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Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage

Open access
Liu, Jingyuan, Liu, Yao, Xiang, Pan, Pu, Lin, Xiong, Haofeng, Li, Chuansheng, Zhang, Ming, Tan, Jianbo, Xu, Yanli, Song, Rui, Song, Meihua, Wang, Lin, Zhang, Wei, Han, Bing, Yang, Li, Wang, Xiaojing, Zhou, Guiqin, Zhang, Ting, Li, Ben, Wang, Yanbin, Chen, Zhihai, Wang, Xianbo·2020·Journal of Translational Medicine
DOI 10.1186/s12967-020-02374-0

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Abstract

Background: Patients with critical illness due to infection with the 2019 coronavirus disease (COVID-19) show rapid disease progression to acute respiratory failure. The study aimed to screen the most useful predictive factor for critical illness caused by COVID-19. Methods: The study prospectively involved 61 patients with COVID-19 infection as a derivation cohort, and 54 patients as a validation cohort. The predictive factor for critical illness was selected using LASSO regression analysis. A nomogram based on non-specific laboratory indicators was built to predict the probability of critical illness. Results: The neutrophil-to-lymphocyte ratio (NLR) was identified as an independent risk factor for critical illness in patients with COVID-19 infection. The NLR had an area under receiver operating characteristic of 0.849 (95% confidence interval [CI], 0.707 to 0.991) in the derivation cohort and 0.867 (95% CI 0.747 to 0.944) in the validation cohort, the calibration curves fitted well, and the decision and clinical impact curves showed that the NLR had high standardized net benefit. In addition, the incidence of critical illness was 9.1% (1/11) for patients aged ≥ 50 and having an NLR < 3.13, and 50% (7/14) patients with age ≥ 50 and NLR ≥ 3.13 were predicted to develop critical illness. Based on the risk stratification of NLR according to age, this study has developed a COVID-19 pneumonia management process. Conclusions: We found that NLR is a predictive factor for early-stage prediction of patients infected with COVID-19 who are likely to develop critical illness. Patients aged ≥ 50 and having an NLR ≥ 3.13 are predicted to develop critical illness, and they should thus have rapid access to an intensive care unit if necessary.

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Research works printed but not linked: 26

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Metadata

Authors
Liu, J., Liu, Y., Xiang, P., Pu, L., Xiong, H., Li, C., Zhang, M., Tan, J., Xu, Y., Song, R., Song, M., Wang, L., Zhang, W., Han, B., Yang, L., Wang, X., Zhou, G., Zhang, T., Li, B., Wang, Y., Chen, Z., & Wang, X.
Venue
Journal of Translational Medicine
Publisher
Springer Science and Business Media LLC
Published
2020-05-20
Volume
18
Issue
1
Pages
206-206
ISSN
1479-5876 (ISSN-L)
DOI
10.1186/s12967-020-02374-0
OpenAlex
W3025063365
Cited by
1,082
References
4
FWCI
28.94
Type
journal article
Language
en
Open access
gold
Licence

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CoChat. (2026). Citation check: Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage. https://app.cochat.ai/papers/10.1186/s12967-020-02374-0
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Liu, J., Liu, Y., Xiang, P., Pu, L., Xiong, H., Li, C., Zhang, M., Tan, J., Xu, Y., Song, R., Song, M., Wang, L., Zhang, W., Han, B., Yang, L., Wang, X., Zhou, G., Zhang, T., Li, B., . . . Wang, X. (2020). Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage. Journal of Translational Medicine. https://doi.org/10.1186/s12967-020-02374-0

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