Highlights • NCD4LR will contribute to the prediction of NCT in COVID-19 patients. • Patients in the high NCD4LR group had a longer NCT. • NCD4LR shows better predictive value than NLR in predicting NCT. • NCD4LR is a potential biomarker for clinical outcome in COVID-19 patients. Background Since December 2019, novel coronavirus (SARS-CoV-2)-infected pneumonia (COVID-19) occurred in Wuhan, and rapidly spread throughout China. Our study aimed to evaluate the robustness of neutrophil to CD4+ lymphocyte ratio (NCD4LR) in predicting the negative conversion time (NCT) of SARS-CoV-2 in COVID-19 patients. Methods Univariate and multivariate analysis were conducted to evaluate the independency of NCD4LR in predicting NCT. Receiver operating characteristic (ROC) curve analysis and area under the curve (AUC) were used to assess the diagnostic accuracy. Results Compared with low NCD4LR patients, patients with high NCD4LR had an older age; higher incidence of fever, fatigue, chest distress/breath shortness, severer disease assessment on admission; higher levels of inflammatory indicators; low levels of lymphocyte subsets, and a longer NCT. Multivariate analysis also identified NCD4LR as an independent risk factor for delayed NCT. ROC analysis showed that NCD4LR had a better performance than neutrophil to lymphocyte ratio in predicting the virus negative conversion within 2 weeks (AUC = 0.772), 3 weeks (AUC = 0.710), 4 weeks (AUC = 0.728), or 5 weeks (AUC = 0.815). Conclusion This study suggests that NCD4LR is a potential and useful biomarker for predicting the virus negative conversion time in COVID-19 patients. Furthermore, due to the NCDLR value is easily calculated, it can be widely used as a clinical biomarker for disease progression and clinical outcomes in COVID-19 patients.
【저자키워드】 COVID-19, SARS-CoV-2, Negative conversion time, Neutrophil to CD4+ lymphocyte ratio, 【초록키워드】 Biomarker, fatigue, Pneumonia, neutrophil, diagnostic, Lymphocyte subsets, virus, Novel coronavirus, Clinical outcome, Spread, China, Disease progression, lymphocyte, ROC, Accuracy, Chest, Fever, Wuhan, Patient, incidence, disease, patients, COVID-19 patients, ROC analysis, Multivariate analysis, NLR, Analysis, Inflammatory, AUC, Predictive, receiver operating characteristic, Older, Negative conversion, CD4+, independent risk factor, Result, evaluate, occurred, conducted, calculated, were used, contribute, 【제목키워드】 Biomarker, virus, lymphocyte, Negative conversion, CD4+,