scholarly journals Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio and Their Role as Predictors of Disease Severity of Coronavirus Disease 2019 (COVID-19)

2021 ◽  
Author(s):  
Rohit Jain ◽  
Arun Gopal ◽  
Basant Kumar Pathak ◽  
Sourya Sourabh Mohakuda ◽  
TVSVGK Tilak ◽  
...  
Keyword(s):  
Disease Severity ◽  
Complete Blood Count ◽  
Wide Spectrum ◽  
Statistical Significance ◽  
Severe Disease ◽  
Neutrophil To Lymphocyte Ratio ◽  
Screening Tools ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Time Of Admission

Abstract Context Due to the wide spectrum of clinical illness in coronavirus disease 2019 (COVID-19) patients, it is important to stratify patients into severe and nonsevere categories. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been evaluated rapidly by a few studies worldwide for its association with severe disease, but practically none have been conducted in the Indian population. This study was undertaken to examine the role of NLR and PLR in predicting severe disease in Indian patients. Objectives The objective was to study the association of NLR and PLR observed at the time of admission with maximum disease severity during hospitalization and to study their role in predicting disease severity. Material and Methods A total of 229 COVID-19 patients were admitted at the center during the study period. After applying inclusion and exclusion criteria, 191 patients were included in the study. The demographic, clinical, and laboratory (complete blood count, NLR, and PLR) data of all patients were obtained at the time of admission. Maximum disease severity of all patients was assessed during hospitalization. Statistical Analysis Chi-square and Mann–Whitney U tests were used to assess statistical significance. Receiver operating characteristic curve (ROC) was plotted for NLR and PLR to estimate the cutoff values and sensitivity and specificity using Youden’s index for predicting severe disease. Logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals. Results Mean NLR and PLR were significantly higher in severe patients (NLR = 7.41; PLR = 204) compared with nonsevere patients (NLR = 3.30; PLR = 121). ROC analysis showed that NLR, in comparison to PLR, had a higher area under the curve (AUC) of 0.779, with a larger OR of 1.237 and cutoff of 4.1, and showed 69% sensitivity and 78% specificity in predicting severe disease. Cut off for PLR was 115.3, which showed 79% sensitivity and 62% specificity in predicting severe disease. Conclusion NLR and PLR, both showing acceptable AUCs, can be used as screening tools to predict disease severity. However, NLR was a better predictor of disease severity.

scholarly journals Prognostic biomarkers in COVID-19 infection: value of anemia, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and D-dimer

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Maiada K. Hashem ◽  
Eman M. Khedr ◽  
Enas Daef ◽  
Aliae Mohamed-Hussein ◽  
Ehab F. Mostafa ◽  
...  
Keyword(s):  
Liver Enzymes ◽  
Significant Risk ◽  
Neutrophil To Lymphocyte Ratio ◽  
University Hospitals ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Icu Admission ◽  
Laboratory Biomarkers ◽  
Time Of Admission ◽  
D Dimer

Abstract Background Being highly infectious disease, COVID-19 exhausts most of efficient healthcare systems worldwide. Simple and rapid risk stratification methods are mandatory to recognize severe patients. This study aims to highlight the simple available laboratory biomarkers of good predictive value for COVID-19 severity. Results Three hundred fifty-one COVID-19 positive patients admitted to two University Hospitals between the 1st of June and the 31st of July 2020 were retrospectively collected and classified to severe and non-severe COVID-19 patients according to need for ICU admission. All basic laboratory biomarkers at time of admission were recorded. Of included patients, 145 (41.3%) needed ICU admission. Anemia, leukocytosis, lymphopenia, NLR, and PLR together with liver enzymes, INR, ferritin, CRP, and D-dimer were significantly higher in patients needed ICU admission (p < 0.001). However, by applying multivariate logistic regression, only anemia, high NLR, high PLR, and high D-dimer levels showed significant risk for ICU admission with OR equal 3.6 (95% CI 1.8–7.0), 9.0 (95% CI 3.6–22.6), 3.0 (95% CI 1.3–7.1), and 2.5 (95% CI 1.3–4.7), respectively. Conclusion Anemia, increased neutrophil-to-lymphocyte ratio (> 8), platelet-to-lymphocyte ratio (> 192), and D-dimer level (> 0.9 mg\L) at time of admission could be simple available predictors for severe COVID-19 infection requiring ICU admission.

