2519. The Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Patients With Crimean-Congo Haemorrhagic Fever

Abstract

BackgroundThe neutrophil-to-lymphocyte ratio (NLR) has been shown to be associated with poor prognosis in both malign and benign disorders. However, the studies regarding NLR as a prognostic marker in Crimean-Congo hemorrhagic fever (CCHF) are limited. This study aimed to investigate the relationship between NLR and survival outcome in patients with CCHF.MethodsThe demographic and laboratory characteristics of 723 adult patients having a positive IgM and/or a positive PCR result for CCHF in the blood sample between 2007 and 2017 were reviewed. The patients were divided into two groups according to survival and fatal outcome. The area under an ROC curve was calculated to evaluate the relationship between NLR and survival outcome. The statistical significance was set at P < 0.05.ResultsPlasma NLR, creatinine, AST, ALT, LDH and CK levels in fatal cases were significantly higher than those in survival ones (P < 0.001 for all parameters), while platelet count was significantly lower (P < 0.001). All population were re-evaluated according to NLR. Plasma ALT, AST, LDH, CK, and creatinine levels when NLR was ≤ 2 were significantly lower than those when NLR was > 2 (P = 0.006, P = 0.017, P < 0.001, P < 0.001, and P < 0.001, respectively) (Table 1). The area under an ROC curve for NLR was 72% (P < 0.001).Table 1:Demographic and Laboratory Characteristics in the Patients With Crimean-Congo Hemorrhagic FeverCharacteristicsSurvival Patients (n = 693)Fatal Patients (n = 30) P-ValueNLR ≤ 2 (n = 384)NLR > 2 (n = 339)P-ValueAge (%)49.1 (17.5)64.6 (14.3)0.00148.6 (17.0)51 (18.3)0.080Gender (% Female)46.6400.47751.340.70.004Platelet count, (×103 platelets/mm3)49.8 (35.4)17.8 (7.5)0.00149.9 (33.7)46.7 (36.9)0.032ALT (U/L)230.2 (429.4)1386 (1295.6)0.001225.3(320.5)338.1(715.5)0.006AST (U/L)387.7 (529.1)3327.1(3478.8)0.001406.7(801.2)626.4(1262.3)0.017LDH (U/L)857.3(1049.9)5385.1(5404.3)0.001813.4(972.3)1307.6(2303.4)0.001CK (U/L)850.0(1173.3)3171.5(5353.2)0.001743.5(1023.3)1176.2(2109.3)0.001Creatinine (mg/dl)0.9 (0.5)2.7 (2.5)0.0010.9 (0.6)1,1 (0.9)0.001NLR2.9 (3.5)4.5 (3.3)0.001Dead (%)1.67.10.001ConclusionNLR for clinicians may be an additional test as useful as platelet count and plasma creatinine, AST, ALT, LDH, and CK levels. Our study shows that NLR might be used as a prognostic marker to predict the severity of the disease in CCHF.Disclosures All authors: No reported disclosures.