PB2296: THE PROGNOSTIC ROLE OF NEUTROPHIL TO LYMPHOCYTE RATIO AND PLATELET TO LYMPHOCYTE RATIO IN COVID-19 PATIENTS: A MONOCENTRIC STUDY

Abstract

Background: Several studies described numerous factors to affect the prognosis and predict the severity of COVID-19. Inflammatory markers like neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been used to prognosticate cancers and inflammatory diseases such as COVID-19. Aims: To describe and identify the predictive factors of intensive care unit admission in COVID-19. Methods: This is a retrospective study conducted in Fattouma Bourguiba University Hospital of Monastir, Tunisia, from April 2020 to February 2022. Our study concerned patients diagnosed with COVID-19 during this period. NLR and PLR were investigated for each patient at the first day of hospitalization and all patients were followed in order to notice who required intensive care unit (ICU). Results: We enrolled 569 patients. The median age was 62 years old (ranged 1-96) and we had male predominance (sex ratio 1.63). Seventy one per cent of our population had lymphopenia and polynucleosis was found in 45.7% of cases. The median NLR and the median PLR were respectively 6.37 and 232.05. NLR >3, NLR >9 and PLR >180 accounted for 77%, 35% and 57.9% respectively. Twenty three per cent of our population required hospitalization in ICU and this condition was significantly associated with elevated NLR and elevated PLR in univariate analysis (Table 1). Table 1: - Univariate analysis Total ICU N % N % p NLR >3 431 77 112 26 0.002 NLR>9 196 35 73 37.2 0.000 PLR >180 324 57.9 92 28.4 0.000 Age >60 years 310 54.5 76 24.5 0.250 Age >75 years 81 14.2 12 14.8 0.068 In multivariate analysis, elevated NLR (>9) (hazard risk [HR] 2.83, 95% confidence interval [CI] 1.75–4.57) was retained as only factor associated with intensive care hospitalization. Summary/Conclusion: Many factors can modify the clinical outcome in COVID-19 patients. Our study supports the fact that elevated NLR (>9) may be a prognostic biomarker.