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Prognostic value of neutrophil-to-lymphocyte ratio in COVID-19 patients: A systematic review and meta-analysis.
Ulloque-Badaracco, Juan R; Ivan Salas-Tello, W; Al-Kassab-Córdova, Ali; Alarcón-Braga, Esteban A; Benites-Zapata, Vicente A; Maguiña, Jorge L; Hernandez, Adrian V.
  • Ulloque-Badaracco JR; Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
  • Ivan Salas-Tello W; Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
  • Al-Kassab-Córdova A; Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
  • Alarcón-Braga EA; Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
  • Benites-Zapata VA; Vicerrectorado de Investigación Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru.
  • Maguiña JL; Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
  • Hernandez AV; Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, EsSalud, Lima, Peru.
Int J Clin Pract ; 75(11): e14596, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1297678
ABSTRACT

BACKGROUND:

Neutrophil-to-lymphocyte ratio (NLR) is an accessible and widely used biomarker. NLR may be used as an early marker of poor prognosis in patients with COVID-19.

OBJECTIVE:

To evaluate the prognostic value of the NLR in patients diagnosed with COVID-19.

METHODS:

We conducted a systematic review and meta-analysis. Observational studies that reported the association between baseline NLR values (ie, at hospital admission) and severity or all-cause mortality in COVID-19 patients were included. The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS). Random effects models and inverse variance method were used for meta-analyses. The effects were expressed as odds ratios (ORs) and their 95% confidence intervals (CIs). Small study effects were assessed with the Egger's test.

RESULTS:

We analysed 61 studies (n = 15 522 patients), 58 cohorts, and 3 case-control studies. An increase of one unit of NLR was associated with higher odds of severity (OR 6.22; 95%CI 4.93 to 7.84; P < .001) and higher odds of all-cause mortality (OR 12.6; 95%CI 6.88 to 23.06; P < .001). In our sensitivity analysis, we found that 41 studies with low risk of bias and moderate heterogeneity (I2  = 53% and 58%) maintained strong association between NLR values and both outcomes (severity OR 5.36; 95% CI 4.45 to 6.45; P < .001; mortality OR 10.42 95% CI 7.73 to 14.06; P = .005).

CONCLUSIONS:

Higher values of NLR were associated with severity and all-cause mortality in hospitalised COVID-19 patients.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Neutrophils Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Int J Clin Pract Journal subject: Medicine Year: 2021 Document Type: Article Affiliation country: Ijcp.14596

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Neutrophils Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Int J Clin Pract Journal subject: Medicine Year: 2021 Document Type: Article Affiliation country: Ijcp.14596