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Prognostic Value of Neutrophil/Lymphocyte, Lymphocyte/C-reactive protein, Platelet/ Lymphocyte Rates in Covid-19
Nurbanu Sezak1, Banu Karaca2, Recep Balik3
1Department of Infectious Disease and Clinical Microbiology, Izmir Democracy University Faculty of Medicine, Izmir, Turkiye.
Insights
High neutrophil-to-lymphocyte ratio (NLR) and low lymphocyte-to-C-reactive protein ratio (LCR) can predict mortality in intensive care unit (ICU) patients with COVID-19. These markers may help identify high-risk patients early.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Hematology
Background:
- COVID-19 poses a significant mortality risk, yet prognostic indicators remain under-investigated.
- Identifying early warning signs is crucial for managing critically ill patients.
Purpose of the Study:
- To evaluate the prognostic value of neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-C-reactive protein ratio (LCR), and platelet-to-lymphocyte ratio (PLR) in predicting mortality among intensive care unit (ICU) patients with COVID-19.
Main Methods:
- A retrospective study of 222 ICU patients with COVID-19.
- Analysis of demographic data, comorbidities, laboratory parameters, and clinical outcomes.
- Evaluation of NLR, LCR, and PLR as predictors of mortality, including univariate and multivariate analyses.
Main Results:
- The overall mortality rate was 57.65%.
- Higher SOFA scores, obesity, oxygen therapy, and invasive mechanical ventilation were associated with mortality.
- Patients with lung involvement >50% and low lymphocyte counts showed higher NLR and lower LCR (P=.001).
- Multivariate analysis indicated PLR was independently associated with mortality.
Conclusions:
- Elevated NLR and decreased LCR at ICU admission may serve as early indicators of mortality risk in COVID-19 patients.
- These hematological ratios can aid clinicians in identifying high-risk individuals for timely intervention.
Abstract:
Coronavirus 2019 (COVID-19) infection has a significant mortality rate. Despite the disease's extensive effects, little is known about the prognostic indicators that can be used. We aimed to assess the prognostic value of neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-C-reactive protein ratio (LCR) and platelet-to- lymphocyte ratio (PLR) in predicting mortality of intensive care unit (ICU) patients. Demographic data, underlying diseases, laboratory parameters were evaluated. The study included 222 cases. The mortality rate was 57.65%. No significant differences in terms of sex, age, or underlying disease were observed between the two groups with and without mortality. Obesity, oxygen therapy, invasive mechanical ventilation (IMV) rates and high SOFA (Sequential Organ Failure Assessment) scores were found to be significantly higher in the group with a mortal course. The mortality rate was significantly higher in patients with lung involvement over 50%, with a low lymphocyte count at ICU admission. In this patient group, NLR was found to be higher, and LCR was found to be lower (P = .001). Although there was no significant difference in PLR between the two groups in univariate analysis, multivariate analysis revealed that PLR was independently associated with mortality. High NLR and low LCR values at ICU admission might serve as early warning signs for healthcare providers, allowing them to identify patients at higher risk of mortality.
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