scholarly journals Can the neutrophil/lymphocyte ratio (NLR) have a role in the diagnosis of coronavirus 2019 disease (COVID-19)?

2020 ◽  
Vol 66 (6) ◽  
pp. 746-751 ◽  
Author(s):  
Ahmet Nalbant ◽  
Tezcan Kaya ◽  
Ceyhun Varim ◽  
Selçuk Yaylaci ◽  
Ali Tamer ◽  
...  
Keyword(s):  
Blood Count ◽  
Total Bilirubin ◽  
Complete Blood Count ◽  
Data Management System ◽  
Hospital Data ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Auc Value ◽  
Internal Medicine Clinic

SUMMARY OBJECTIVE The present study aimed to investigate the role of neutrophil/lymphocyte ratio (NLR), an inflammation marker, complete blood count, and biochemical parameters in the diagnosis of COVID-19. METHODS A total of 80 patients who had been hospitalized in the internal medicine clinic were enrolled in the study. The cases were allocated into two groups, i.e., COVID (+) and (-), based on real-time reverse transcription-polymerase chain reaction. The demographic, clinical, and laboratory [NLR, platelet/lymphocyte ratio (PLR), complete blood count, biochemistry, and serology] data of the patients were retrospectively obtained from the hospital data management system. RESULTS NLR and fever levels were found to be higher in COVID-19 (+) cases (P=0.021, P=0.001, respectively). There was no difference between males and females with regard to COVID-19 positivity (P=0.527). Total bilirubin levels were found to be lower in COVID-19 (+) cases (P=0.040). When the ROC analysis was carried out for NLR in COVID-19 (+) cases, the AUC value was found to be 0.660 (P=0.021), sensitivity as 69.01 %, specificity as 65.40 %, LR+: 1.98 and LR- : 0.48, PPV: 80.43, and NPV: 50.00, when the NLR was ≥2.4. The risk of COVID-19 was found to be 20.3-fold greater when NLR was ≥ 2.4 in the logistic regression (P=0.007). CONCLUSION NLR is an independent predictor for the diagnosis of COVID-19. We also found that fever and total bilirubin measurements could be useful for the diagnosis of COVID-19 in this population.

scholarly journals Relationship Between Preoperative Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios in the Probable Diagnosis of Malignant or Borderline Ovarian Tumors

2021 ◽  
Author(s):  
Tae Hui Yoon ◽  
Eun Byeol Cho ◽  
Ki Ho Seol ◽  
Jung Min Ryu ◽  
Youn Seok Choi
Keyword(s):  
Odds Ratio ◽  
Blood Count ◽  
Complete Blood Count ◽  
Ovarian Tumors ◽  
Imaging Diagnosis ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Borderline Ovarian Tumors ◽  
Benign Ovarian Tumors ◽  
Probable Diagnosis

Abstract Background: The purpose of this study was to investigate whether neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) can be supplementary tools to differentiate benign, borderline, and malignant ovarian tumors.Methods: This retrospective study reviewed the postoperative histopathology in patients with ovarian tumors (220 benign, 59 borderline, and 228 malignant). White blood cell, platelet, neutrophil and lymphocyte counts, percentage of neutrophils and lymphocytes, calculated NLR and PLR were analyzed between groups using complete blood count tests performed before surgery. Results: The platelet count and PLR in borderline ovarian tumors tended to be statistically close to benign ovarian tumors, while the neutrophil and lymphocyte count, NLR tended to be statistically close to malignancy. The diagnostic cut-off value of NLR for differentiating between benign and borderline was 2.42, PLR for differentiating between borderline and malignancy was 140.96. When the NLR was 2.4 or higher, the odds ratio of borderline or malignant risk was 3.264. In the case of PLR, 140 or higher, the odds ratio of malignancy was 1.916. When both PLR and NLR were above each cut-off, the sensitivity of malignancy diagnosis was 51.5%, specificity was 77.0%. Conclusions: In the case of borderline ovarian tumors, the NLR was higher than benign and similarly tend to malignancy, but the PLR was lower than malignancy and similarly tend to benign. We suggest that the NLR and PLR can be used as a supplementary tool for diagnosing benign, borderline, and malignant ovarian tumors in addition to imaging diagnosis and tumor markers such as CA125.

