Abstract
Object: The study aimed to utilize the peripheral blood immunological parameters and resulting individual and combined inflammatory indices [neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR) and C-reactive protein/lymphocyte ratio (CLR)] in predicting the prognosis and mortality in COVID-19 patients.
Materials and methods: The measurements of individual and combined inflammatory indices (NLR, LMR and CLR) were performed at hospital admission and at last day of hospitalization for COVID-19 patients.
Results: Prominent elevation of NLR and CLR among patients with refractory disease admitted to Intensive Care Unit (ICU) and deceased patients was found when compared with moderate ill patients and healthy controls. Interestingly, NLR and CLR typically returned to near normal value as patients recover from severe infection. By contrast, deceased patients had persistent increased NLR and CLR until last day of hospitalization in ICU. ROC obtained for the above parameters showed that NLR and CLR were the most associated immunological parameters with the severity of COVID-19 disease. Using multivariate logistic regression analysis, CLR > 69.46 is an independent prognostic factors in identifying critically ill COVID-19 cases. Study of the combined markers NLR and CLR showed that most of patients admitted in ICU were characterized with high NLR combined with high CLR, while most of healthy subjects and non-ICU group have low NLR combined with low CLR.
Conclusion: The combination of NLR and CLR could improve the predictive efficacy compared to individual markers to segregate patients who will develop a severe disease from those with a mild pathology.
Keywords: CLR; COVID-19; Combined markers; NLR; Prognosis; SARS-CoV-2.
【저자키워드】 COVID-19, Prognosis, SARS-CoV-2., NLR, CLR, Combined markers, 【초록키워드】 SARS-CoV-2, pathology, Severe infection, Efficacy, Mortality, Prognosis, Hospitalization, neutrophil, intensive care unit, C-reactive protein, ICU, COVID-19 disease, Peripheral blood, lymphocyte, Critically ill, ROC, severity of COVID-19, Patient, Mild, Hospital admission, neutrophil/lymphocyte ratio, disease, moderate, COVID-19 patients, marker, Combination, Analysis, Inflammatory, Deceased, severe disease, COVID-19 cases, Prognostic factor, Predictive, normal value, healthy subjects, multivariate logistic regression, non-ICU, healthy controls, multivariate logistic regression analysis, material, parameter, independent, Combined, IMPROVE, resulting, performed, develop, characterized, healthy subject, returned, ill patient, immunological parameter, Prominent, 【제목키워드】 disease severity, outcome, patients with COVID-19,