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Usefulness of the neutrophil-to-lymphocyte ratio in predicting the severity of COVID-19 patients: a retrospective cohort study
Yilmaz, Erdal; Ak, Rohat; Doganay, Fatih.
  • Yilmaz, Erdal; Kartal Dr. Lütfi Kirdar Sehir Hastanesi. Department of Emergency Medicine. Istanbul. TR
  • Ak, Rohat; Kartal Dr. Lütfi Kirdar Sehir Hastanesi. Department of Emergency Medicine. Istanbul. TR
  • Doganay, Fatih; Edremit Devlet Hastanesi. Department of Emergency Medicine. Balikesir. TR
São Paulo med. j ; 140(1): 81-86, Jan.-Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1357470
ABSTRACT
ABSTRACT

BACKGROUND:

Quick and accurate identification of critically ill patients ensures appropriate and correct use of medical resources. In situations that threaten public health, like pandemics, rapid and effective methods are needed for early disease detection among critically ill patients.

OBJECTIVE:

To determine the relationship between the neutrophil-to-lymphocyte ratio (NLR) of coronavirus disease-19 (COVID-19) patients upon admission to the emergency department (ED) and these patients' prognosis. DESIGN AND

SETTING:

Retrospective cohort study among COVID-19 patients in the ED of a tertiary-level hospital.

METHODS:

Data on patients' age, gender, vital signs, chronic diseases, laboratory tests and clinical outcomes were collected from electronic medical records. Receiver operating characteristic (ROC) curve analysis was performed. The area under the curve (AUC) was used to assess the accuracy of NLR for predicting in-hospital mortality risk and intensive care unit (ICU) requirement. The Youden J index (YJI) was used to determine optimal threshold values.

RESULTS:

1,175 patients were included. Their median age was 63 years (IQR, 48-75). With an NLR cutoff value of 5.14, the sensitivity, specificity, PPV, AUC and YJI for ICU requirement were calculated as 77.87%, 74.08%, 92.4%, 0.811 and 0.5194, respectively. With the same cutoff value, the sensitivity, specificity, AUC and YJI for in-hospital mortality were 77.27%, 75.82%, 0.815 and 0.5309, respectively. In addition, advanced age, leukocytosis, anemia and lymphopenia were found to be associated with poor prognosis.

CONCLUSION:

The NLR, which is a widely available simple parameter, can provide rapid insights regarding early recognition of critical illness and prognosis among COVID-19 patients.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: COVID-19 Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Humans Language: English Journal: São Paulo med. j Journal subject: Cirurgia Geral / Ciˆncia / Ginecologia / Medicine / Medicina Interna / Obstetr¡cia / Pediatria / Sa£de Mental / Sa£de P£blica Year: 2022 Type: Article Affiliation country: Turkey Institution/Affiliation country: Edremit Devlet Hastanesi/TR / Kartal Dr. Lütfi Kirdar Sehir Hastanesi/TR

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Full text: Available Index: LILACS (Americas) Main subject: COVID-19 Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Humans Language: English Journal: São Paulo med. j Journal subject: Cirurgia Geral / Ciˆncia / Ginecologia / Medicine / Medicina Interna / Obstetr¡cia / Pediatria / Sa£de Mental / Sa£de P£blica Year: 2022 Type: Article Affiliation country: Turkey Institution/Affiliation country: Edremit Devlet Hastanesi/TR / Kartal Dr. Lütfi Kirdar Sehir Hastanesi/TR