scholarly journals Neutrophil-to-lymphocyte ratio (NLR) greater than 6.5 may reflect the progression of COVID-19 towards an unfavorable clinical outcome

2020 ◽  
Author(s):  
Ali Pirsalehi ◽  
Sina Salari ◽  
Ahmadreza Baghestani ◽  
Mohammad Vahidi ◽  
Laya Jalilian Khave ◽  
...  
Keyword(s):  
Intensive Care ◽  
Clinical Outcome ◽  
False Negative ◽  
Neutrophil To Lymphocyte Ratio ◽  
Molecular Testing ◽  
Gold Standard Method ◽  
Lymphocyte Ratio ◽  
Negative Results ◽  
Short Period ◽  
Unfavorable Clinical Outcome

Background and Objectives: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was first described during a pneumonia outbreak in Wuhan, has attracted tremendous attention in a short period of time as the death toll and the number of confirmed cases is growing unceasingly. Although molecular testing is the gold standard method of SARS-CoV-2 detection, the existence of the false-negative results presents a major limitation to this method. Materials and Methods: This retrospective Double-Centre study was conducted on 1320 COVID-19 patients recruited at Taleghani and Shohadae Tajrish Hospitals in Tehran, Iran. We analyzed the leukocyte, lymphocyte and neutrophil counts of hospitalized cases both on admission and at discharge. We also evaluated the alteration of these parameters within a seven-day follow-up. Results: Of the whole, 1077 (81.6%) neither were admitted to intensive care unit (ICU) nor experienced death, and were defined as the mild-moderate group. Of 243 severe cases, while 59 (24.3%) were admitted to ICU and cured with the intensive care services, 184 (75.7%) patients died of the disease, either with or without ICU admission. Calculation of neutrophil-to-lymphocyte ratio (NLR) revealed that the mild-moderate cases had a lower ratio at discharge. On the other hand, the ratio was significantly higher in the death group as compared to the ICU group; highlighting the fact that patients with a higher degree of neutrophilia and a greater level of lymphopenia have a poor prognosis. Conclusion: We suggest that NLR greater than 6.5 may reflect the progression of the disease towards an unfavorable clinical outcome, with this notion that the ratios higher than 9 may strongly result in death.

The elevated preoperative derived neutrophil-to-lymphocyte ratio predicts poor clinical outcome in breast cancer patients

Tumor Biology ◽  
2015 ◽  
Vol 37 (1) ◽  
pp. 361-368 ◽  
Author(s):  
Sabine Krenn-Pilko ◽  
Uwe Langsenlehner ◽  
Tatjana Stojakovic ◽  
Martin Pichler ◽  
Armin Gerger ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Outcome ◽  
Cancer Patients ◽  
Neutrophil To Lymphocyte Ratio ◽  
Breast Cancer Patients ◽  
Poor Clinical Outcome ◽  
Lymphocyte Ratio

scholarly journals Correlation of neutrophil-to-lymphocyte ratio and clinical outcome of acute thrombotic stroke in patients with COVID-19

Narra J ◽  
2021 ◽  
Vol 1 (3) ◽  
Author(s):  
Rizky Sarengat ◽  
Mohammad S. Islam ◽  
Mohammad S. Ardhi
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Acute Ischemic Stroke ◽  
National Institutes Of Health ◽  
Neutrophil To Lymphocyte Ratio ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Lymphocyte Ratio ◽  
Life Threatening ◽  
The Mean

The coronavirus disease 2019 (COVID-19) pandemic has caused millions of deaths worldwide. Acute ischemic stroke is a life-threatening risk factor for COVID-19 infection. Neutrophil-to-lymphocyte ratio (NLR) is one of the predictors of poor prognosis in acute ischemic stroke. The aim of this study was to assess the correlation between NLR values and the clinical outcome of acute thrombotic stroke patients with COVID-19 that was measured using the National Institutes of Health Stroke Scale (NIHSS). A cross-sectional hospital-based study was conducted in Dr. Soetomo General Hospital Surabaya, Indonesia. Patients with acute thrombotic stroke and COVID-19 admitted between 1 March 2020 and 31 May 2021 were recruited. The NLR values and the NIHSS scores were assessed during the admission and the correlation between NLR and NIHSS scores was calculated. This study included 21 patients with acute thrombotic stroke and COVID-19, consisting of 12 males and 9 females. The mean age was 57.6 years old. The mean NLR values was 8.33±6.7 and the NIHSS scores ranging from 1 to 33. Our data suggested a positive correlation between NLR values and NIHSS scores, r=0.45 with p=0.041. In conclusion, the NLR value is potentially to be used as a predictor of the clinical outcome in acute thrombotic stroke patients with COVID-19. However, further study is warranted to validate this finding.

scholarly journals The Predictive Role of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio on Intensive Care Unit Admission and Mortality of COVID-19 Patients in Iran

2021 ◽  
Author(s):  
Peiman Foroughi ◽  
Mojtaba Varshochi ◽  
Mehdi Hassanpour ◽  
Meisam Amini ◽  
Behnam Amini ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Risk Factor ◽  
Intensive Care ◽  
Independent Risk Factor ◽  
Multivariate Logistic Regression Analysis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Icu Admission ◽  
Inflammatory Index

