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Neutrophil-to-Lymphocyte and Platelet Ratio (N/LP Ratio), a Reliable Criterion for Predicting In-Hospital Mortality

Jafar Mohammadshahi1, Hassan Ghobadi2, Afshan Shargi3

  • 1Department of Infectious Diseases and Tropical Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.

Mediators of Inflammation
|January 6, 2025
PubMed

Insights

The neutrophil-to-lymphocyte and platelet ratio (N/LP ratio) effectively predicts mortality in hospitalized COVID-19 patients. This inflammatory marker demonstrated significant associations with survival outcomes in both men and women.

Area of Science:

  • Hematology
  • Immunology
  • Infectious Diseases

Background:

  • Systemic inflammatory markers like NLR, MLR, PLR, dNLR, N/LP ratio, AISI, SIRI, and SII are crucial for assessing inflammatory disease severity and prognosis.
  • These markers are increasingly recognized for their role in predicting outcomes for various conditions, including infections.

Purpose of the Study:

  • To evaluate the impact of systemic inflammatory markers on mortality prediction in male and female patients hospitalized with SARS-CoV-2 infection.
  • To identify reliable predictors of COVID-19 mortality.

Main Methods:

  • Retrospective analysis of laboratory parameters from 2007 COVID-19 patients (1145 men, 862 women).
  • Receiver operating characteristic (ROC) analysis to assess marker capability in differentiating COVID-19 severity.
  • Kaplan-Meier curves to determine survival probability, with death as the endpoint.
  • Univariate analysis for Charlson Comorbidity Index (CCI) and adjustments for confounding factors.

Main Results:

  • Higher values of adjusted-NLR, adjusted-MLR, N/LP ratio, adjusted-dNLR, adjusted-AISI, adjusted-SII, and adjusted-SIRI were observed in non-survivors compared to survivors.
  • Multivariate Cox regression revealed a significant association between survival and the N/LP ratio in men (HR=1.564, p<0.01) and women (HR=1.745, p<0.01).
  • Adjusted-SII was also significantly associated with survival in women (HR=6.855, p<0.05).

Conclusions:

  • The neutrophil-to-lymphocyte and platelet ratio (N/LP ratio) is a reliable predictor of mortality in both men and women with COVID-19.
  • Systemic inflammatory markers, particularly the N/LP ratio, offer valuable prognostic information for COVID-19 patients.

Keywords:
COVID-19coronavirussex differencesystemic inflammation indices

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