Neutrophil to lymphocyte ratio (NLR) in COVID-19: A cheap prognostic marker in a resource constraint setting.

Kaleem Ullah Toori,Muhammad Farhan Safdar,Muhammad Arsalan Qureshi,Asma Chaudhry

doi:10.12669/pjms.37.5.4194

Abstract

Objectives:To identify association of neutrophil to lymphocyte ratio with disease severity and mortality.Methods:Total 720 Corona Virus RT-PCR positive patients were included in this cross-sectional study. Patients were admitted to KRL Hospital Islamabad from April 2020 to August 2020. Neutrophil to lymphocyte ratio (NLR) was recorded on admission and then serially. NLR cut-off was 3.0. WHO categories for disease severity (asymptomatic, mild, moderate and severe) were used. Demographic profile, symptoms and co-morbidities were recorded.Results:The mean age of patients was 40 ± 12.4 years with 96% being males. Majority patients (76.5%) were asymptomatic. Amongst symptoms, fever was the most common symptom. Diabetes mellitus was most common recorded co-morbidity. The mean NLR 2.5 ± 2.78. Significant association was found between NLR and disease severity as well as mortality. Difference in mean NLR amongst disease severity categories was also significantConclusion:Results are compatible with worldwide studies and NLR is a cheap and easily available marker of disease severity and mortality.

Highlights

Coronavirus Disease 2019 (COVID-19) is a rapidly spreading disease; first cases of Corona virus emerged in China in 2019, following which it was declared a global pandemic in March 2020 by World Health Organization (WHO).[1]
Neutrophil to lymphocyte ratio (NLR) has been shown to be a reliable indicator to determine disease severity in COVID-19.11,12 Many mechanisms have been postulated regarding the response of neutrophils and lymphocytes to corona virus infection
Our study has shown that mean NLR value significantly increases as disease severity progresses with lowest NLR recorded in asymptomatic and mild disease

Summary

Introduction

Coronavirus Disease 2019 (COVID-19) is a rapidly spreading disease; first cases of Corona virus emerged in China in 2019, following which it was declared a global pandemic in March 2020 by World Health Organization (WHO).[1] COVID-19 presents with a wide range of symptoms. The spectrum of disease is variable, with majority cases being mild and self-limiting. The disease can be fatal with development of severe pneumonia progressing to acute respiratory distress syndrome (ARDS) and multi-organ failure.[2]. Inflammation plays a major role in development and progression of COVID-19. People infected with COVID-19 are known to have an immune system that is dysregulated and can cause abnormal

Objectives

Methods

Conclusion