Abstract Since the outbreak of COVID-19 several studies conducted to identify predictive factors which are associated with prognosis of COVID-19. In this study we aimed to determine whether the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) could help the clinicians to predict intensive care unit (ICU) admission and mortality of COVID-19 patients. This retrospective cohort study involved examining the medical records of 311 Iranian COVID-19 patients from 22 July 2020 to 22 August 2020. All characteristic data and laboratory results were recorded. The receiver operating characteristic (ROC) curve was used to identify the predictive value of studied parameters for ICU admission and death. Comparison of data revealed that some factors were jointly higher in non-survivors and ICU admitted patients than survivors and non-ICU admitted patients, such as: age, hemoglobin (HB), NLR, derived neutrophil-to-lymphocyte ratio (dNLR), PLR, systemic inflammatory index (SII), lactate dehydrogenase (LDH), Respiratory diseases, ischemic heart disease (IHD). Multivariate logistic regression analysis showed that only hypertension (OR 3.18, P=0.02) is an independent risk factor of death in COVID-19 patients, and also PLR (OR 1.02, P=0.05), hypertension (OR 4.00, P=0.002) and IHD (OR 5.15, P=0.008) were independent risk factor of ICU admission in COVID-19 patients. This study revealed that the NLR, PLR, platelet-to-white blood Cell ratio (PWR), dNLR and SII are valuable factors for predicting ICU admission and mortality of COVID-19 patients.

scholarly journals Clinical Performance of SARS-CoV-2 Molecular Tests

2020 ◽  
Vol 58 (8) ◽  
Author(s):  
Daniel A. Green ◽  
Jason Zucker ◽  
Lars F. Westblade ◽  
Susan Whittier ◽  
Hanna Rennert ◽  
...  
Keyword(s):  
Clinical Performance ◽  
Severe Disease ◽  
False Negative ◽  
Patient Specific ◽  
Molecular Testing ◽  
Repeat Testing ◽  
Initial Testing ◽  
Molecular Assays ◽  
Negative Results ◽  
Positive Results

ABSTRACT Molecular testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the gold standard for diagnosis of coronavirus disease 2019 (COVID-19), but the clinical performance of these tests is still poorly understood, particularly with regard to disease course, patient-specific factors, and viral shedding. From 10 March to 1 May 2020, NewYork-Presbyterian laboratories performed 27,377 SARS-CoV-2 molecular assays from 22,338 patients. Repeat testing was performed for 3,432 patients, of which 2,413 had initial negative and 802 had initial positive results. Repeat-tested patients were more likely to have severe disease and low viral loads. The negative predictive value of the first-day result among repeat-tested patients was 81.3% The clinical sensitivity of SARS-CoV-2 molecular assays was estimated between 58% and 96%, depending on the unknown number of false-negative results in single-tested patients. Conversion to negative was unlikely to occur before 15 to 20 days after initial testing or 20 to 30 days after the onset of symptoms, with 50% conversion occurring at 28 days after initial testing. Conversion from first-day negative to positive results increased linearly with each day of testing, reaching 25% probability in 20 days. Sixty patients fluctuated between positive and negative results over several weeks, suggesting that caution is needed when single-test results are acted upon. In summary, our study provides estimates of the clinical performance of SARS-CoV-2 molecular assays and suggests time frames for appropriate repeat testing, namely, 15 to 20 days after a positive test and the same day or next 2 days after a negative test for patients with high suspicion for COVID-19.

scholarly journals Prognostic value of rise in neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in predicting the mortality in paediatric intensive care

2019 ◽  
Vol 6 (3) ◽  
pp. 1052
Author(s):  
Siby Mathews ◽  
Aswathy Rajan ◽  
Santosh T. Soans
Keyword(s):  
Intensive Care ◽  
Prognostic Value ◽  
Demographic Data ◽  
Medical Science ◽  
Predictive Biomarkers ◽  
Pediatric Intensive Care ◽  
The Body ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio

Background: When the body is stressed in diverse pathological conditions, it responds by mounting an inflammatory response. Predictive biomarkers reflecting the response may serve as guide to management. Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio has been frequently used in adult patients as an indicator for mortality. However, no study has looked into their use within pediatric population. The objective of the study is to assess the prognostic value of rise in NLR and PLR in pediatric intensive care as markers of mortality.Methods: A retrospective study based on 3 year data from HIMS and G-HEALTH data systems of AJ Institute of Medical Science, of all patients admitted to PICU after excluding those in whom all the study parameters were not retrievable, were postoperative patients and/or stay was less than 5 days. NLR and PLR ratios were determined and compared to PELOD 2 using SPSS version 17.0.Results: The demographic data was matched. PELOD 2 (>20) predicted mortality in 72.2% of the patients, while NLR increase predicted in 61.1% and PLR increase in 77.8%. A decreasing trend in NLR and PLR were both closely related to better survival. Among the 3, Rise in PLR had higher sensitivity, specificity, PPV, NPV, and overall accuracy of 72.73% (p <0.001) to predict mortality.Conclusions: The study gives an insight into the fact that simple and inexpensive markers such as rise in NLR and PLR helps in predicting the mortality in the pediatric intensive care which is comparable to PELOD 2 score.

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