Prognostic value of neutrophil-to-lymphocyte ratio, lactate dehydrogenase, D-dimer, and computed tomography score in patients with coronavirus disease 2019

Abstract Background To explore the significance of neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), D-dimer and CT score in evaluating the severity and prognosis of coronavirus disease – 2019 (COVID-19). Methods Patients with laboratory confirmed COVID-19 were retrospectively enrolled. The baseline data, laboratory findings, chest computed tomography (CT) results evaluating by CT score on admission, and clinical outcomes were collected and compared. The logistic regression was used to assess the independent relationship between the baseline level of four indicators (NLR, LDH, D-dimer, CT score) and the severity of COVID-19. Results Among 432 patients, 125 (28.94%) cases were divided into severe group, the remaining (n = 307, 71.06%) were in non-severe group. In multivariate logistic regression, high level of NLR, LDH were independent predictor of the severe group in COVID-19 (OR = 2.163; 95%CI = 1.162–4.026; p = 0.015 for NLR > 3.82; OR = 2.298; 95%CI = 1.327–3.979; p = 0.003 for LDH > 246U/L). Combining NLR > 3.82 and LDH > 246U/L increased the sensitivity of diagnosis in severe patients (NLR > 3.82 [50.40%] vs. Combined diagnosis [72.80%]; p = 0.0007; LDH > 246 [59.2%] vs. Combined diagnosis [72.80%]; p < 0.0001). Conclusions High levels of NLR and LDH in serum have potential value in the early identification of severe patients with COVID-19. The combination of LDH and NLR can improve the sensitivity of diagnosis.

Download Full-text

Evaluation of the prognostic value of the neutrophil to lymphocyte ratio, lactate dehydrogenase enzyme, and proteinuria in patients with acute pancreatitis admitted at Assiut University Hospitals and its correlation with Ranson’s criteria scoring system

The Egyptian Journal of Internal Medicine ◽

10.1186/s43162-020-00001-4 ◽

2020 ◽

Vol 32 (1) ◽

Author(s):

Lobna Abdel-wahid Ahmed ◽

Abd-Alla Ismail Ali Kelani ◽

Fady Refaat Edwar Nasr-Allah

Keyword(s):

Acute Pancreatitis ◽

Intensive Care ◽

Lactate Dehydrogenase ◽

Scoring System ◽

Prognostic Value ◽

Neutrophil To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Dehydrogenase Enzyme ◽

The Mean ◽

Time Of Admission

Abstract Background Acute pancreatitis is a relatively common acute medical presentation that may progress beyond the pancreas to cause multi-organ failure or death. It is associated with high morbidity and mortality with mortality rates changing little in the past few decades despite advances in intensive care and surgical management. Early evaluation of acute pancreatitis severity is essential to allow the clinician to predict the patient’s clinical course, estimate the prognosis, determine the need for intensive care unit admission, and prevent complications. So, the purpose of our study is to evaluate the prognostic value of the neutrophil to lymphocyte ratio, lactate dehydrogenase enzyme, and proteinuria in patients with acute pancreatitis and its correlation with Ranson’s criteria scoring system as new, rapid, and easy parameters to predict severity of acute pancreatitis. Results The mean age of patients in years was 47.97, and the median was 52 with a range of ages between 18 and 87; 38% of the patients included were males, and 61% were females. The mean Ranson’s score was 2.77 ± 1.4, and the median was 3 with a range of 0–6; 44.5% of patients included have low severity, 42.4% have mild severity, and 13.1% of patients have high severity. Neutrophil to lymphocyte ratio both at the time of admission and after 48 h of admission was significantly increasing with an increase in disease severity with a P value of < 0.001 that was statistically significant. Lactate dehydrogenase enzyme at the time of admission was also significantly increasing with diseased severity with a P value of 0.001 that was statistically significant and the same for lactate dehydrogenase enzyme level after 48 h of admission with a P value of 0.002 that was also statistically significant. Proteinuria is positive only in 15.2% of patients and with the same result after 48 h of admission. Conclusion The neutrophil to lymphocyte ratio gives a rapid impression of the extent of the inflammatory process, and it can effectively predict severity at the time of admission and even after 48 h of admission and can also differentiate between patients with mild and severe acute pancreatitis in both calcular and non-calcular cause-dependent acute pancreatitis patients. Lactate dehydrogenase can be used to predict severity in calcular cause-dependent acute pancreatitis patients only at the time of admission and after 48 h of admission. Proteinuria in urine analysis on admission and after 48 h does not seem to be a reliable predictor for disease severity in acute pancreatitis.

