Significance of neutrophil to lymphocyte ratio evaluation as a prognostic indicator in dengue patients

Abstract

Dengue is the most important arthropod borne re-emerging tropical viral infection in human beings resulting in more illness and deaths. Platelet count and hematocrit estimations are the most common parameters to assess the severity of dengue. However, due to the heterogeneous nature of the clinical presentation of dengue patients, it’s difficult to identify sensitive clinical or laboratory predictor to assess dengue severity. Neutrophil - Lymphocyte ratio (NLR) has been proved as a prognostic marker in various diseases and may emerge as a potential predictor for the dengue severity and its prognosis. This study aims to evaluate the NLR in dengue patients and to assess its role in relation with patients clinical and serological profile as well as platelet counts. A retrospective observational study was conducted in which 100 cases (≥12 years of age) of dengue which were diagnosed at our laboratory were studied and their clinical and laboratory data were analysed. Test of significance was done by Chi Square test with consideration of P value ≤ 0.05 as statistically significant. Male predominance was observed with dengue infection. NS1Ag (+) was the most common dengue serological profile. NLR ≤2 significantly correlates with thrombocytopenia. A significant relation was found between NLR and severity of the dengue patients. In conclusion, NLR ≤2 correlates with low platelet count which corresponds to more severity of the dengue disease. NLR >2 indicates more platelet count and less severity of the disease. Hence NLR evaluation can be used as a prognostic indicator in dengue patients.