Impact of preoperative neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) on overall survival or recurrence free survival in muscle-invasive bladder cancer at cystectomy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17050-e17050
Author(s):  
Scott Dawsey ◽  
Iris Yeong- Fung Sheng ◽  
Moshe Chaim Ornstein ◽  
Wei Wei ◽  
Byron H Lee ◽  
...  
Keyword(s):  
Overall Survival ◽  
Complete Blood Count ◽  
Cleveland Clinic ◽  
Neutrophil To Lymphocyte Ratio ◽  
Recurrence Free Survival ◽  
Platelet To Lymphocyte Ratio ◽  
Free Survival ◽  
Lymphocyte Ratio ◽  
Molecular Features ◽  
Markers Of Inflammation

e17050 Background: The role of Neutrophil to Lymphocyte Ratio (NLR) and Platelet to Lymphocyte Ratio (PLR) in prognostication of MIBC is not clearly understood. There is growing evidence that, as markers of inflammation, they may have prognostic utility in MIBC at radical cystectomy (RC). Methods: We performed a retrospective analysis of MIBC patients who underwent RC at the Cleveland Clinic from 2/2015 to 1/2018. 84 patients were identified who were either diagnosed with TaN0M0 treated with Neoadjuvant Chemotherapy (NAC) or T1-T4N0M0 disease treated with or without NAC. For NAC, 27 patients received gemcitabine and cisplatin, 2 patients received gemcitabine and carboplatin, 4 patients received unknown regimen, and 3 patients received MVAC. Of the patients, there were 1 with Ta, 34 with T1, 44 with T2, 1 with T3 and 4 with T4 disease. Complete Blood Count with Differential closest to or on the day of resection was used. NLR and PLR were calculated by dividing Absolute Neutrophil Count and Platelet Count by the Absolute Lymphocyte Count, respectively. PLR and NLR were dichotomized at the median. Outcomes were analyzed via Kruskal-Wallis test. Results: Median follow up of patients was 28.8 months. Median NLR and PLR were 15.7 and 263, respectively. Mean NLR and PLR were 18.9 and 310, respectively. NLR and PLR did not correlate with overall survival, recurrence free survival, T or N stage post resection, or pathological response. Females were found to have a higher NLR than males. Conclusions: Contrary to previous reports, our study did not find any prognostic value of NLR and PLR in MIBC patients at RC. Further evaluation of PLR and NLR in MIBC and correlation with molecular features may help understand its potential prognostic role in patients undergoing surgical resection.

Do platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) have a predictive value on pediatric extracorporeal membrane oxygenation (ECMO) results?

2021 ◽  
pp. 1-6
Author(s):  
Ergin Arslanoğlu ◽  
Nihat Çine ◽  
Kenan Abdurrahman Kara ◽  
Eylem Tunçer ◽  
Fatma Ukil Işıldak ◽  
...  
Keyword(s):  
Heart Surgery ◽  
Complete Blood Count ◽  
Blood Parameters ◽  
Congenital Heart Surgery ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Pediatric Heart Surgery ◽  
Prediction Of Mortality ◽  
Pediatric Cardiovascular Surgery

Abstract Background: It is difficult to predict the complications and prognosis of ECMO, which is gaining widespread use in patients with pediatric surgery. Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) are emerging inflammatory markers that can be calculated from complete blood count, which is a cheap and easily accessible laboratory analysis. The ratios between cellular elements in peripheral blood have been demonstrated to provide information on inflammation, infection, and immune response. Methods: Sixty-seven patients who needed ECMO application after undergoing pediatric cardiovascular surgery in our clinic, between May 2005 and April 2020, were included in this study. The age of patients varied between 4 days and 17 years with a mean of 30.59 ± 147.26 months. Results: The relationships between PLR or NLR values and various blood parameters and blood gas results were found to be statistically nonsignificant in our group of pediatric ECMO recipients. Even if the effect of PLR and NLR values on mortality and prognosis is statistically nonsignificant in patients who need ECMO after congenital heart surgery, PLR and NLR are typically elevated in the postoperative period. An increase in these values above a certain threshold may be a statistically significant indicator for the prediction of mortality. Conclusions: There are few studies in the literature concerning PLR and NLR values in patients with pediatric heart surgery. We consider this study will make way for new studies in the future.

scholarly journals Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio and Complete Blood Count Components in the First Trimester Do Not Predict HELLP Syndrome

Medicina ◽  
2019 ◽  
Vol 55 (6) ◽  
pp. 219 ◽  
Author(s):  
Giovanni Sisti ◽  
Andrea Faraci ◽  
Jessica Silva ◽  
Ruchi Upadhyay
Keyword(s):  
Hellp Syndrome ◽  
Blood Count ◽  
Complete Blood Count ◽  
First Trimester ◽  
Neutrophil To Lymphocyte Ratio ◽  
Sudden Increase ◽  
Care Hospital ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Elevated Liver Enzymes

