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

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 Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios Predict All-Cause Mortality in Acute Pulmonary Embolism

2020 ◽  
Vol 26 ◽  
pp. 107602961990054 ◽  
Author(s):  
Trung Phan ◽  
Yevgeniy Brailovsky ◽  
Jawed Fareed ◽  
Debra Hoppensteadt ◽  
Omer Iqbal ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Prediction Models ◽  
Area Under The Curve ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Useful Components ◽  
Significant Difference ◽  
All Cause Mortality

The aim of this study was to investigate the utility of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to predict all-cause mortality in patients presenting with acute pulmonary embolism (PE). Three hundred consecutive patients with acute PE between March 2016 and December 2018 were retrospectively analyzed. We identified 191 patients who met the study inclusion criteria. Twenty-eight patients died during the study period. There was a significant difference in PLR, but not NLR, between patients with low risk, submassive, and massive risk PE ( P = .02 and P = .58, respectively, by the Kruskal-Wallis test). Elevated NLR and PLR were associated with all-cause mortality ( P < .01 and P < .01, respectively). Neutrophil-to-lymphocyte ratio of 5.46 was associated with all-cause mortality with sensitivity of 75.0% and specificity of 66.9% (area under the curve [AUC]: 0.692 [95% confidence interval, CI]: 0.568-0.816); P < .01). Platelet-to-lymphocyte ratio of 256.6 was associated with all-cause mortality with sensitivity of 53.6% and specificity of 82.2% (AUC: 0.693 [95% CI: 0.580-0.805]; P < .01). Neutrophil-to-lymphocyte ratio and PLR are simple biomarkers that are readily available from routine laboratory values and may be useful components of PE risk prediction models.

scholarly journals Study of hematological and biochemical parameters in a cohort of Indian COVID-19 patients admitted in a tertiary care centre

2020 ◽  
Vol 7 (12) ◽  
pp. 1840
Author(s):  
Abhishek Agrawal ◽  
Princy Tyagi ◽  
Sunil Mahavar ◽  
Subrata Banerjee ◽  
Raman Sharma ◽  
...  
Keyword(s):  
Severe Disease ◽  
Tertiary Care ◽  
Total Leucocyte Count ◽  
Platelet To Lymphocyte Ratio ◽  
Tertiary Care Centre ◽  
Lymphocyte Ratio ◽  
Factors Associated ◽  
Severity Of Disease ◽  
Periodic Monitoring ◽  
Hematological And Biochemical Parameters

Background: In this study authors retrospectively analyzed the record of 102 patients with confirmed COVID-19 infection to determine factors associated with severity of disease.  Methods: Clinical, biochemical, radiological and hematological profiles of 102 patients with confirmed SARS-CoV-2 RNA testing were obtained and analyzed.  Results: A total of 102 patients were enrolled, with median age of patients of 32.5 years (range 10-85 years), of which 83.3% (85/102) were asymptomatic and 16.67% (17/102) symptomatic. Eighteen (17.6%) patients had co-existing illnesses. Clinical spectrum among COVID-19 patients varied from being asymptomatic to having symptoms like fever, dry cough, breathlessness with few progressing to respiratory failure and multi-organ failure. In our study, 97.05% (99/102) recovered while 2.94% (3/102) died. Mean age, total leucocyte count (TLC), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lactate dehydrogenase (LDH) of severely ill patients were significantly higher than those of patients with non-severe illness.Conclusions: Elevated NLR, TLC, PLR, LDH and lymphopenia were seen in the symptomatic patients especially manifesting severe disease. Early intervention and periodic monitoring of these parameters in patients, especially with severe disease may help in improving disease outcome.

scholarly journals Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as independent predictors of outcome in infective endocarditis (IE)

2019 ◽  
Vol 71 (1) ◽  
Author(s):  
Marwa Sayed Meshaal ◽  
Abdo Nagi ◽  
Ahmed Eldamaty ◽  
Wae’el Elnaggar ◽  
Mervat Gaber ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Infective Endocarditis ◽  
Hospital Mortality ◽  
Roc Curve ◽  
Area Under The Curve ◽  
Neutrophil To Lymphocyte Ratio ◽  
Total Leucocyte Count ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Neutrophil Percentage

