The Trend of Platelet-To-Lymphocyte Ratio (PLR) and Absolute-Lymphocyte-Count (ALC) in the Severity of Covid-19 Patients

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Markus Gatot Sura Wijaya ◽  
Arie Utariani ◽  
Hamzah Hamzah ◽  
Bambang Pujo Semedi ◽  
Prananda Surya Airlangga
Keyword(s):  
Lymphocyte Count ◽  
Time Course ◽  
Complete Blood Count ◽  
Absolute Lymphocyte Count ◽  
P Value ◽  
Research Subjects ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Severity Class ◽  
Critical Patients

Background: Cytokine storms and severe immune injury are suspected as the cause of the occurrence of Acute Respiratory Distress Syndrome (ARDS), sepsis and various another organ failure. The trend of Platelet-to-Lymphocyte Ratio (PLR) and Absolute Lymphocyte Count (ALC) were expected to show the inflammatory process and the cytokine storm in the severity of Covid-19 patients. This research’s purpose is to analyze the time course and dynamic changes of PLR and ALC in each severity. Method: The research method used was an observational analytic study with a prospective cohort design. The research sample taken was Covid-19 patients admitted from July to October 2020 who met the inclusion and exclusion criteria. PLR, ALC was counted from the CBC (Complete Blood Count) examination checked every three days. The PLR and ALC trend of 14-days were then analyzed. Result: A total of 119 research subjects were involved in this study. PLR is significantly different at day-0 and the day-3 with p-value <0.001 and 0.003. On the 3rd day of treatment, PLR of moderate severity rose rapidly. Mild, severe, and critical cases’ PLR rose until day-6. After the day-6, PLR of all severity class tend to decrease. ALC was significantly different on day-0, day-3, day-6 and day-9 with p-value <0.001, 0.006, 0.024 and 0.001. ALC day-0 in critical patients is the lowest, and tend to be the lowest throughout the 14 days. ALC in mild, moderate and severe declined until day 6, then began to rise until day 14. Conclusion: In Conclusion, PLR tend to increase from day-0 of treatment and peak in day-3 or day-6 of treatment and then decreased gradually until day-14 of the treatment. Meanwhile, ALC tend to decrease from day-0 of treatment and reach the lowest point at day-6 of treatment and then increased gradually until day-14 of the treatment. PLR was significantly different among the severity in day-0 and day-3 with p-value <0.001 and 0.003. ALC was significantly different among the severity in day-0, day-3, day-6 and day-9 with p-value <0.001, 0.006, 0.024 and 0.001.

Absolute Lymphocyte Count, Platelet-to-Lymphocyte Ratio, and Overall Survival in Eribulin-treated HER2-negative Metastatic Breast Cancer Patients

2021 ◽  
Vol 1 (5) ◽  
pp. 435-441
Author(s):  
YOICHI KOYAMA ◽  
SAORI KAWAI ◽  
NATSUKI UENAKA ◽  
MIKI OKAZAKI ◽  
MARIKO ASAOKA ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Lymphocyte Count ◽  
Univariate Analysis ◽  
Metastatic Breast ◽  
Absolute Lymphocyte Count ◽  
Breast Cancer Patients ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio

Background/Aim: To investigate the utility of peripheral blood biomarkers – absolute lymphocyte count (ALC), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) – for predicting outcomes in eribulin-treated patients with metastatic human epidermal growth factor receptor type 2 (HER2)-negative breast cancer. Patients and Methods: ALC, NLR, and PLR were retrospectively obtained from pre-treatment blood sampling results of 120 patients and stratified according to means. Univariate and multivariate analyses were performed to investigate the association of clinicopathological factors, including these values, with overall survival (OS) and progression-free survival (PFS). Results: The ALC, NLR, and PLR cut-off points were 1,285/μl, 3.3, and 235, respectively. No biomarkers were associated with PFS. However, univariate analysis showed ALC (p=0.044) and PLR (p=0.044) to be significantly associated with OS. Conclusion: ALC and PLR can predict eribulin efficacy in terms of OS, reflecting the antitumour immune response in the microenvironment and indicating eribulin’s effectiveness.