Background and Objectives: Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), and other components of the routine complete blood count (CBC) were found to be sensitive biomarkers of preeclampsia and other inflammatory obstetric conditions in previous studies, with conflicting results. We speculated that the same associations existed with hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome in the first trimester of pregnancy. Materials and Methods: We conducted a retrospective case–control study at a tertiary care hospital in NY (USA), in the time frame between January 2016 and December 2018. Our population consisted of pregnant women in the first trimester: We compared patients with HELLP syndrome (cases) with healthy patients (controls) matched by age, body mass index (BMI), parity, and race. Patients with preeclampsia, infection, and fever were excluded. Venous blood samples were obtained as part of the routine work-up during the first prenatal visit in the first trimester, which includes a CBC. The main outcomes were NLR and PLR, and the secondary outcomes were hemoglobin, RDW, platelet count, MPV, neutrophils, and lymphocytes. Results: There were 10 patients in each group. There were no differences in NLR and PLR levels and other CBC components between the two groups. Conclusions: In our study NLR, PLR, and other CBC components did not predict HELLP syndrome. We speculate that HELLP syndrome has a sudden increase of tissue inflammation in the third trimester that is not manifested during the early phases of placentation. Larger studies are needed to evaluate the true ability of NLR, PLR, and CBC components to predict HELLP syndrome in the first trimester.

Investigation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume in patients with tinnitus

2018 ◽  
Vol 132 (2) ◽  
pp. 129-132 ◽  
Author(s):  
B Ulusoy ◽  
K Bozdemir ◽  
M Akyol ◽  
H İ Mişe ◽  
A Kutluhan ◽  
...  
Keyword(s):  
Mean Platelet Volume ◽  
Statistical Significance ◽  
Neutrophil To Lymphocyte Ratio ◽  
Control Group ◽  
Platelet Distribution Width ◽  
Platelet Volume ◽  
Platelet To Lymphocyte Ratio ◽  
Distribution Width ◽  
Significance Level ◽  
Lymphocyte Ratio

AbstractObjective:This study aimed to evaluate patients with tinnitus in terms of mean platelet volume and platelet distribution width, and to explore neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio, recently reported in the literature as being possible inflammation markers.Methods:This study comprised 64 tinnitus patients and 64 age-matched healthy controls. Statistical significance level was accepted as p < 0.05.Results:Mean platelet volume (t = 3.245, p = 0.002) and platelet distribution width (Z = 3.945, p < 0.001) were significantly higher in the patient group than the control group.Conclusion:The results suggest that a prothrombotic condition might play a role in the pathophysiology of tinnitus.

scholarly journals Platelet-to-Lymphocyte Ratio and Neutrophil-to-Lymphocyte Ratio Predict Mucosal Disease Severity in Ulcerative Colitis

2018 ◽  
Vol 37 (2) ◽  
pp. 155-162 ◽  
Author(s):  
Muhammet Yener Akpinar ◽  
Yasemin Ozderin Ozin ◽  
Mustafa Kaplan ◽  
Ihsan Ates ◽  
Ismail Hakki Kalkan ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
High Risk ◽  
Disease Severity ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Mucosal Disease ◽  
Cutoff Values ◽  
Risk Patients ◽  
Active Disease

SummaryBackground:We investigated the sensitivity of neutrophil to lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), as well as a combination of NLR and PLR to predict endoscopic disease severity based on mucosal assessment in ulcerative colitis (UC).Methods:The study group consisted 104 patients with active UC, 104 patients in remission, and 105 healthy individuals. Disease activity was described with Rachmilewitz endoscopic activity index (EAI). Curve analysis was used to determine the optimal cutoff values of NLR and PLR for obtaining remission. The patients with both PLR and NLR values higher than the cutoff values were coded as »high risk,« those with one parameter higher were coded as »moderate risk«, those with both parameters lower than the cutoff values were coded as »low-risk« patients.Results:The mean NLR and PLR values in the endoscopically active disease group were higher than the others, with higher values in the endoscopic remission group compared with the control group (p<0.001). Rachmilewitz EAI in high-risk patients was significantly higher than that in others (p<0.001). In Cox regression analyses, moderate and high risk, high erythrocyte sedimentation rate and high EAI were found as independent predictors of endoscopic active disease.Conclusions:This is the first study that investigated the use of NLR and PLR combination to assess endoscopic disease severity in UC. Either high NLR or PLR levels can predict active endoscopic disease. However, the use of these parameters in combination is more accurate in evaluating mucosal disease and inflammation in UC.