Parameters of Complete Blood Count Might Predict the Prognosis of Patients with Advanced Gastric Cancer

2021 ◽  
Author(s):  
Osman Sutcuoglu ◽  
Abdülkadir Fincan ◽  
Fatih Gürler ◽  
Bediz Kurt İnci ◽  
Nuriye Özdemir ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Advanced Gastric Cancer ◽  
Blood Count ◽  
Complete Blood Count ◽  
Independent Predictor ◽  
Common Disease ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Disease Prognosis ◽  
The Relationship

Abstract PurposeMetastatic gastric cancer is a common disease with poor prognosis. In this common disease, estimating the prognosis with a simple complete blood count has attracted the attention in many studies. However, the results of the studies are incompatible with each other. The aim of the study was to evaluate the relationship between parameters of the complete blood count and disease prognosis in patients with advanced gastric cancer(AGC).MethodsBetween 2009 and May 2019, the files of patients with AGC were retrospectively evaluated. Blood counts of the patients were examined before receiving any treatment at the time of diagnosis of AGC. All parameters derived from complete blood count and defined in literature were evaluated in this study. These were; Neutrophil lymphocyte ratio(NLR), platelet lymphocyte ratio(PLR), monocyte lymphocyte ratio(MLR), systemic immune-inflammation index(SII), hemoglobin, lymphocyte, platelet. The patients were divided in two subgroups according to the median values of NLR, PLR, MLR and SII.ResultsA total of 105 patients with AGC were included in the study. The median survival in the patients with low NLR group was 14.6 months compared with high NLR group was 7.9 months (p=0.008). In low PLR and MLR group the median survivals were 12.7 and 14.6 months compared with high PLR and MLR were 8.2 and 7.9 months respectively (p=0.019, p=0.06). There was no significant relationship with SII (p=0.375). Multivariate analysis showed that NLR was an independent predictor of overall survival.ConclusionThrough the parameters derived from complete blood count, NLR appears to be a promising prognostic marker in patients with AGC.

Comparison of hematological parameters and perinatal outcomes between COVID-19 pregnancies and healthy pregnancy cohort

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Esin Merve Erol Koç ◽  
Rahime Bedir Fındık ◽  
Hatice Akkaya ◽  
Işılay Karadağ ◽  
Eda Özden Tokalıoğlu ◽  
...  
Keyword(s):  
Complete Blood Count ◽  
Perinatal Outcomes ◽  
Control Group ◽  
Strong Positive Correlation ◽  
Monocyte Count ◽  
Distribution Width ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Significant Difference ◽  
Adverse Perinatal Outcomes

AbstractObjectivesTo evaluate the relationship between Coronavirus Disease 2019 (COVID-19) in pregnancy and adverse perinatal outcomes. The secondary aim is to analyze the diagnostic value of hematologic parameters in COVID-19 complicated pregnancies.MethodsThe current study is conducted in a high volume tertiary obstetrics center burdened by COVID-19 pandemics, in Turkey. In this cohort study, perinatal outcomes and complete blood count indices performed at the time of admission of 39 pregnancies (Study group) complicated by COVID-19 were compared with 69 uncomplicated pregnancies (Control group).ResultsThere was no significant difference between the obstetric and neonatal outcomes of pregnancies with COVID-19 compared to data of healthy pregnancies, except the increased C-section rate (p=0.026). Monocyte count, red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) were significantly increased (p<0.0001, p=0.009, p=0.043, p<0.0001, respectively) whereas the MPV and plateletcrit were significantly decreased (p=0.001, p=0.008) in pregnants with COVID-19. ROC analysis revealed that the optimal cut-off value for MLR was 0.354 which indicated 96.7% specificity and 59.5% sensitivity in diagnosis of pregnant women with COVID-19. A strong positive correlation was found between the MLR and the presence of cough symptom (r=41.4, p=<0.0001).ConclusionsThe study revealed that, pregnancies complicated by COVID-19 is not related with adverse perinatal outcomes. MLR may serve as a supportive diagnostic parameter together with the Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) in assessment of COVID-19 in pregnant cohort.

scholarly journals Can Hematological Parameters Play a Role in the Differential Diagnosis of Adrenal Tumors?

