Can the neutrophil/lymphocyte ratio (NLR) have a role in the diagnosis of coronavirus 2019 disease (COVID-19)?

ABSTRACT

SUMMARY OBJECTIVE The present study aimed to investigate the role of neutrophil/lymphocyte ratio (NLR), an inflammation marker, complete blood count, and biochemical parameters in the diagnosis of COVID-19. METHODS A total of 80 patients who had been hospitalized in the internal medicine clinic were enrolled in the study. The cases were allocated into two groups, i.e., COVID (+) and (-), based on real-time reverse transcription-polymerase chain reaction. The demographic, clinical, and laboratory [NLR, platelet/lymphocyte ratio (PLR), complete blood count, biochemistry, and serology] data of the patients were retrospectively obtained from the hospital data management system. RESULTS NLR and fever levels were found to be higher in COVID-19 (+) cases (P=0.021, P=0.001, respectively). There was no difference between males and females with regard to COVID-19 positivity (P=0.527). Total bilirubin levels were found to be lower in COVID-19 (+) cases (P=0.040). When the ROC analysis was carried out for NLR in COVID-19 (+) cases, the AUC value was found to be 0.660 (P=0.021), sensitivity as 69.01 %, specificity as 65.40 %, LR+ 1.98 and LR- 0.48, PPV 80.43, and NPV 50.00, when the NLR was ≥2.4. The risk of COVID-19 was found to be 20.3-fold greater when NLR was ≥ 2.4 in the logistic regression (P=0.007). CONCLUSION NLR is an independent predictor for the diagnosis of COVID-19. We also found that fever and total bilirubin measurements could be useful for the diagnosis of COVID-19 in this population.

RESUMO

RESUMO OBJETIVO O objetivo do presente estudo foi investigar o papel da razão neutrófilos/linfócitos (RNL), um marcador de inflamação, hemograma completo e parâmetros bioquímicos no diagnóstico de COVID-19. MÉTODOS Um total de 80 pacientes internados na clínica médica foram incluídos no estudo. Os casos foram alocados em dois grupos, COVID (+) e (-), de acordo com a reação em cadeia da polimerase com transcrição reversa em tempo real. Os dados demográficos, clínicos e laboratoriais [NLR, relação plaquetas / linfócitos (PLR), hemograma completo, bioquímica e sorologia]) dos pacientes foram obtidos retrospectivamente no sistema de gerenciamento de dados hospitalares. RESULTADOS Os níveis de NLR e febre foram maiores nos casos de COVID-19 (+) (P = 0,021, P = 0,001,respectivamente). Não houve diferença entre homens e mulheres em relação à positividade para COVID-19 (P = 0,527). Os níveis totais de bilirrubina foram menores nos casos de COVID-19 (+) (P = 0,040). Quando a análise ROC foi realizada para NLR nos casos COVID-19 (+), o valor da AUC foi de 0,660 (P = 0,021), sensibilidade 69,01%, especificidade 65,40%, LR + 1,98 e LR- 0,48 , PPV 80,43 e NPV 50,00 quando o NLR era> 2,4. The risk of COVID-19 was found to be 20.3-fold greater when NLR was ≥ 2.4 in the logistic regression (P=0.007). CONCLUSÃO NLR é um preditor independente para o diagnóstico de COVID-19. Também concluímos que aferições de febre e bilirrubina total podem ser úteis para o diagnóstico de COVID-19 nesta população.