scholarly journals Predictive value of the neutrophil to lymphocyte ratio for disease deterioration and serious adverse outcomes in patients with COVID-19: a prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhi-Yong Zeng ◽  
Shao-Dan Feng ◽  
Gong-Ping Chen ◽  
Jiang-Nan Wu
Keyword(s):  
Cohort Study ◽  
Hospital Admission ◽  
Clinical Outcomes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Characteristic Curve ◽  
Adverse Outcomes ◽  
Neutrophil To Lymphocyte Ratio ◽  
Predictive Values ◽  
Lymphocyte Ratio

Abstract Background Early identification of patients who are at high risk of poor clinical outcomes is of great importance in saving the lives of patients with novel coronavirus disease 2019 (COVID-19) in the context of limited medical resources. Objective To evaluate the value of the neutrophil to lymphocyte ratio (NLR), calculated at hospital admission and in isolation, for the prediction of the subsequent presence of disease progression and serious clinical outcomes (e.g., shock, death). Methods We designed a prospective cohort study of 352 hospitalized patients with COVID-19 between January 9 and February 26, 2020, in Yichang City, Hubei Province. Patients with an NLR equal to or higher than the cutoff value derived from the receiver operating characteristic curve method were classified as the exposed group. The primary outcome was disease deterioration, defined as an increase of the clinical disease severity classification during hospitalization (e.g., moderate to severe/critical; severe to critical). The secondary outcomes were shock and death during the treatment. Results During the follow-up period, 51 (14.5%) patients’ conditions deteriorated, 15 patients (4.3%) had complicated septic shock, and 15 patients (4.3%) died. The NLR was higher in patients with deterioration than in those without deterioration (median: 5.33 vs. 2.14, P < 0.001), and higher in patients with serious clinical outcomes than in those without serious clinical outcomes (shock vs. no shock: 6.19 vs. 2.25, P < 0.001; death vs. survival: 7.19 vs. 2.25, P < 0.001). The NLR measured at hospital admission had high value in predicting subsequent disease deterioration, shock and death (all the areas under the curve > 0.80). The sensitivity of an NLR ≥ 2.6937 for predicting subsequent disease deterioration, shock and death was 82.0% (95% confidence interval, 69.0 to 91.0), 93.3% (68.0 to 100), and 92.9% (66.0 to 100), and the corresponding negative predictive values were 95.7% (93.0 to 99.2), 99.5% (98.6 to 100) and 99.5% (98.6 to 100), respectively. Conclusions The NLR measured at admission and in isolation can be used to effectively predict the subsequent presence of disease deterioration and serious clinical outcomes in patients with COVID-19.

scholarly journals Predictive value of the neutrophil to lymphocyte ratio for disease deterioration and serious adverse outcomes in patients with COVID-19: a prospective cohort study

2021 ◽  
Author(s):  
Zhi-Yong Zeng ◽  
Shao-Dan Feng ◽  
Gong-Ping Chen ◽  
Jiang-Nan Wu
Keyword(s):  
Cohort Study ◽  
Hospital Admission ◽  
Clinical Outcomes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Characteristic Curve ◽  
Adverse Outcomes ◽  
Neutrophil To Lymphocyte Ratio ◽  
Predictive Values ◽  
Lymphocyte Ratio

Abstract Background: Early identification of patients who are at high risk of poor clinical outcomes is of great importance in saving the lives of patients with novel coronavirus disease 2019 (COVID-19) in the context of limited medical resources.Objective: To evaluate the value of the neutrophil to lymphocyte ratio (NLR), calculated at hospital admission and in isolation, for the prediction of the subsequent presence of disease progression and serious clinical outcomes (e.g., shock, death).Methods: We designed a prospective cohort study of 352 hospitalized patients with COVID-19 between January 9 and February 26, 2020, in Yichang City, Hubei Province. Patients with an NLR equal to or higher than the cutoff value derived from the receiver operating characteristic curve method were classified as the exposed group. The primary outcome was disease deterioration, defined as an increase of the clinical disease severity classification during hospitalization (e.g., moderate to severe/critical; severe to critical). The secondary outcomes were shock and death during the treatment.Results: During the follow-up period, 51 (14.5%) patients’ conditions deteriorated, 15 patients (4.3%) had complicated septic shock, and 15 patients (4.3%) died. The NLR was higher in patients with deterioration than in those without deterioration (median: 5.33 vs. 2.14, P <0.001), and higher in patients with serious clinical outcomes than in those without serious clinical outcomes (shock vs. no shock: 6.19 vs. 2.25, P <0.001; death vs. survival: 7.19 vs. 2.25, P <0.001). The NLR measured at hospital admission had high value in predicting subsequent disease deterioration, shock and death (all the areas under the curve > 0.80). The sensitivity of an NLR ≥ 2.6937 for predicting subsequent disease deterioration, shock and death was 82.0% (95% confidence interval, 69.0 to 91.0), 93.3% (68.0 to 100), and 92.9% (66.0 to 100), and the corresponding negative predictive values were 95.7% (93.0 to 99.2), 99.5% (98.6 to 100) and 99.5% (98.6 to 100), respectively.Conclusions: The NLR measured at admission and in isolation can be used to effectively predict the subsequent presence of disease deterioration and serious clinical outcomes in patients with COVID-19.