Correlation of Platelet-Lymphocyte Ratio towards the Incidence of Follicular Thyroid Carcinoma

2021 ◽  
Vol 8 (9) ◽  
pp. 36-42
Author(s):  
Gagang Guntaran Kalbuningwang ◽  
Dwi Hari Susilo ◽  
Marjono Dwi Wibowo
Keyword(s):  
Thyroid Carcinoma ◽  
Complete Blood Count ◽  
Follicular Thyroid Carcinoma ◽  
Benign Lesion ◽  
P Value ◽  
Pathology Report ◽  
Research Subjects ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Significant Difference

Background: Recently, there is some consistent evidence that the inflammatory process is related to the development and progression of cancer. Platelet-lymphocyte ratio (PLR) may acts as simple biomarker for predicting the occurrence of cancer. Since fine needle aspiration could not distinguish between follicular thyroid carcinoma and benign lesion, the researchers were interested in conducting research correlation of PLR towards incidence of follicular thyroid carcinoma in Dr Soetomo Hospital Surabaya. Methods: This study used secondary data from medical record of surgical pathology report diagnosed with follicular thyroid carcinoma who had undergone thyroid surgery at RSUD Dr. Soetomo Surabaya. Preoperative complete blood count was investigated then platelet-lymphocyte ratio was counted. Results: The total research subjects were 40 people, consisting of 31 women (77.5%), 9 men (22.5%). Among three analyses between gender, age, and PLR towards follicular thyroid carcinoma, there is only one analysis which statistically had significant difference, that is correlation between PLR value towards incidence of follicular thyroid carcinoma (p value = 0.003). Two remaining analyses showed there were no statistically significant difference between gender (p value = 0.451) and age (p value = 0.336) towards follicular thyroid carcinoma. It was also found that patients with the higher PLR value had eight point five times higher suffering follicular thyroid carcinoma than those who had low PLR value. Conclusion: According to this study, there was a statistically significant difference between PLR towards incidence of follicular thyroid carcinoma. The higher platelet-lymphocyte ratio (PLR) value, it is more likely to develop follicular thyroid carcinoma. Keywords: Platelet lymphocyte ratio, platelet-lymphocyte ratio, follicular thyroid carcinoma

scholarly journals Investigation of the Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio in Patients with Neuromyelitis Optica Spectrum Disorders

2021 ◽  
Author(s):  
Qingli SUN ◽  
Dongsheng FAN
Keyword(s):  
Absolute Neutrophil Count ◽  
Neutrophil Count ◽  
Lymphocyte Count ◽  
Roc Analysis ◽  
Absolute Lymphocyte Count ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Spectrum Disorders ◽  
Wbc Count ◽  
Inflammatory Changes

Abstract Background: This study aimed to explore the differences in the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with neuromyelitis optica spectrum disorders (NMOSDs) as well as their relationship with the onset of the diseases.Methods: The clinical data, laboratory findings, and imaging data of patients with NMOSD admitted to Perking University Third Hospital from January 2015 to December 2020 were retrospectively analyzed. Routine blood tests of patients performed within one week of the appearance of new clinical symptoms or imaging lesions were collected to calculate the NLR and PLR. The routine blood test of the patients in remission was performed more than 6 months after the patients stopped hormone use. The NLR and PLR of patients were compared with those of 100 healthy subjects undergoing physical examinations.Results: A total of 55 patients with NMOSD were enrolled. 44 patients with NMOSD were followed up. In patients with NMOSD, the white blood cell (WBC) count, absolute neutrophil count, and NLR were significantly higher than those in patients in remission and the controls, while the absolute lymphocyte count was significantly lower than that in patients in remission and the controls. In patients with NMOSD in remission, there were no statistically significant differences in the WBC count, absolute neutrophil count, absolute lymphocyte count, or NLR compared with the controls. The PLR of patients with NMOSD in the attack stage was significantly higher than that of the controls, while the PLR of patients with NMOSD in remission was not significantly different from that of the attack stage and the controls. There were no statistically significant differences between APQ4 (+) and APQ4 (-) in patients with NMOSD at the attack stage in the WBC count, absolute neutrophil count, absolute lymphocyte count, platelet count, NLR or PLR. ROC analysis of NLR and PLR for the diagnosis of inflammatory changes in NMOSD at the attack stage and controls: The ROC curve was plotted using NLR and PLR as dependent variables. In patients with NMOSD, the AUC was 0.806 for NLR and 0.612 for PLR. ROC analysis of NLR and PLR for the diagnosis of inflammatory changes in NMOSD at the attack stage and remission stage. The AUC was 0.728 for NLR and 0.594 for PLR.Conclusion: Patients with NMOSD had significantly higher WBC counts, absolute neutrophil counts and NLRs, and elevated NLRs were correlated with inflammatory activity in NMOSD.

