The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients

Ai-Ping Yang, Jian-Ping Liu, Wen-Qiang Tao, Hui-Ming Li, Ai-Ping Yang, Jian-Ping Liu, Wen-Qiang Tao, Hui-Ming Li

Abstract

Aim: To accumulate evidence that indicated the key role played by virus-triggered inflammation in the 2019-novel coronavirus disease (COVID-19) which emerged in Wuhan City and rapidly spread throughout China.

Methods: Age, neutrophil(NEU)-to-lymphocyte (LYM) ratio (NLR), lymphocyte-to-monocyte (MON) ratio, platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP) of 93 patients with laboratory confirmed COVID-19 were investigated and compared. The receiver operating characteristic curve was applied to determine the thresholds for five bio-markers, and their prognostic values were assessed via the Kaplan-Meier curve and multivariate COX regression models.

Results: The median age was 46.4 years old, and 37cases were females. A total of 27.8% of patients had been to Wuhan, and 73.1% had contacted with people from Wuhan. Fever (83.8%) and cough (70.9%) were the two most common symptoms. Elevated NLR and age were significantly associated with illness severity. The binary logistic analysis identified elevated NLR (hazard risk [HR] 2.46, 95% confidence interval [CI] 1.98-4.57) and age (HR 2.52, 95% CI 1.65-4.83) as independent factors for poor clinical outcome of COVID-19. NLR exhibited the largest area under the curve at 0.841, with the highest specificity (63.6%) and sensitivity (88%).

Conclusions: Elevated age and NLR can be considered independent biomarkers for indicating poor clinical outcomes.

Keywords: Age; COVID-19; Neutrophil-to-lymphocyte ratio; Platelet-to-LYM ratio; Predictive.

Conflict of interest statement

Declaration of Competing Interest The authors declared that there is no conflict of interest.

Copyright © 2020 Elsevier B.V. All rights reserved.

Figures

Fig. 1
Fig. 1
ROC curve used to distinguish patients with severe and non-severe COVID-19.
Fig. 2
Fig. 2
Kaplan–Meier curves of NLR for non-sever of COVID-19.
Fig. 3
Fig. 3
Kaplan–Meier curves of d-NLR for non-sever of COVID-19.
Fig. 4
Fig. 4
Kaplan–Meier curves of PLR for non-sever of COVID-19.

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