Download Full-text

The Prognostic Value of the Serum Levels of Brain Natriuretic Peptide, Troponin I, and D-Dimer, in Addition to the Neutrophil-to-Lymphocyte Ratio, for the Disease Evaluation of Patients with Acute Pulmonary Embolism

International Journal of General Medicine ◽

10.2147/ijgm.s288975 ◽

2021 ◽

Vol Volume 14 ◽

pp. 303-308

Author(s):

Wenmiao Bi ◽

Shaoqing Liang ◽

Zhihong He ◽

Ying Jin ◽

Zhe Lang ◽

...

Keyword(s):

Pulmonary Embolism ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Prognostic Value ◽

Acute Pulmonary Embolism ◽

Troponin I ◽

Serum Levels ◽

Neutrophil To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

D Dimer

Download Full-text

Prognostic Value of Neutrophil-To-Lymphocyte Ratio, Lactate Dehydrogenase, D-Dimer and CT Score in Patients with COVID-19

10.21203/rs.3.rs-30959/v1 ◽

2020 ◽

Author(s):

Yu-Qing Cai ◽

Xiao-Bin Zhang ◽

Hui-Qing Zeng ◽

Xiao-Jie Wei ◽

Zhen-Yu Zhang ◽

...

Keyword(s):

Logistic Regression ◽

Lactate Dehydrogenase ◽

Early Identification ◽

Neutrophil To Lymphocyte Ratio ◽

Laboratory Findings ◽

Lymphocyte Ratio ◽

Potential Value ◽

Severe Group ◽

High Level ◽

D Dimer

Abstract Background: To explore the significance of neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), D-dimer and CT score in evaluating the severity and prognosis of coronavirus disease – 2019 (COVID-19) in two centers of Hubei, China.Methods: A total of 432 patients with laboratory confirmed COVID-19 were retrospectively enrolled and divided into non-severe and severe groups. The baseline data, laboratory findings, chest computed tomography (CT) results evaluating by CT score on admission, and clinical outcomes were collected and compared. The logistic regression was used to assess the independent relationship between the baseline level of four indicators (NLR, LDH, D-dimer, CT score) on admission and the severity of COVID-19, respectively.Results: Among 432 patients, 125 (28.94%) cases were divided into severe group, the remaining (n = 307, 71.06%) were in non-severe group. In multivariate logistic regression, the high level of NLR, LDH were independent predictor in the early classification of patients with COVID-19 (OR = 2.163; 95%CI = 1.162–4.026; p = 0.015 for NLR > 3.82; OR = 2.298; 95%CI = 1.327–3.979; p = 0.003 for LDH > 246U/L). Furthermore, combining NLR > 3.82 and LDH > 246U/L could increase the sensitivity of diagnosis in severe patients (NLR > 3.82 [50.40%] vs. Combined diagnosis [72.80%]; p = 0.0007; LDH > 246 [59.2%] vs. Combined diagnosis [72.80%]; p < 0.0001).Conclusions: The high levels of NLR and LDH in serum have potential value in the early identification of severe patients with COVID-19. The combination of LDH and NLR can improve the sensitivity of diagnosis.Importance: COVID-19 has been a global pandemic. The mortality rate is range from 3.5-6.0%. In order to predict the risk factors of severity of COVID-19. we explore the significance of neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), D-dimer and CT score in evaluating the severity and prognosis of coronavirus disease – 2019 (COVID-19) in two centers of Hubei, China. We found that the high levels of NLR and LDH in serum have potential value in the early identification of severe patients with COVID-19. The combination of LDH and NLR can improve the sensitivity of diagnosis.