scholarly journals Combined Diagnostic Efficacy of Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Mean Platelet Volume (MPV) as Biomarkers of Systemic Inflammation in the Diagnosis of Colorectal Cancer

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Milica Stojkovic Lalosevic ◽  
Aleksandra Pavlovic Markovic ◽  
Sanja Stankovic ◽  
Mirjana Stojkovic ◽  
Ivan Dimitrijevic ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Roc Curve ◽  
Mean Platelet Volume ◽  
Lymphocyte Count ◽  
Absolute Lymphocyte Count ◽  
Platelet Volume ◽  
Platelet To Lymphocyte Ratio ◽  
Diagnostic Efficacy ◽  
Lymphocyte Ratio ◽  
The Absolute

Background. Systemic inflammation in colorectal cancer (CRC) may be reflected by neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV). This study was designed to investigate the efficiency of preoperative NLR, PLR, and MVP as a tool for the assessment of tumor characteristics in newly diagnosed patients with CRC. Patients and Methods. For 300 patients and 300 healthy volunteers, complete blood counts with automated differential counts were performed. The NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count; PLR was calculated by dividing the absolute platelet count by the absolute lymphocyte count. The diagnostic performance of NLR, PLR, and MVP was estimated by ROC curve. Results. ROC curve analysis showed high diagnostic efficacy of NLR and PLR in CRC patients with cut-off values of 2.15 (AUC=0.790, 95% CI 0.736-0.884, Se=74.1%, and Sp=73%) and 123 (AUC=0.846, 95% CI 0.801-0.891, Se=73.5%, and Sp=80%) compared to healthy controls, respectively. The diagnostic efficacy of three combined markers was superior compared with individual markers (AUC=0.904, 95% CI 0.812-0.989, Se=96%, and Sp=70%). Conclusion. NRL, PLR, and MPV may be useful markers in diagnostic and early recognition of different stages of CRC; additionally combined all together have stronger diagnostic efficacy.

scholarly journals Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Routine Complete Blood Count Components in HELLP Syndrome: A Matched Case Control Study

Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 123 ◽  
Author(s):  
Giovanni Sisti ◽  
Andrea Faraci ◽  
Jessica Silva ◽  
Ruchi Upadhyay
Keyword(s):  
Platelet Count ◽  
Hellp Syndrome ◽  
Case Control Study ◽  
Complete Blood Count ◽  
P Value ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Matched Case ◽  
Matched Case Control Study ◽  
Control Study

Background and objective: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are new readily available inflammatory markers that have been analyzed in pregnancy-induced hypertensive disorders such as preeclampsia. Studies on the NLR/PLR ratio in hemolysis, elevated liver enzymes, low-platelet count (HELLP) syndrome are limited in the current literature. We compared NLR/PLR and other complete blood count (CBC) components between women with HELLP syndrome and women with healthy pregnancies. Methods: We conducted a retrospective matched case–control study at a tertiary care hospital in NY (USA) in the time frame between January 2016 and December 2018. The study compared pregnant women with HELLP syndrome (cases) to women with healthy pregnancies in the third trimester (controls), matched by age, body mass index (BMI), parity, and race. Patient with preeclampsia, infection, and fever were excluded. Venous blood samples were obtained as part of the routine work-up at admission for delivery, which included a CBC. The main outcomes were NLR and PLR. The secondary outcomes were hemoglobin, red cell distribution width (RDW), platelet count, mean platelet volume (MPV), neutrophils, lymphocytes. Results: There were 14 patients in each group. They were matched by age, race, BMI, and parity. NLR (5.8 vs. 3.6, p-value = 0.002) and neutrophil count (10.7 vs. 6.8, p-value = 0.001) were higher in women with HELLP compared to controls. PLR (34 vs. 130.2, p-value < 0.001) and platelet count (71 vs. 223, p-value < 0.001) were lower in the study group compared to controls. Conclusions: NLR was higher, and PLR was lower in women with HELLP syndrome. These inflammatory markers can be incorporated into the diagnostic algorithm for HELLP syndrome. Future studies are needed to evaluate their ability to predict HELLP syndrome.

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.

