survived group and 75.6±11.1 in the dead group (p=0.000). In addition, neutrophil, C-reactive protein, and neutrophil-lymphocyte ratio values were significantly higher in the dead group (p=0.000). platelet-lymphocyte ratio was slightly higher in the dead group, but this difference was not significant (p=0.42). The area under the curve values for age, lymphocyte, platelet, C-reactive protein, and neutrophil-lymphocyte ratio are 0.797, 0.424, 0.485, 0.778, and 0.729, respectively.
Conclusions:
Our results showed that neutrophil-lymphocyte ratio and C-reactive protein are significantly higher in patients leading to death and could be effective biomarkers in predicting COVID-19 fatality. Furthermore, C-reactive protein could be used as an independent biomarker to predict death in patients with COVID-19, regardless of gender and age (p=0.000).