Download Full-text

Systemic inflammatory markers and psychophysical olfactory scores in coronavirus disease 2019 patients: is there any correlation?

The Journal of Laryngology & Otology ◽

10.1017/s0022215121001651 ◽

2021 ◽

pp. 1-6

Author(s):

L A Vaira ◽

A De Vito ◽

G Deiana ◽

C Pes ◽

F Giovanditto ◽

...

Keyword(s):

Lactate Dehydrogenase ◽

Clinical Research ◽

Inflammatory Markers ◽

Serum Levels ◽

Neutrophil To Lymphocyte Ratio ◽

C Reactive Protein ◽

Lymphocyte Ratio ◽

Reactive Protein ◽

Clinical Research Center ◽

D Dimer

Abstract Objective To analyse the correlations between olfactory psychophysical scores and the serum levels of D-dimer, C-reactive protein, ferritin, lactate dehydrogenase, procalcitonin and neutrophil-to-lymphocyte ratio in coronavirus disease 2019 patients. Methods Patients underwent psychophysical olfactory assessment with the Connecticut Chemosensory Clinical Research Center test, and determination of blood serum levels of the inflammatory markers D-dimer, C-reactive protein, ferritin, lactate dehydrogenase, procalcitonin and neutrophil-to-lymphocyte ratio within 10 days of the clinical onset of coronavirus disease 2019 and 60 days after. Results Seventy-seven patients were included in this study. D-dimer, procalcitonin, ferritin and neutrophil-to-lymphocyte ratio correlated significantly with severe coronavirus disease 2019. No significant correlations were found between baseline and 60-day Connecticut Chemosensory Clinical Research Center test scores and the inflammatory markers assessed. Conclusion Olfactory disturbances appear to have little prognostic value in predicting the severity of coronavirus disease 2019 compared to D-dimer, ferritin, procalcitonin and neutrophil-to-lymphocyte ratio. The lack of correlation between the severity and duration of olfactory disturbances and serum levels of inflammatory markers seems to further suggest that the pathogenetic mechanisms underlying the loss of smell in coronavirus disease 2019 patients are related to local rather than systemic inflammatory factors.

Download Full-text

Prognostic value of Neutrophil‐to‐lymphocyte ratio in COVID‐19 patients: A systematic review and meta‐analysis

International Journal of Clinical Practice ◽

10.1111/ijcp.14596 ◽

2021 ◽

Author(s):

Juan R. Ulloque‐Badaracco ◽

W. Ivan Salas‐Tello ◽

Ali Al‐kassab‐Córdova ◽

Esteban A. Alarcón‐Braga ◽

Vicente A. Benites‐Zapata ◽

...

Keyword(s):

Systematic Review ◽

Prognostic Value ◽

Meta Analysis ◽

Neutrophil To Lymphocyte Ratio ◽

Lymphocyte Ratio

Download Full-text

Prognostic value of the neutrophil-to-lymphocyte ratio in acute organophosphorus pesticide poisoning

Open Life Sciences ◽

10.1515/biol-2021-0069 ◽

2021 ◽

Vol 16 (1) ◽

pp. 703-710

Author(s):