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.

scholarly journals Platelet-to-lymphocyte ratio (PLR) and Plateletcrit (PCT) in young patients with morbid obesity

2019 ◽  
Vol 65 (9) ◽  
pp. 1182-1187 ◽  
Author(s):  
Emrah Erdal ◽  
Mehmet İnanir
Keyword(s):  
Morbid Obesity ◽  
Healthy Subjects ◽  
Complete Blood Count ◽  
Young Patients ◽  
Obese Group ◽  
Platelet To Lymphocyte Ratio ◽  
Distribution Width ◽  
Lymphocyte Ratio ◽  
Platelet Counts ◽  
Significant Difference

SUMMARY OBJECTIVE To compare the complete blood counts, namely the plateletcrit (PCT) and Platelet-To-Lymphocyte Ratio (PLR) of healthy subjects and those with morbid obesity in the young population. METHODS We included 45 patients with morbid obesity (body mass index -BMI - greater than or equal to 45 kg/m2) and 45 healthy subjects (BMI less than or equal to 25 kg/m2) in our study. Blood samples were obtained from the participants following a 12-hour fasting period. Then we evaluated the levels of hemoglobin (Hb), hematocrit (HCT), red cell distribution width (RDW), mean platelet volume (MPV), white blood cell (WBC), PLR, platelet counts, and PCT in the complete blood count. RESULTS The morbid obesity group had significantly higher platelet counts and PCT values (p<0.001), and PLR values (p=0.033). The value of WBC was also higher in the obese group (p=0.001). MPV was lower in the obesity group but not statistically significant (p=0.815). No significant difference was found between hemoglobin and hematocrit values in these groups; but RDW valuewere higher and statistically significant in the obese group (p=0.001). CONCLUSION PLR or PCT may be more useful as a marker in determining an increased thrombotic state and inflammatory response in morbid obesity.

Pretreatment Absolute Lymphocyte Count and Neutrophil-to-lymphocyte Ratio Are Prognostic Factors for Stage III Breast Cancer

2021 ◽  
Vol 41 (7) ◽  
pp. 3625-3634
Author(s):  
KOSHO YAMANOUCHI ◽  
SHIGETO MAEDA ◽  
DAIKI TAKEI ◽  
YOICHI KOGA ◽  
MANPEI YAMASHITA ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Lymphocyte Count ◽  
Absolute Lymphocyte Count ◽  
Neutrophil To Lymphocyte Ratio ◽  
Stage Iii ◽  
Lymphocyte Ratio ◽  
Stage Iii Breast Cancer

Study of Absolute Lymphocyte Count as a Marker of COVID 19 Disease Severity in Tertiary Care Centre, Suryapet

2021 ◽  
Vol 8 (23) ◽  
pp. 1960-1965
Author(s):  
Bellala Venkata Anuradha Devi ◽  
Cigiri Saritha ◽  
Ravuri Swarupa ◽  
Jeshtadi Anunayi
Keyword(s):  
Disease Severity ◽  
Lymphocyte Count ◽  
Complete Blood Count ◽  
Tertiary Care ◽  
Absolute Lymphocyte Count ◽  
World Health ◽  
Total Leucocyte Count ◽  
Global Public Health ◽  
Tertiary Care Centre ◽  
Absolute Lymphocyte Counts

BACKGROUND The World Health Organization (WHO) has declared Coronavirus disease 2019 (COVID - 19) as a global public health pandemic. Clinical and laboratory biomarkers to predict the severity of corona virus 2019 are essential in this pandemic. Lymphocyte count has been a marker of interest in order to investigate the association of lymphocyte count and severity of COVID-19. We would like to analyse the relationship between absolute lymphocyte count (ALC) & COVID-19 disease severity. METHODS We performed a retrospective study on patients admitted to Government general hospital, Suryapet for COVID-19 illness from September 1st 2020 to September 16th 2020. Age, gender and complete blood count of patients admitted in the hospital was collected. Haemoglobin, total leucocyte count (TLC), absolute neutrophilic count (ANC), absolute lymphocyte count (ALC) and platelet counts were compared between ICU and Non-ICU groups and comparison of absolute lymphocyte counts in each group - ICU alive, ICU death and non-ICU groups was carried out. RESULTS 134 patients who were admitted in the hospital were analysed. Mean age and gender were compared between ICU and Non-ICU groups. We compared ALC between ICU alive, ICU death and non-ICU groups. Mean ALC in ICU death group was 0.81, in ICU alive group 1.04 and in non-ICU as 1.75. We found that patients with disease severity have lower absolute lymphocyte counts. In addition to this we also found that there was neutrophilia and lower haemoglobin levels in ICU patients. CONCLUSIONS We conclude that lymphopenia, defined as absolute lymphocyte count less than 1.1 x 109 /L may be useful in predicting the severity of COVID-19 illness. KEYWORDS COVID-19, Absolute Lymphocyte Count (ALC), Lymphopenia, SARS COV2

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