Samir ALLAHVERDİYEV, Alaa QUISI, Hazar HARBALIOĞLU, Gökhan ALICI, Ömer GENÇ, Abdullah YILDIRIM, İbrahim Halil KURT

The Neutrophil to Lymphocyte Ratio and In-Hospital All-Cause Mortality in Patients with COVID-19

Objective: In December 2019, pneumonia associated with severe acute respiratory syndrome coronavirus 2 emerged in China, andhas been spread worldwide eventuating the coronavirus disease 2019 (COVID-19) pandemic. As of June 27, 2020, 195,883 peoplehave been diagnosed with COVID-19 in Turkey, among them 5082 are dead. Moreover, 9,999,606 people were infected worldwide.The neutrophil-to-lymphocyte ratio (NLR) has been reported as an inflammatory biomarker. This study aimed to evaluate the relationship between NLR on admission and in-hospital all-cause mortality in adult patients with COVID-19.Methods: This retrospective cohort study included a total of 455 COVID-19 patients from Turkey. The diagnosis of COVID-19 wasmade according to the World Health Organization’s interim guidance and confirmed by RNA detection of SARS-CoV-2. The NLRwas calculated for each patient.Results: The NLR on admission was found to be significantly higher in nonsurvivor COVID-19 patients than survivors (12.3 [0.8–137.3] vs. 3.2 [0.6–79.0], p

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1. Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med 2020; 382: 727-33. [Crossref]
2. Faria SS, Fernandes Jr PC, Silva MJ, Lima VC, Fontes W, Freitas-Junior R, et al. The neutrophil-to-lymphocyte ratio: a narrative review. Ecancermedicalscience 2016; 10: 702. [Crossref]
3. Imtiaz F, Shafique K, Mirza SS, Ayoob Z, Vart P, Rao S. Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. Int Arch Med 2012; 5: 2. [Crossref]
4. de Jager CP, Wever PC, Gemen EF, Kusters R, van Gageldonk-Lafeber AB, van der Poll T, et al. The neutrophil-lymphocyte count ratio in patients with community-acquired pneumonia. PLoS One 2012; 7: e46561. [Crossref]
5. Curbelo J, Rajas O, Arnalich B, Galvan-Roman JM, Luquero-Bueno S, Ortega-Gomez M, et al. Neutrophil Count Percentage and Neutrophil-Lymphocyte Ratio as Prognostic Markers in Patients Hospitalized for Community-Acquired Pneumonia. Arch Bronconeumol 2019; 55: 472-7. [Crossref]
6. Kaushik R, Gupta M, Sharma M, Jash D, Jain N, Sinha N, et al. Diagnostic and Prognostic Role of Neutrophil-to-Lymphocyte Ratio in Early and Late Phase of Sepsis. Indian J Crit Care Med 2018; 22: 660- 3. [Crossref]
7. Liu Y, Du X, Chen J, Jin Y, Peng L, Wang HHX, et al. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect 2020; 81: e6-e12. [Crossref]
8. Liu J, Liu Y, Xiang P, Pu L, Xiong H, Li C, et al. Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage. J Transl Med 2020; 18: 206. [Crossref]
9. Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of immune response in patients with COVID-19 in Wuhan, China. Clin Infect Dis 2020; 71: 762-8. [Crossref]
10. Mo P, Xing Y, Xiao Y, Deng L, Zhao Q, Wang H, et al. Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, China. Clin Infect Dis 2020. [Crossref]
11. Channappanavar R, Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Semin Immunopathol 2017; 39: 529-39. [Crossref]
12. He Z, Zhao C, Dong Q, Zhuang H, Song S, Peng G, et al. Effects of severe acute respiratory syndrome (SARS) coronavirus infection on peripheral blood lymphocytes and their subsets. Int J Infect Dis 2005; 9: 323-30. [Crossref]
13. Min CK, Cheon S, Ha NY, Sohn KM, Kim Y, Aigerim A, et al. Comparative and kinetic analysis of viral shedding and immunological responses in MERS patients representing a broad spectrum of disease severity. Sci Rep 2016; 6: 25359. [Crossref]
14. Al-Tawfiq JA, Hinedi K, Abbasi S, Babiker M, Sunji A, Eltigani M. Hematologic, hepatic, and renal function changes in hospitalized patients with Middle East respiratory syndrome coronavirus. Int J Lab Hematol 2017; 39: 272-8. [Crossref]
15. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497-506. [Crossref]
16. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395: 1054-62. [Crossref]
17. Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med 2020; 46: 846-8. [Crossref]
18. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 2020; 323: 1061-9. [Crossref]
19. Zhang J, Wang X, Jia X, Li J, Hu K, Chen G, et al. Risk factors for disease severity, unimprovement, and mortality of COVID-19 patients in Wuhan, China. Clin Microbiol Infect 2020; 26: 767-72. [Crossref]