Assessing the Diagnostic Values of the Neutrophil-to-Lymphocyte Ratio (NLR) and Systematic Immunoinflammatory Index...

Area of Science:

• Hematology
• Infectious Diseases
• Biomarker Research

Background:

• COVID-19 presents unpredictable clinical trajectories, complicating the identification of high-risk patients.
• Predicting severe COVID-19 and mortality is crucial for effective clinical management.

Purpose of the Study:

• To evaluate and compare the diagnostic utility of the neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) as biomarkers for predicting COVID-19 severity, specifically mortality.
• To assess the predictive capabilities of NLR and SII in a Saudi Arabian patient cohort.

Main Methods:

• A multicentre comparative study involving 855 COVID-19 patients in Saudi Arabia.
• Descriptive and analytical statistics were employed to compare hematological indices between survivors and non-survivors.
• Receiver operating characteristic (ROC) curve analysis was used to determine the area under the curve (AUC) for NLR and SII.

Main Results:

• Non-survivors were significantly older and exhibited lower red blood cell counts, hemoglobin, and hematocrit levels compared to survivors.
• Significantly higher white blood cell and neutrophil counts were observed in non-survivors.
• Both NLR and SII were significantly higher in non-survivors, indicating their potential as severity markers. The NLR showed a larger AUC, suggesting superior discriminatory power.

Conclusions:

• The NLR and SII are valuable biomarkers for predicting COVID-19 severity and mortality.
• The NLR is more sensitive and specific than the SII in differentiating between survivors and non-survivors.
• Clinical guidelines should consider incorporating the NLR for improved COVID-19 patient management and risk stratification.