Uro ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 39-44
Author(s):  
Mehmet Gürkan Arıkan ◽  
Göktan Altuğ Öz ◽  
Nur Gülce İşkan ◽  
Necdet Süt ◽  
İlkan Yüksel ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Inflammatory Markers ◽  
Blood Count ◽  
Complete Blood Count ◽  
Low Cost ◽  
Easy Access ◽  
Adrenal Tumors ◽  
Tumor Diameter ◽  
Lymphocyte Ratio ◽  
Significant Difference

There have been few studies reported with conflicting results in the use of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), redcell-distribution-width (RDW), etc. for predicting prognosis and differential diagnosis of adrenal tumors. The aim of this study is to investigate the role of inflammatory markers through a complete blood count, which is an easy access low-cost method, for the differential diagnosis of adrenocortical adenoma (ACA), adrenocortical carcinoma (ACC), and pheochromocytoma. The data of patients who underwent adrenalectomy between the years of 2010–2020 were retrospectively analyzed. Systemic hematologic inflammatory markers based on a complete blood count such as neutrophil ratio (NR), lymphocyte ratio (LR), NLR, PLR, RDW, mean platelet volume (MPV), and maximum tumor diameter (MTD) were compared between the groups. A statistically significant difference was found between the three groups in terms of PLR, RDW, and MTD. With post-hoc tests, a statistically significant difference was found in PLR and MTD between the ACA and ACC groups. A statistically significant difference was found between the ACA and pheochromocytoma groups in PLR and RDW values. In conclusion, it could be possible to plan a more accurate medical and surgical approach using PLR and RDW, which are easily calculated through an easy access low-cost method such as a complete blood count, together with MTD in the differential diagnosis of ACC, ACA, and pheochromocytoma.

Immature granulocyte and other hematological inflammatory parameters in patients with migraine headache

2021 ◽  
pp. 101-104
Keyword(s):  
Complete Blood Count ◽  
Control Group ◽  
Age And Gender ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Inflammatory Parameters ◽  
Group Data ◽  
Healthy Control ◽  
Immature Granulocyte ◽  
And Gender

Background: Today, many hypotheses have been proposed in the pathogenesis of migraine. The inflammatory hypothesis is one of them. The immature granulocyte count (IGC) is also an inflammatory parameter which importance has been understood recently. There are no studies evaluating IGC in migraine. The aim of the study to investigate the levels of IGC and other hematological inflammatory parameters in migraine. Material and Method: Materials and Methods: Forty-eight patients diagnosed with migraine who applied to Kastamonu Training and Research Hospital Neurology outpatient clinic between 07.01.2020 and 10.01.2021 were included in the study. 42 people with similar age and gender distribution were included for the control group. Data on laboratory tests, age and gender of patients were obtained from the hospital Laboratory Information System (LIS). CBC parameters of the patients at the first admission and before any treatment, calculated with an automated hematological analyzer (XN-1000-Hematology-analyzer-Sysmex Corporation, Japan) were analyzed. Using Complete Blood Count (CBC) data, neutrophil count (NEUT#), neutrophil percentage (NEUT%), lymphocyte percentage (LYMPH%), and IGC were recorded. Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and systemic immune inflammation index (SII) values were calculated with the formula. Results: In our study, NLR and IGC was significantly higher than the healthy control group (p=0.002, p=0.025). PLR was also found to be high, but it was not statistically significant (p=0.063). Conclusion: The significantly higher NLR and IGC levels in migraine patients compared to the healthy controls support the role of inflammation in etiopathogenesis.

