The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients
Open accessAbstract
Aim To accumulate evidence that indicated the key role played by virus-triggered inflammation in the 2019-novel coronavirus disease (COVID-19) which emerged in Wuhan City and rapidly spread throughout China.Methods Age, neutrophil(NEU)-to-lymphocyte (LYM) ratio (NLR), lymphocyte-to-monocyte (MON) ratio, platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP) of 93 patients with laboratory confirmed COVID-19 were investigated and compared. The receiver operating characteristic curve was applied to determine the thresholds for five bio-markers, and their prognostic values were assessed via the Kaplan-Meier curve and multivariate COX regression models.Results The median age was 46.4 years old, and 37cases were females. A total of 27.8% of patients had been to Wuhan, and 73.1% had contacted with people from Wuhan. Fever (83.8%) and cough (70.9%) were the two most common symptoms. Elevated NLR and age were significantly associated with illness severity. The binary logistic analysis identified elevated NLR (hazard risk [HR] 2.46, 95% confidence interval [CI] 1.98-4.57) and age (HR 2.52, 95% CI 1.65-4.83) as independent factors for poor clinical outcome of COVID-19. NLR exhibited the largest area under the curve at 0.841, with the highest specificity (63.6%) and sensitivity (88%).Conclusions Elevated age and NLR can be considered independent biomarkers for indicating poor clinical outcomes.
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Melanoma patients on PD-1 therapy with high NLR had worse overall and progression-free survival than those with low NLR.
“Consistent with published studies in multiple settings21–24, PD-1-treated patients with melanoma with a high NLR had poorer survival (OS/PFS) than those with a low NLR.”
From Intestinal microbiota signatures of clinical response and immune-related adverse events in melanoma patients treated with anti-PD-1 (2022) · cites this paper as [24]
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Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30183-5 · Cited by 48,884 · see citing works
Self-citationA novel coronavirus from patients with pneumonia in China, 2019
Zhu, N., Zhang, D., Wang, W., Li, X., Yang, B., Song, J., Zhao, X., Huang, B., Shi, W., Lu, R., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2001017 · Cited by 28,244 · see citing works
Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia
Li, Q., Guan, X., Wu, P., Wang, X., Zhou, L., Tong, Y., Ren, R., Leung, K. S. M., Lau, E. H. Y., Wong, J. Y., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa2001316 · Cited by 16,575 · see citing works
Self-citationHui, D. S., I Azhar, E., Madani, T. A., Ntoumi, F., Kock, R., Dar, O., Ippolito, G., Mchugh, T. D., Memish, Z. A., Drosten, C., et al. (2020) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2020.01.009 · Cited by 3,809 · see citing works
Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle
Lu, H., Stratton, C. W., & Tang, Y. (2020) · Journal of Medical Virology · doi:10.1002/jmv.25678 · Cited by 3,497 · see citing works
MERS, SARS and other coronaviruses as causes of pneumonia
Yin, Y., & Wunderink, R. G. (2017) · Respirology · doi:10.1111/resp.13196 · Cited by 1,095 · see citing works
Infections as a major preventable cause of human cancer
Kuper, H., Adami, H. ‐., & Trichopoulos, D. (2000) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.2000.00742.x · Cited by 740 · see citing works
Cross-host evolution of severe acute respiratory syndrome coronavirus in palm civet and human
Song, H., Tu, C., Zhang, G., Wang, S., Zheng, K. C., Lei, L., Chen, Q., Gao, Y., Zhou, H., Xiang, H., et al. (2005) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0409608102 · Cited by 683 · see citing works
Self-citationMiddle East respiratory syndrome coronavirus in dromedary camels: an outbreak investigation
Haagmans, B. L., Dhahiry, S. H. S. A., Reusken, C. B. E. M., Raj, V. S., Galiano, M., Myers, R. E., Godeke, G.-J., Jonges, M., Farag, E., Diab, A. H. M., et al. (2013) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(13)70690-x · Cited by 672 · see citing works
Chronic inflammation and cancer.
Shacter, E. B., & Weitzman, S. A. (2002) · PubMed · Cited by 634 · see citing works
Chronic Inflammation and Cancer
Oshima, M. (2013) · Medical Entomology and Zoology · Cited by 582 · see citing works
Kusumanto, Y. H., Dam, W., Hospers, G. A. P., Meijer, C., & Mulder, N. H. (2003) · Angiogenesis · doi:10.1023/b:agen.0000029415.62384.ba · Cited by 530 · see citing works
Blaser, M. J., Chyou, P.-H., & Nomura, A. M. Y. (1995) · PubMed · Cited by 398 · see citing works
Ying, H.-Q., Deng, Q.-W., He, B., Pan, Y.-Q., Wang, F., Sun, H.-L., Chen, J., Liu, X., & Wang, S.-K. (2014) · Medical Oncology · doi:10.1007/s12032-014-0305-0 · Cited by 319 · see citing works
Tao, Y., Shī, M., Chommanard, C., Queen, K. J., Zhang, J., Markotter, W., Kuzmin, I. V., Holmes, E. C., & Tong, S. (2017) · Journal of Virology · doi:10.1128/jvi.01953-16 · Cited by 266 · see citing works
What to do next to control the 2019-nCoV epidemic?
