Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19
- PMID: 32283162
- PMCID: PMC7195072
- DOI: 10.1016/j.jinf.2020.04.002
Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19
Abstract
Background: Several studies have described the clinical characteristics of patients with novel coronavirus (SARS-CoV-2) infected pneumonia (COVID-19), indicating severe patients tended to have higher neutrophil to lymphocyte ratio (NLR). Whether baseline NLR could be an independent predictor of in-hospital death in Chinese COVID-19 patients remains to be investigated.
Methods: A cohort of patients with COVID-19 admitted to the Zhongnan Hospital of Wuhan University from January 1 to February 29 was retrospectively analyzed. The baseline data of laboratory examinations, including NLR, were collected. Univariate and multivariate logistic regression models were developed to assess the independent relationship between the baseline NLR and in-hospital all-cause death. A sensitivity analysis was performed by converting NLR from a continuous variable to a categorical variable according to tertile. Interaction and stratified analyses were conducted as well.
Results: 245 COVID-19 patients were included in the final analyses, and the in-hospital mortality was 13.47%. Multivariate analysis demonstrated that there was 8% higher risk of in-hospital mortality for each unit increase in NLR (Odds ratio [OR] = 1.08; 95% confidence interval [95% CI], 1.01 to 1.14; P = 0.0147). Compared with patients in the lowest tertile, the NLR of patients in the highest tertile had a 15.04-fold higher risk of death (OR = 16.04; 95% CI, 1.14 to 224.95; P = 0.0395) after adjustment for potential confounders. Notably, the fully adjusted OR for mortality was 1.10 in males for each unit increase of NLR (OR = 1.10; 95% CI, 1.02 to 1.19; P = 0.016).
Conclusions: NLR is an independent risk factor of the in-hospital mortality for COVID-19 patients especially for male. Assessment of NLR may help identify high risk individuals with COVID-19.
Keywords: COVID-19; Mortality; Neutrophil-to-Lymphocyte Ratio; Risk factors.
Copyright © 2020. Published by Elsevier Ltd.
Conflict of interest statement
Declaration of Competing Interest The authors state that they have no conflicts of interest to disclosure.
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Comment in
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Comparing hospitalised, community and staff COVID-19 infection rates during the early phase of the evolving COVID-19 epidemic.J Infect. 2020 Oct;81(4):647-679. doi: 10.1016/j.jinf.2020.05.029. Epub 2020 May 19. J Infect. 2020. PMID: 32442455 Free PMC article. No abstract available.
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Neutrophil-to-lymphocyte ratio on admission is an independent risk factor for the severity and mortality in patients with coronavirus disease 2019.J Infect. 2021 Feb;82(2):e16-e18. doi: 10.1016/j.jinf.2020.09.022. Epub 2020 Sep 24. J Infect. 2021. PMID: 32979408 Free PMC article. No abstract available.
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References
-
- Azab B., Zaher M., Weiserbs K.F. Usefulness of neutrophil to lymphocyte ratio in predicting short- and long-term mortality after non-ST-elevation myocardial infarction. Am J Cardiol. 2010;106(4):470–476. - PubMed
-
- Guthrie G.J., Charles K.A., Roxburgh C.S., Horgan P.G., McMillan D.C., Clarke S.J. The systemic inflammation-based neutrophil-lymphocyte ratio: experience in patients with cancer. Crit Rev Oncol Hematol. 2013;88(1):218–230. - PubMed
-
- Giede-Jeppe A., Bobinger T., Gerner S.T. Neutrophil-to-Lymphocyte Ratio Is an Independent Predictor for In-Hospital Mortality in Spontaneous Intracerebral Hemorrhage. Cerebrovasc Dis. 2017;44(1-2):26–34. - PubMed
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