This retrospective cohort study aimed to investigate the correlation of the neutrophil-to-lymphocyte ratio (NLR) with critical illness in older patients with COVID-19, and evaluate the prognostic power of the NLR at admission. We enrolled 232 patients with COVID-19, aged ≥60 y, in Zhejiang province from January 17 to March 3, 2020. Primary outcomes were evaluated until April 13. Cox regression was performed for prognostic factors. Twenty-nine (12.5%) patients progressed to critical illness. Age, shortness of breath, comorbidities including hypertension, heart disease, and chronic obstructive pulmonary disease, higher NLR, lower albumin levels, and multiple mottling and ground-glass opacity were associated with progression. In the multivariate analysis, older age (hazard ratio [HR] 1.121, confidence interval [CI] 1.070-1.174, P<0.001), heart disease (HR 2.587, CI 1.156-5.787, P=0.021), higher NLR (HR 1.136, CI 1.094-1.180, P < 0.001), and multiple mottling and ground-glass opacity (HR 4.518, CI 1.906-10.712, P<0.001) remained critical illness predictors. The NLR was independently associated with progression to critical illness; the relationship was significant and graded (HR: 1.16 per unit; 95% CI: 1.10-1.22; P for trend < 0.001). Therefore, NLR can be adopted as a prognostic tool to assist healthcare providers predict the clinical outcomes of older patients suffering from COVID-19.
【저자키워드】 COVID-19, SARS-CoV-2, risk factor, Neutrophil-to-lymphocyte ratio, older patients, 【초록키워드】 Comorbidity, predictors, progression, outcome, hypertension, Clinical outcome, ground-glass opacity, older patient, Patient, Older age, Prognostic factors, prognostic, correlation, disease, Admission, Critical, predict, pulmonary disease, NLR, Analysis, Cox regression, Shortness of breath, retrospective cohort study, confidence interval, Healthcare provider, hazard ratio, albumin levels, Zhejiang, enrolled, evaluate, remained, evaluated, was performed, adopted, assist, chronic obstructive, patients with COVID-19, progressed, with COVID-19, 【제목키워드】 progression, Retrospective study, older patient, multicenter, Critical,