Wang, F., & Zhang, C. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30300-7 · Cited by 242 · see citing works
Hanrahan, V., Currie, M. J., Gunningham, S. P., et al. (2003) · The Journal of Pathology · doi:10.1002/path.1339 · Cited by 236 · see citing works
High Neutrophil-to-Lymphocyte Ratio Predicts Stroke-Associated Pneumonia
Nam, K., Kim, T. J., Lee, J. S., Kwon, H., Lee, Y.-S., Ko, S., & Yoon, B. (2018) · Stroke · doi:10.1161/strokeaha.118.021228 · Cited by 233 · see citing works
Uslu, A. U., Küçük, A., Şahin, A., et al. (2015) · International Journal of Rheumatic Diseases · doi:10.1111/1756-185x.12582 · Cited by 232 · see citing works
Changes in blood lymphocyte populations after multiple trauma
Menges, T., Engel, J., Welters, I. D., et al. (1999) · Critical Care Medicine · doi:10.1097/00003246-199904000-00026 · Cited by 227 · see citing works
Scholl, S. M., Pallud, C., Beuvon, F., Hacene, K., Stanley, E. R., Rohrschneider, L., Tang, R., Pouillart, P., & Lidereau, R. (1994) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/86.2.120 · Cited by 226 · see citing works
RABINOWICH, H., Cohen, R., BRUDERMAN, I., et al. (1987) · PubMed · Cited by 176 · see citing works
Xiang, N., Havers, F. P., Chen, T., Song, Y., Tu, W., Li, L., Cao, Y., Liu, B., Zhou, L., Meng, L., et al. (2013) · Emerging infectious diseases · doi:10.3201/eid1911.130865 · Cited by 87 · see citing works
Yadav, A. R., & Mohite, S. K. (2020) · Research Journal of Pharmaceutical Dosage Forms and Technology · doi:10.5958/0975-4377.2020.00030.0 · Cited by 87 · see citing works
Zhang, Y., Zou, P., Gao, H., Yang, M., Yi, P., Gan, J., Shen, Y., Wang, W., Zhang, W., Li, J., et al. (2019) · Therapeutics and Clinical Risk Management · doi:10.2147/tcrm.s206930 · Cited by 45 · see citing works
Jeon, Y. L., Lee, W., Kang, S. Y., et al. (2019) · Laboratory Medicine · doi:10.1093/labmed/lmy083 · Cited by 40 · see citing works
Kim, S., Lee, S.-T., Trang, K. T. T., et al. (2014) · International Journal of Molecular Medicine · doi:10.3892/ijmm.2014.1669 · Cited by 35 · see citing works
Shimoyama, Y., Umegaki, O., Inoue, S., et al. (2018) · PubMed · doi:10.18926/amo/56377 · Cited by 18 · see citing works
Saeed, A. M., Rosati, L. M., Narang, A. K., et al. (2015) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/j.ijrobp.2015.07.949 · Cited by 3 · see citing works
Dolan, W. D. (1972) · Laboratory Medicine · doi:10.1093/labmed/3.6.3 · Cited by 1 · see citing works
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Research works printed but not linked: 1
- [24]Ying H.Q. Deng Q.W. He B.S. The prognostic value of preoperative NLR, d-NLR, PLR and LMR for predicting clinical outcome in surgical colorectal cancer patients Med. Oncol. 31 12 2014 305 25355641
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Abou-Ismail, M. Y., Diamond, A., Kapoor, S., Arafah, Y., & Nayak, L. (2020) · Thrombosis Research · doi:10.1016/j.thromres.2020.06.029 · Cited by 694 · see citing works
McCulloch, J. A., Davar, D., Rodrigues, R. R., Badger, J. H., Fang, J. R., Cole, A. M., Balaji, A. K., Vetizou, M., Prescott, S. M., Fernandes, M. R., et al. (2022) · Nature Medicine · doi:10.1038/s41591-022-01698-2 · Cited by 472 · see citing works
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Ahmed, S., Zimba, O., & Gasparyan, A. Y. (2020) · Clinical Rheumatology · doi:10.1007/s10067-020-05275-1 · Cited by 251 · see citing works
- Authors
- Yang, A.-P., Liu, J.-P., Tao, W.-Q., & Li, H.-M.
- Affiliations
- First Affiliated Hospital of Nanchang University (CN)
- Venue
- International Immunopharmacology
- Publisher
- Elsevier BV
- Published
- 2020-07
- Volume
- 84
- Pages
- 106504
- ISSN
- 1567-5769 (ISSN-L)
- PMC
- PMC7152924
- OpenAlex
- W3016987930
- Cited by
- 1,138
- References
- 30
- Citations by year
- 2026: 27 · 2025: 47 · 2024: 85 · 2023: 207 · 2022: 273 · 2021: 312 · 2020: 184 · 2019: 1 · 2017: 1
- FWCI
- 32.02
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- International Immunopharmacology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Hangzhou Science and Technology Bureau (20181228Y86)
- Topics
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Keywords
- COVID-19 pandemic, neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio, C-reactive protein, prognostic factors, disease severity, age as risk factor, inflammatory markers, clinical outcome prediction
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adult, Blood Platelets, C-Reactive Protein, Female, Humans, Lymphocytes, Male, Middle Aged, Monocytes, Neutrophils, Pneumonia, Viral, Prognosis, ROC Curve, Coronavirus Infections, Lymphocyte Count, Epidemics, Pandemics
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