scholarly journals Predictive value of the neutrophil to lymphocyte ratio for disease deterioration and serious adverse outcomes in patients with COVID-19: a prospective cohort study

2020 ◽  
Author(s):  
Zhi-Yong Zeng ◽  
Shao-Dan Feng ◽  
Gong-Ping Chen ◽  
Jiang-Nan Wu
Keyword(s):  
Cohort Study ◽  
Hospital Admission ◽  
Clinical Outcomes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Characteristic Curve ◽  
Adverse Outcomes ◽  
Neutrophil To Lymphocyte Ratio ◽  
Predictive Values ◽  
Lymphocyte Ratio

Abstract Background: Early identification of patients who are at high risk of poor clinical outcomes is of great importance in saving the lives of patients with novel coronavirus disease 2019 (COVID-19) in the context of limited medical resources.Objective: To evaluate the value of the neutrophil to lymphocyte ratio (NLR), calculated at hospital admission and in isolation, for the prediction of the subsequent presence of disease progression and serious clinical outcomes (e.g., shock, death).Methods: We designed a prospective cohort study of 352 hospitalized patients with COVID-19 between January 9 and February 26, 2020, in Yichang City, Hubei Province. Patients with an NLR equal to or higher than the cutoff value derived from the receiver operating characteristic curve method were classified as the exposed group. The primary outcome was disease deterioration, defined as an increase of the clinical disease severity classification during hospitalization (e.g., moderate to severe/critical; severe to critical). The secondary outcomes were shock and death during the treatment.Results: During the follow-up period, 51 (14.5%) patients’ conditions deteriorated, 15 patients (4.3%) had complicated septic shock, and 15 patients (4.3%) died. The NLR was higher in patients with deterioration than in those without deterioration (median: 5.33 vs. 2.14, P <0.001), and higher in patients with serious clinical outcomes than in those without serious clinical outcomes (shock vs. no shock: 6.19 vs. 2.25, P <0.001; death vs. survival: 7.19 vs. 2.25, P <0.001). The NLR measured at hospital admission had high value in predicting subsequent disease deterioration, shock and death (all the areas under the curve > 0.80). The sensitivity of an NLR ≥ 2.6937 for predicting subsequent disease deterioration, shock and death was 82.0% (95% confidence interval, 69.0 to 91.0), 93.3% (68.0 to 100), and 92.9% (66.0 to 100), and the corresponding negative predictive values were 95.7% (93.0 to 99.2), 99.5% (98.6 to 100) and 99.5% (98.6 to 100), respectively.Conclusions: The NLR measured at admission and in isolation can be used to effectively predict the subsequent presence of disease deterioration and serious clinical outcomes in patients with COVID-19.

scholarly journals Predictive Value of Neutrophil to Lymphocyte Ratio for Disease Deterioration and Serious Adverse Outcomes in Patients with COVID-19: A Prospective Cohort Study

2020 ◽  
Author(s):  
Zhi-Yong Zeng ◽  
Gong-Ping Chen ◽  
Jiang-Nan Wu
Keyword(s):  
Cohort Study ◽  
Hospital Admission ◽  
Clinical Outcomes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Virus Disease ◽  
Adverse Outcomes ◽  
Neutrophil To Lymphocyte Ratio ◽  
Predictive Values ◽  
Lymphocyte Ratio

Abstract Background: Early identification of patients who are at high risk of poor clinical outcomes is of great important in saving lives for patients with the novel corona virus disease 2019 (COVID-19) in context of limited medical resources. Objective: To evaluate value of the neutrophil to lymphocyte ratio (NLR), calculated at hospital admission and in isolation, for prediction of the subsequent presence of disease aggravation and serious clinical outcomes (e.g., shock, death).Methods: We designed a prospective cohort study of 352 hospitalized patients with COVID-19 between January 9 and February 26, 2020 in Yichang city, Hubei province. Patients with a NLR equal to and higher than the cutoff value derived from the receiver operating characteristic curve method were classified as the exposure group. The primary outcome was disease deterioration, defined as promotion of clinical classifications of the disease during hospitalization (e.g., moderate to severe/critical; severe to critical,). The secondary outcomes were shock and death occurred during the treatment.Results: During the follow up, 51 (14.5%) patients’ condition deteriorated, 15 patients (4.3%) complicated septic shock, and 15 patients (4.3%) died. NLR was higher in patients with deterioration than those without (median: 5.33 vs. 2.14, P <0.001), as well as between patients with and without serious clinical outcomes (shock vs. no shock: 6.19 vs. 2.25, P <0.001; death vs. survival: 7.19 vs. 2.25, P <0.001). NLR measured at hospital admission had high value in predicting subsequent disease deterioration, shock and death (all the areas under the curve > 0.80). The sensitivity of ≥ 2.6937 for the NLR in predicting subsequent disease deterioration, shock and death were 82.0% (95% confidence interval, 69.0 to 91.0), 93.3% (68.0 to 100), and 92.9% (66.0 to 100); and the corresponding negative predictive values were 95.7% (93.0 to 99.2), 99.5% (98.6 to 100) and 99.5% (98.6 to 100), respectively. Conclusions: The NLR measured at admission and in isolation can be used to effectively predict subsequent presence of disease deterioration and serious clinical outcomes for patients with COVID-19.

