OBJECTIVE: SARS-CoV-2 (Se- vere Acute Respiratory Syndrome Coronavirus 2) has been identified in China as responsible for viral pneumonia, now called COVID-19 (Coro- navirus Disease 2019). Patients infected can de- velop common symptoms like cough and sore throat, and, in severe cases, acute respiratory syndrome and even death. To optimize the avail- able resources, it is necessary to identify in ad- vance the subjects that will develop a more se- rious illness, therefore requiring intensive care. The neutrophil / lymphocyte ratio (NLR) param- eter, resulting from the blood count, could be a significant marker for the diagnosis and man- agement of risk stratification. PATIENTS AND METHODS: A retrospective, single-center case-control observational study was conducted. The differential cell count of leu- kocytes, the NLR and the clinical course of pa- tients hospitalized in intensive care with COVID-19 were analyzed, comparing them with other pa- tients (COVID-19 and non-COVID-19) and healthy individuals selected among workers of the Teach- ing Hospital Policlinico Umberto I in Rome. RESULTS: 370 patients (145 cases and 225 controls) were included in the case-control study, 211 males (57%) and 159 females (43%). The average age of the population was 63 years (SD 16.35). In the group of cases, out of 145 pa- tients, 57 deaths and 88 survivors were record- ed, with a lethality rate of 39.3%. The group of cases has an NLR of 7.83 (SD = 8.07), a much higher value than the control group where an NLR of 2.58 was recorded (SD = 1.93) (p <0.001). The Neutrophils / Lymphocytes ratio may prove to be a diagnostic factor for COVID-19, an NLR> 3.68 revealed an OR 10.84 (95% CI = 6.47 - 18.13) (p <0.005). CONCLUSIONS: The value of NLR considered together with the age variable allows a risk strat- ification and allows the development of diagnos- tic and treatment protocols for patients affect- ed by COVID-19. A high neutrophil to lymphocyte ratio suggests worse survival. Risk stratification and management help alleviate the shortage of medical resources and reduce the mortality of critically ill patients.

The neutrophil/lymphocyte ratio as a prognostic factor in COVID-19 patients: a case-control study / LA TORRE, Giuseppe; Marte, M.; Massetti, A. P.; Carli, S. M.; Romano, F.; Mastroianni, C. M.; Minorenti, M.; Alessandri, F.; Ajassa, C.; Fusconi, M.; DE VINCENTIIS, M.; DE MEO, D.; Villani, C.; Cardi, M.; Pugliese, F.; Aronica, Raissa; Mauro, Vera; Casali, Elena; Di Bari Silvia, ; Gavaruzzi, Francesca; Romani, FRANCESCO EUGENIO; Fassari, Alessia; Filippi, Valeria; Ambrogio, Curtolo; Piero Giuseppe Meliante, ; Roger, Altomari. - In: EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES. - ISSN 2284-0729. - 26:3(2022), pp. 1056-1064. [10.26355/eurrev_202202_28017]

The neutrophil/lymphocyte ratio as a prognostic factor in COVID-19 patients: a case-control study

Giuseppe LA TORRE
Primo
;
A. P. MASSETTI;F. ROMANO;C. M. MASTROIANNI;F. ALESSANDRI;C. AJASSA;M. FUSCONI;M. DE VINCENTIIS;D. DE MEO;C. VILLANI;M. CARDI;F. PUGLIESE;Aronica Raissa;Mauro Vera;Gavaruzzi Francesca;Romani Francesco Eugenio;Fassari Alessia;Filippi Valeria;
2022

Abstract

OBJECTIVE: SARS-CoV-2 (Se- vere Acute Respiratory Syndrome Coronavirus 2) has been identified in China as responsible for viral pneumonia, now called COVID-19 (Coro- navirus Disease 2019). Patients infected can de- velop common symptoms like cough and sore throat, and, in severe cases, acute respiratory syndrome and even death. To optimize the avail- able resources, it is necessary to identify in ad- vance the subjects that will develop a more se- rious illness, therefore requiring intensive care. The neutrophil / lymphocyte ratio (NLR) param- eter, resulting from the blood count, could be a significant marker for the diagnosis and man- agement of risk stratification. PATIENTS AND METHODS: A retrospective, single-center case-control observational study was conducted. The differential cell count of leu- kocytes, the NLR and the clinical course of pa- tients hospitalized in intensive care with COVID-19 were analyzed, comparing them with other pa- tients (COVID-19 and non-COVID-19) and healthy individuals selected among workers of the Teach- ing Hospital Policlinico Umberto I in Rome. RESULTS: 370 patients (145 cases and 225 controls) were included in the case-control study, 211 males (57%) and 159 females (43%). The average age of the population was 63 years (SD 16.35). In the group of cases, out of 145 pa- tients, 57 deaths and 88 survivors were record- ed, with a lethality rate of 39.3%. The group of cases has an NLR of 7.83 (SD = 8.07), a much higher value than the control group where an NLR of 2.58 was recorded (SD = 1.93) (p <0.001). The Neutrophils / Lymphocytes ratio may prove to be a diagnostic factor for COVID-19, an NLR> 3.68 revealed an OR 10.84 (95% CI = 6.47 - 18.13) (p <0.005). CONCLUSIONS: The value of NLR considered together with the age variable allows a risk strat- ification and allows the development of diagnos- tic and treatment protocols for patients affect- ed by COVID-19. A high neutrophil to lymphocyte ratio suggests worse survival. Risk stratification and management help alleviate the shortage of medical resources and reduce the mortality of critically ill patients.
2022
neutrophil to lymphocyte ratio; case-control; Prognosis; COVID-19
01 Pubblicazione su rivista::01a Articolo in rivista
The neutrophil/lymphocyte ratio as a prognostic factor in COVID-19 patients: a case-control study / LA TORRE, Giuseppe; Marte, M.; Massetti, A. P.; Carli, S. M.; Romano, F.; Mastroianni, C. M.; Minorenti, M.; Alessandri, F.; Ajassa, C.; Fusconi, M.; DE VINCENTIIS, M.; DE MEO, D.; Villani, C.; Cardi, M.; Pugliese, F.; Aronica, Raissa; Mauro, Vera; Casali, Elena; Di Bari Silvia, ; Gavaruzzi, Francesca; Romani, FRANCESCO EUGENIO; Fassari, Alessia; Filippi, Valeria; Ambrogio, Curtolo; Piero Giuseppe Meliante, ; Roger, Altomari. - In: EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES. - ISSN 2284-0729. - 26:3(2022), pp. 1056-1064. [10.26355/eurrev_202202_28017]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1640901
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