Correlation between neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume with severity of carditis in children with rheumatic fever

2021 ◽  
pp. 1-5
Author(s):  
I Gusti Ayu D. Aryani ◽  
Ni Putu V. K. Yantie ◽  
Eka Gunawijaya ◽  
I Wayan Gustawan
Keyword(s):  
Rheumatic Fever ◽  
Mean Platelet Volume ◽  
Complete Blood Count ◽  
Neutrophil To Lymphocyte Ratio ◽  
Diagnostic Study ◽  
Strong Positive Correlation ◽  
Platelet Volume ◽  
Platelet To Lymphocyte Ratio ◽  
Positive Correlation ◽  
Lymphocyte Ratio

Abstract Background: The most serious manifestation of rheumatic fever is carditis, as it can lead to chronic rheumatic heart disease. Neutrophil-to-lymphocyte ratio, platelet-to lymphocyte ratio and mean platelet volume have been accepted as novel indicators of the continuing inflammation that is correlated with the severity of valvular involvement in patients with rheumatic carditis. Objective: As a diagnostic study to investigate the correlation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume with the severity of carditis in children with rheumatic fever. Methods: This was a cross-sectional study at Sanglah Hospital, Bali. Data were collected retrospectively from medical records. Severity of carditis was characterised by a clinical, audible murmur during physical examination and demonstration of valvular involvement by echocardiography. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and mean platelet volume were calculated from complete blood count. The correlation between parameters was assessed using Spearman’s correlation tests. Results: From January 2018 to December 2020, we found 45 cases admitted to Sanglah Hospital. Carditis was present in 40 (88.9%) subjects. Neutrophil-to-lymphocyte ratio had a strong positive correlation with severity of carditis (r = 0.66, p = 0.001), while platelet-to-lymphocyte ratio had a weak positive correlation with the severity of carditis (r = 0.23, p = 0.13) and mean platelet volume had a very weak negative correlation with the severity of carditis (r = −0.01, p = 0.95). Using a cut-off of 3.4, neutrophil-to-lymphocyte ratio predicted severe carditis with a sensitivity of 81.8% and specificity of 91.3%. Conclusion: There was a positive correlation between neutrophil-to-lymphocyte ratio and severity of carditis in children with rheumatic fever. Neutrophil-to-lymphocyte ratio might be used as a diagnostic tool to predict the diagnosis of carditis severity.

scholarly journals NEUTROPHIL TO LYMPHOCYTE RATIO VS PLATELETS TO LYMPHOCYTE RATIO: BIOMARKERS TO PREDICT SEVERITY OF DISEASE AND THEIR COMPARISON IN PATIENTS OF COVID-19

2020 ◽  
Vol 70 (6) ◽  
pp. 1609-15
Author(s):  
Muhammad Adil ◽  
Zahid Farooq Baig ◽  
Muhammad Amir ◽  
Sohail Saqib Chatha ◽  
Aamir Habib ◽  
...  
Keyword(s):  
Virus Disease ◽  
Severe Disease ◽  
Area Under The Curve ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Severity Of Disease ◽  
Significant Area ◽  
Polymerase Chain ◽  
Complete Blood Counts

Objective: To determine and compare Neutrophil to Lymphocyte Ratio (NLR) and Platelet to Lymphocyte Ratio (PLR) in predicting severity of disease in patients with COVID-19. Study design: Descriptive comparative study. Place and Duration of study:  Department of Medicine, CMH Thal from April to July, 2020 Patients & Methods: 61 patients of COVID-19 confirmed through polymerase chain reaction were recruited and divided into severe and non severe disease. Complete blood counts were done. Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio were calculated and analyzed. Results: 14 patients (23%) of severe disease had mean age of 49.93±19.42 and 47 patients (77%) with non-severe disease had mean age of 33.32±9.16. The mean Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte ratio in patients who had severe disease was 7.20±4.20 and 204.25±148.42 (p=0.001 and p=0.026) respectively. The diagnostic performance of both Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio produced statistically significant area under the curve (AUC), (p <0.001). The adjusted and unadjusted area under curve for Neutrophil to Lymphocyte Ratio was 0.92 (95% CI: 0.85–1.00) and 0.923 (95% CI: 0.839-1.000) and for Platelet to Lymphocyte Ratio it was 0.883 (95% CI: 0.781–0.985) and 0.825(95% CI:  0.707-0.943) respectively.  Conclusion: Elevated Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio are independent biomarkers which predict severity of disease in COVID-19 patients with Neutrophil to Lymphocyte Ratio being better predictor in terms of diagnostic accuracy.  Keywords: Corona virus disease 2019 (COVID‐19), Neutrophil to Lymphocyte ratio, Platelet to Lymphocyte ratio

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