scholarly journals Optimal cut-off for neutrophil-to-lymphocyte ratio: Fact or Fantasy? A prospective cohort study in metastatic cancer patients

PLoS ONE ◽  
2018 ◽  
Vol 13 (4) ◽  
pp. e0195042 ◽  
Author(s):  
Yann-Alexandre Vano ◽  
Stéphane Oudard ◽  
Marie-Agnès By ◽  
Pauline Têtu ◽  
Constance Thibault ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cancer Patients ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Metastatic Cancer ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio

scholarly journals Albumin and CRP, Which is the Best Biomarker for Postoperative Complications on Colorectal Surgery? Prospective Cohort Study

2021 ◽  
Author(s):  
Miguel Fernandes Cunha ◽  
Beatriz Mendes ◽  
Pedro Mendanha ◽  
Ines Miguel ◽  
Juan Rachadell ◽  
...  
Keyword(s):  
Cohort Study ◽  
Postoperative Complications ◽  
Colorectal Surgery ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Characteristic Curve ◽  
Univariate Analysis ◽  
Predictive Marker ◽  
Elective Colorectal Surgery ◽  
Predictive Values

Abstract Aim Our purpose was to investigate the potential role of albumin variation in comparison to C-reactive protein (CRP) variation as a predictive marker for postoperative complications in colorectal surgery. Methods An prospective cohort study was conducted. Adult patients who underwent elective colorectal surgery between January 2019 and December 2020 were eligible. Serum levels of albumin and CRP were measured preoperatively and on the first 4 postoperative days. Univariate analysis were performed to assess the association of albumin (Alb) and CRP with postoperative complications. Serum albumin variation (ΔAlb) and CRP variation (ΔCRP) were calculated. Receiver operating characteristic curve analysis and the Youden test were used to determine acuity and predictive cut-off values. Results Ninety-three patients were included. A CRP cut-off of 83.4 mg/dL on postoperative day (POD) 4 was the best predictor of postoperative global complications (p<0.001; AUC 0.83, 70% sensitivity, 91% specificity). Major complications were best correlated with ΔAlb on POD 2, 3 and 4 (p<0.001), with a ΔAlb cut-off of 27.4% on POD 2 showing the strongest association with this outcome (AUC 0.834, 83% sensitivity, 90% specificity). Regarding anastomotic leak, CRP on POD 3 showed better predictive values (p=0.037; AUC 0.792) with a cut-off value of 88.7 mg/dL (100% sensitivity, 52% specificity). Discussion Herein, the authors demonstrate there is a role for albumin variation, as an earlier and sensitive marker, to predict major postoperative complications in colorectal surgery. This analysis may be further applied to aid in the early identification of significant causes of re-operation and long-term morbimortality.

scholarly journals Prenatal Sociodemographic Factors Predicting Maltreatment of Children up to 3 Years Old: A Prospective Cohort Study Using Administrative Data in Japan

2021 ◽  
Vol 18 (5) ◽  
pp. 2505
Author(s):  
Aya Isumi ◽  
Kunihiko Takahashi ◽  
Takeo Fujiwara
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Child Maltreatment ◽  
Survey Data ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Characteristic Curve ◽  
Risk Scores ◽  
Prenatal Risk ◽  
Prenatal Risk Factors

Identifying risk factors from pregnancy is essential for preventing child maltreatment. However, few studies have explored prenatal risk factors assessed at pregnancy registration. This study aimed to identify prenatal risk factors for child maltreatment during the first three years of life using population-level survey data from pregnancy notification forms. This prospective cohort study targeted all mothers and their infants enrolled for a 3- to 4-month-old health check between October 2013 and February 2014 in five municipalities in Aichi Prefecture, Japan, and followed them until the child turned 3 years old. Administrative records of registration with Regional Councils for Children Requiring Care (RCCRC), which is suggestive of child maltreatment cases, were linked with survey data from pregnancy notification forms registered at municipalities (n = 893). Exact logistic regression was used for analysis. A total of 11 children (1.2%) were registered with RCCRC by 3 years of age. Unmarried marital status, history of artificial abortion, and smoking during pregnancy were significantly associated with child maltreatment. Prenatal risk scores calculated as the sum of these prenatal risk factors, ranging from 0 to 7, showed high predictive power (area under receiver operating characteristic curve 0.805; 95% confidence interval (CI), 0.660–0.950) at a cut-off score of 2 (sensitivity = 72.7%, specificity = 83.2%). These findings suggest that variables from pregnancy notification forms may be predictors of the risk for child maltreatment by the age of three.

Sign in / Sign up

Export Citation Format

Share Document