The role of coinfection with influenza viruses in the pathogenesis of severe infection in patients with COVID-19

2021 ◽  
Vol 21 (3) ◽  
pp. 159-164
Author(s):  
Tamara N. Shvedova ◽  
Olga S. Kopteva ◽  
Polina A. Kudar ◽  
Anna A. Lerner ◽  
Yuliya A. Desheva
Keyword(s):  
Influenza A ◽  
Fold Increase ◽  
Igg Antibodies ◽  
C Reactive Protein ◽  
S Protein ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Coronavirus Infection

BACKGROUND: Despite the continuing global spread of the coronavirus infection COVID-19 caused by the SARS-CoV-2 coronavirus, the mechanisms of the pathogenesis of severe infections remain poorly understood. The role of comorbidity with other seasonal viral infections, including influenza, in the pathogenesis of the severe course of COVID-19 remains unclear. MATERIALS AND METHODS: The present study used sera left over from ongoing laboratory studies of patients with varying degrees of severity of COVID-19. The study was approved by the Local Ethics Committee of the Federal State Budgetary Scientific Institution IEM (protocol 3/20 from 06/05/2020). We studied 28 paired samples obtained upon admission of patients to the hospital and after 57 days of hospital stay. Paired sera of patients with COVID-19 were tested for antibodies to influenza A and B viruses. The presence of IgG antibodies specific to the SARS-CoV-2 spike (S) protein was studied using an enzyme-linked immunosorbent assay (ELISA). The serum concentration of C-reactive protein and the neutrophil-lymphocyte ratio on the day of hospitalization were also assessed. RESULTS: At least a 4-fold increase in serum IgG antibodies to SARS-CoV-2 S protein was found both in patients with PCR-confirmed SARS-CoV-2 infection and without PCR confirmation. It was shown that out of 18 patients with moderate and severe forms of COVID-19 infection, six of them showed at least a 4-fold increase in antibodies to influenza A/H1N1, in one to influenza A/H3N2 and in two cases to the influenza B. Laboratory data in these two groups were characterized by significant increases in serum C-reactive protein and neutrophil-lymphocyte ratio concentrations compared with the moderate COVID-19 group. CONCLUSIONS: Serological diagnostics can additionally detect cases of coronavirus infection when the virus was not detected by PCR. In moderate and severe cases of COVID-19, coinfections with influenza A and B viruses have been identified. The results obtained confirm the need for anti-influenza immunization during the SARS-CoV-2 pandemic. Influenza virus screening can significantly improve patient management because recommended antiviral drugs (neuraminidase inhibitors) are available.

Prediction of Troponin elevation in Non- ST Acute Coronary Syndrome Patients presenting to The Emergency Department Using Neutrophil-lymphocyte ratio

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Sarah Mohamed Mahmoud ◽  
Bassam Sobhy ◽  
Ramy Raymond
Keyword(s):  
Emergency Department ◽  
Acute Coronary Syndrome ◽  
Complete Blood Count ◽  
P Value ◽  
Troponin Elevation ◽  
Positive Group ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Coronary Syndrome

Abstract Background The neutrophil–lymphocyte ratio (NLR) is considered an independent predictor of mortality and myocardial infarction (MI) in stable coronary artery disease (SCAD). Also NLR have prognostic value in patients with acute coronary syndromes (ACSs). However the diagnostic power of NLR in patients suspected of ACS is still under study Objective is to determine the ability of neutrophil-lymphocyte ratio to predict troponin elevation in patients presenting to emergency department with acute coronary syndrome Material and Methods From June 2018 to March 2019, 100 patients were enrolled who presented to the ER with NST-ACS. Patients were divided into 2 groups based upon the troponin positivity in the 12- to 24-hour follow-up. Baseline Complete blood count with calculation of NLR is done Results The study population was divided into 2 groups: troponin- negative group (n = 50) and troponin-positive group (n = 50). Mean age was 55.8 ± 11.3. 77% of the patients were male. No significance difference in the level of hemoglobin, WBCs and platelets between the 2 groups. The neutrophil count was significantly higher in the troponin-positive group (p &lt; 0.001). The median admission. NLR was significantly higher in the troponin-positive group (2 vs. 3.9, P &lt; 0.001). A cutoff point of 3.4 for NLR measured on admission had 84% sensitivity and 84% specificity in predicting follow-up troponin positivity. A highly significant correlation was found between NLR and level of troponin change (p value &lt;0.01) Conclusion NLR can be used as a diagnostic tool in the differentiation of patients with acute coronary syndrome. NLR is a non-expensive, simple and available parameter that can be used in diagnosis of NSTEMI.

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