Abstract Background Early and accurate risk assessment is an important clinical demand in patients with infective endocarditis (IE). The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are independent predictors of prognosis in many infectious and cardiovascular diseases. Very limited studies have been conducted to evaluate the prognostic role of these markers in IE. Results We analyzed clinical, laboratory, and echocardiographic data and outcomes throughout the whole period of hospitalization for a total of 142 consecutive patients with definitive IE. The overall in-hospital mortality was 21%. Major complications defined as central nervous system embolization, fulminant sepsis, acute heart failure, acute renal failure, and major artery embolization occurred in 38 (27%), 34 (24%), 32 (22.5%), 40 (28%), and 90 (63.4%) patients, respectively. The NLR, total leucocyte count (TLC), neutrophil percentage, creatinine, and C-reactive protein (CRP) level obtained upon admission were significantly higher in the mortality group [p ≤ 0.001, p = 0.008, p = 0.001, p = 0.004, and p = 0.036, respectively]. A higher NLR was significantly associated with fulminant sepsis and major arterial embolization [p = 0.001 and p = 0.028, respectively]. The receiver operating characteristic (ROC) curve of the NLR for predicting in-hospital mortality showed that an NLR > 8.085 had a 60% sensitivity and an 84.8% specificity for an association with in-hospital mortality [area under the curve = 0.729, 95% confidence interval (CI) 0.616–0.841; p = 0.001]. The ROC curve of the NLR for predicting severe sepsis showed that an NLR > 5.035 had a 71.8% sensitivity and a 68.5% specificity for predicting severe sepsis [area under the curve 0.685, 95% CI 0.582–0.733; p = 0.001]. The PLR showed no significant association with in-hospital mortality or in-hospital complications. Conclusion A higher NLR, TLC, neutrophil percentage, creatinine level, and CRP level upon admission were associated with increased in-hospital mortality and morbidity in IE patients. Furthermore, a lower lymphocyte count/percentage and platelet count were strong indicators of in-hospital mortality among IE patients. Calculation of the NLR directly from a CBC upon admission may assist in early risk stratification of patients with IE.

scholarly journals Prognostic Value of Neutrophil-To-Lymphocyte Ratio and Platelet-To-Lymphocyte Ratio for Renal Outcomes in Patients with Rapidly Progressive Glomerulonephritis

2020 ◽  
Vol 9 (4) ◽  
pp. 1128 ◽  
Author(s):  
Yukari Mae ◽  
Tomoaki Takata ◽  
Ayami Ida ◽  
Masaya Ogawa ◽  
Sosuke Taniguchi ◽  
...  
Keyword(s):  
Renal Function ◽  
Rapidly Progressive Glomerulonephritis ◽  
Area Under The Curve ◽  
Neutrophil To Lymphocyte Ratio ◽  
Renal Outcome ◽  
Maintenance Hemodialysis ◽  
Rapid Decline ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Renal Outcomes

Background: Rapidly progressive glomerulonephritis (RPGN) is a syndrome characterized by a rapid decline in renal function that often causes end-stage renal disease. Although it is important to predict renal outcome in RPGN before initiating immunosuppressive therapies, no simple prognostic indicator has been reported. The aim of this study was to investigate the associations of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) to renal outcomes in patients with RPGN. Methods: Forty-four patients with a clinical diagnosis of RPGN who underwent renal biopsy were enrolled. The relationships between NLR and PLR and renal outcome after 1 year were investigated. Results: NLR and PLR were significantly higher in patients with preserved renal function in comparison to patients who required maintenance hemodialysis (p < 0.05 and p < 0.01, respectively). An NLR of 4.0 and a PLR of 137.7 were the cutoff values for renal outcome (area under the curve, 0.782 and 0.819; sensitivity, 78.4% and 89.2%; specificity, 71.4% and 71.4%, respectively). Furthermore, an NLR of 5.0 could predict recovery from renal injury in patients requiring hemodialysis (area under the curve, 0.929; sensitivity, 83.3%; specificity, 85.7%). Conclusion: NLR and PLR could be candidates for predicting renal outcomes in patients with RPGN.

scholarly journals Platelet to lymphocyte ratio and neutrophil to lymphocyte ratio in patients with rheumatoid arthritis

Open Medicine ◽  
2015 ◽  
Vol 10 (1) ◽  
Author(s):  
You-Fan Peng ◽  
Ling Cao ◽  
Yan-Hua Zeng ◽  
Zhao-Xia Zhang ◽  
Dan Chen ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Roc Curves ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Neutrophil Percentage ◽  
Crude Model

