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Neutrophil/lymphocyte ratio-A marker of COVID-19 pneumonia severity.
Imran, Mehr Muhammad; Ahmad, Umair; Usman, Umer; Ali, Majid; Shaukat, Aamir; Gul, Noor.
  • Imran MM; Department of Pulmonology, District Headquarter Hospital, Faisalabad, Pakistan.
  • Ahmad U; Department of Medicine, Allied Hospital, Faisalabad, Pakistan.
  • Usman U; Medical Unit II, Faisalabad Medical University, Faisalabad, Pakistan.
  • Ali M; Department of Pulmonology, District Headquarter Hospital, Faisalabad, Pakistan.
  • Shaukat A; Medical Unit II, Faisalabad Medical University, Faisalabad, Pakistan.
  • Gul N; College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia.
Int J Clin Pract ; 75(4): e13698, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-744742
ABSTRACT

AIM:

To determine the efficacy of neutrophil/lymphocyte ratio (NLR) as a marker of the severity of COVID-19 pneumonia in the South-Asian population.

METHODS:

This was a prospective, cross-sectional, analytic study conducted at HDU/ICU of District Headquarter Hospital, Faisalabad, Pakistan, from May through July 2020. Sixty-three eligible patients, admitted to the HDU/ICU, were prospectively enrolled in the study. Their NLR, C-reactive protein, serum albumin and serum fibrinogen were measured. Patients' demographic characteristics, comorbidities, clinical manifestations of COVID-19 infection, medication use and history of lung malignancy were retrieved from their medical history. Patients were categorised into either a general group (with mild COVID-19) or a heavy group (with moderate to severe COVID-19).

RESULTS:

There were significant differences between the two groups in diabetes prevalence, NLR, C-reactive protein and serum albumin. NLR and C-reactive protein were positively correlated (P < .001, P = .04, respectively) whereas serum albumin was negatively correlated (P = .009) with severe COVID-19. NLR was found to be an independent risk factor for severe COVID-19 pneumonia in the heavy group (OR = 1.264, 95% CI 1.046~1.526, P = .015). The calculated AUC using ROC for NLR was 0.831, with an optimal limit of 4.795, sensitivity of 0.83 and specificity of 0.75, which is highly suggestive of NLR being a marker for the early detection of deteriorating severe COVID-19 infection.

CONCLUSION:

NLR can be used as an early warning signal for deteriorating severe COVID-19 infection and can provide an objective basis for early identification and management of severe COVID-19 pneumonia.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Lymphocytes / COVID-19 / Neutrophils Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: Asia Language: English Journal: Int J Clin Pract Journal subject: Medicine Year: 2021 Document Type: Article Affiliation country: Ijcp.13698

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Lymphocytes / COVID-19 / Neutrophils Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: Asia Language: English Journal: Int J Clin Pract Journal subject: Medicine Year: 2021 Document Type: Article Affiliation country: Ijcp.13698