Prognostic Implications Of Neutrophil-Lymphocyte Ratio In COVID-19

This study aims to determine whether the neutrophil-to-lymphocyte ratio (NLR) can be useful in the diagnosis and treatment of COVID-19

Keywords: COVID-19; endothelial dysfunction; hyperinflammatory response; Neutrophil–lymphocyte ratio.


– 45 patients (12.1%) experienced severe acute respiratory failure requiring respiratory support.

– 47 patients (12.6%) died.

– Patients with worse outcomes were older (P = 0.002) and had a significantly higher NLR on admission (P = 0.001), a greater increase in peak NLR (P < 0.001) and a greater rate of increase in NLR (P = 0.003) compared to follow-up patients.

– In multivariable logistic regression, age, cardiovascular disease and C-reactive protein at admission and peak NLR were significantly associated with death.

Description of the Study:

  • Title: Prognostic implications of neutrophil-lymphocyte ratio in COVID-19.
  • Principal Investigators: Sara Jimeno, Paula S. Ventura, Jose M. Castellano, Salvador I. García-Adasme, Mario Miranda, Paula Touza, Isabel Lllana and Alejandro López-Escobar.
  • Centre of Implementation: Hospital Universitario HM Puerta del Sur, Madrid.
  • Study Population: 119 patients with COVID-19.
  • Study Type: Retrospective observational study.
  • Design: Patients were recruited from 1 March to 31 March 2020 and were classified according to the WHO R&D Expert Group.

Objectives of the Study:

Principal Objective: To determine whether the neutrophil-to-lymphocyte ratio (NLR), as a marker of endothelial dysfunction, can be useful in identifying patients with a poor prognosis in hospitalised cases of COVID-19.

More about this Study:

Scientific Context: The clinical presentation of COVID-19 varies from mild, self-limiting disease to multiple organ failure and death. The majority of severe cases of COVID-19 present with a low lymphocyte count and high leukocyte count, and accumulating evidence suggests that in a subgroup of patients presenting with severe COVID-19, there may be a hyperinflammatory response driving severe hypercytokinaemia that may be, at least in part, signalling the presence of underlying endothelial dysfunction. In this context, the available data suggest a prognostic role of the neutrophil-lymphocyte ratio (NLR) in various inflammatory diseases and oncological processes. Following this reasoning, we hypothesised that NLR, as a marker of endothelial dysfunction, may be useful to identify patients with a poor prognosis in hospitalised COVID-19 cases.

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