Yuhang Mu ◽

Boqi Hu ◽

Nan Gao ◽

Li Pang

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Hospital Mortality ◽

Logistic Regression Analysis ◽

Poor Prognosis ◽

Prognostic Value ◽

Organophosphorus Pesticide ◽

Neutrophil To Lymphocyte Ratio ◽

Pesticide Poisoning ◽

Lymphocyte Ratio

Abstract This study investigates the ability of blood neutrophil-to-lymphocyte ratio (NLR) to predict acute organophosphorus pesticide poisoning (AOPP). Clinical data of 385 patients with AOPP were obtained within 24 h of admission, and NLR values were calculated based on neutrophil and lymphocyte counts. The patients were divided into two groups – good and poor – based on prognosis. Poor prognosis included in-hospital death and severe poisoning. The factors affecting prognosis were analyzed by logistic regression analysis, and the prognostic value of NLR was evaluated using the area under the receiver operating characteristic curve (AUC). Univariate logistic regression analysis showed that NLR levels, serum cholinesterase, and creatinine levels were good predictors of AOPP. Multivariate logistic regression analysis showed that high NLR was an independent risk factor for severe poisoning (adjusted odds ratio [AOR], 1.13; 95% CI, 1.10–1.17; p < 0.05) and in-hospital mortality (AOR, 1.07; 95% CI, 1.03–1.11; p < 0.05). NLR values >13 and >17 had a moderate ability to predict severe poisoning and in-hospital mortality, respectively (AUC of 0.782 [95% CI, 0.74–0.824] and 0.714 [95% CI, 0.626–0.803], respectively). Our results show that high NLR at admission is an independent indicator of poor prognosis in AOPP and can be used to optimize treatment and manage patients.

Download Full-text

Prognostic value of neutrophil-to-lymphocyte ratio and location in patients with EGFR mutant metastatic non-small cell lung cancer treated with TKIs

10.21203/rs.3.rs-29351/v3 ◽

2020 ◽

Author(s):

Xueqi Xie ◽

Xiaolin Li ◽

Wenjie Tang ◽

Jinlong Chen ◽

Minghuan Li ◽

...

Keyword(s):

Lung Cancer ◽

Prognostic Value ◽

Progression Free Survival ◽

Tumor Location ◽

Small Cell ◽

Neutrophil To Lymphocyte Ratio ◽

Small Cell Lung ◽

Free Survival ◽

Lymphocyte Ratio ◽

Primary Location

Abstract Background: Targeted therapy with the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) has improved the field of metastatic non-small cell lung cancer treatment. Higher neutrophil-to-lymphocyte ratio (NLR) and lower relative lymphocyte counts as inflammatory indicators and associated with worse overall survival and progression free survival (PFS) in several tumor types. Few studies focused on these inflammation markers in context of TKIs eras. Methods: Patients with advanced EGFR mutation NSCLC treated with TKIs were included. Pre-treatment NLR means neutrophil to lymphocyte ratio measured in peripheral blood within one week before treating with TKIs. The baseline clinical characteristics of each group were compared by chi-square and t tests. Cox regression analyses were used to evaluate prognostic value of peripheral blood parameters on progression free survival (PFS). All prognostic factors were explored with multivariable regression. Results: We retrospectively analyzed 221 patients with metastatic NSCLC harboring exon 19 deletion, 21 L858R or rare mutation and receiving TKIs. Finally, a total of 190 patients were analyzed. The optimal cutoff values for pretreatment absolute lymphocyte count (Lym), lymphocyte percentage (Lym%), absolute neutrophil count (Neu), the percentage of neutrophil granulocytes (Neu%) and NLR were 1.625 B, 18.8%, 3.675a, 51.8% and 4.965, respectively. Patients with high neutrophil percent (13.0 months vs 18.8 months, P=0.003), absolute neutrophil counts (12.0 months vs 14.5 months, P=0.014) and NLR (7.0 months vs 15.2 months, P<0.001, one-year PFS Rate, 55.3%, respectively) had worse PFS. In contrast, patients with high absolute lymphocyte counts (13.0 months vs 16.5 months, P=0.012) and lymphocyte percent (8.8 months vs 15.3months, P<0.001) had a better PFS. Besides, tumor location was also an important factor for prognosis (11.6 months vs 14.3 months, P=0.003). On multivariate analysis, NLR and primary tumor location were both identified as independent and significantly risk indicators for worse PFS. Conclusion: NLR and primary location are both independent prognostic factors for PFS in patients with metastatic EGFR mutated lung tumor. Whether or not NLR and primary location could be usefulmarkers in efficacy prediction of TKIs in advanced NSCLC calls for further investigation.

Download Full-text