AbstractObjectives: It has been well documented that the platelet to lymphocyte ratio (PLR) and the neutrophil to lymphocyte ratio (NLR) are associated with outcomes for patients with gastric cancer, non-small cell lung cancer and acute heart failure. Inflammation may be the hidden factor that explains the correlation between NLP, PLR, and these diseases. However, to date, the data concerning NLR, PLR, and its association with inflammation are lacking in patients with rheumatoid arthritis (RA), thus, our aim to discuss whether NLR and PLR are associated with RA. Methods: Patients with RA and healthy individuals were included according to the determined criteria, and laboratory indicators were measured. Results: PLR and NLR were significantly higher in RA patients compared with healthy controls (3.20±2.06 vs. 1.56±0.47, P<0.01; 192.85±101.78 vs. 103.49±28.68, P<0.01). When leukocytes, neutrophil percentage, neutrophil, lymphocyte, platelet, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and rheumatoid factor (RF) were considered as confounders (crude model), our results indicated that ESR and RF were correlated to RA. Of note, ESR, RF, and PLR were associated with RA after further adjustment based on crude model for PLR and NLR. Receiver operating characteristic (ROC) curves analysis showed that PLR values higher than >115.7 evaluated RA with a sensitivity of 82.5%, a specificity of 74.8% and area under the curve ( AUC ) of 0.847. Conclusions:Our results suggest that PLR is associated with RA, and PLR may be an underlying indicator indicating the chronic subclinical inflammation in patients with RA.

scholarly journals Diagnostic Value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Crohn’s Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Jue-Rong Feng ◽  
Xiao Qiu ◽  
Fan Wang ◽  
Peng-Fei Chen ◽  
Qian Gao ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Low Cost ◽  
Diagnostic Value ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Diagnostic Efficacy ◽  
Lymphocyte Ratio ◽  
Lymphocyte To Monocyte Ratio ◽  
Complete Blood Counts

The aim of this study is to investigate the diagnostic efficacy of neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-monocyte ratio (NMR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) in patients with Crohn’s disease (CD) and non-CD controls. These ratios were all derived from complete blood counts. Two hundred and six participants including CD inpatients and non-CD controls were retrospectively enrolled. We found statistically higher NLR and PLR and lower LMR in CD patients than in non-CD controls (all P<0.01). However, NMR was not different between the two groups (P=0.18). In addition, NLR, PLR, and LMR were associated with CRP and ESR. Optimal cutoffs for NLR and PLR were 2.72 (sensitivity: 68.3%, specificity: 75.9%, and overall accuracy: 70.1%) and 132.88 (sensitivity: 76.7%, specificity: 84.8%, and overall accuracy: 80.8%), respectively. In conclusion, the NLR and PLR might be effective, readily available, and low-cost biomarkers for differentiating CD patients from non-CD controls.

Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio: novel markers for the diagnosis and prognosis in patients with restenosis following CAS

2020 ◽  
Vol 14 (4) ◽  
pp. 271-282 ◽  
Author(s):  
Xiang Bao ◽  
Gezhi Zhou ◽  
Wei Xu ◽  
Xiaobo Liu ◽  
Zhijun Ye ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Receiver Operating Characteristic Analysis ◽  
Prognostic Significance ◽  
Area Under The Curve ◽  
Prognostic Indicator ◽  
Neutrophil To Lymphocyte Ratio ◽  
Characteristic Analysis ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Diagnosis And Prognosis

Aim: In this study, we investigated the effect of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio on restenosis status in patients undergoing carotid angioplasty stenting (CAS). Methodology & results: Clinical imageology and receiver operating characteristic analysis were utilized to study the prognostic significance of NLRs/platelet-to-lymphocyte ratios and their correlation with survival. NLR of restenosis (+) patients was evidently increased after the CAS procedures, while the NLR of restenosis (-) patients before the CAS procedures being the lowest. Area under the curve of pre-CAS NLR or/and post-CAS NLR were all evidently higher than 50%. Also, restenosis incidence was the highest in patients with both high pre-CAS and high post-CAS values. Conclusion: Therefore, NLR can be utilized as an independent prognostic indicator to predict the incidence of restenosis after CAS procedures.

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