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Cited by 171COVID-19 Clinical Research StudiesInflammatory Biomarkers in Disease PrognosisSepsis Diagnosis and Treatment

Novel Systemic Inflammation Markers to Predict COVID-19 Prognosis

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Karimi, Amirali, Shobeiri, Parnian, Kulasinghe, Arutha, Rezaei, Nima·2021·Frontiers in Immunology
DOI 10.3389/fimmu.2021.741061PMC PMC8569430
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Abstract

Coronavirus disease 2019 (COVID-19) has resulted in a global pandemic, challenging both the medical and scientific community for the development of novel vaccines and a greater understanding of the effects of the SARS-CoV-2 virus. COVID-19 has been associated with a pronounced and out-of-control inflammatory response. Studies have sought to understand the effects of inflammatory response markers to prognosticate the disease. Herein, we aimed to review the evidence of 11 groups of systemic inflammatory markers for risk-stratifying patients and prognosticating outcomes related to COVID-19. Numerous studies have demonstrated the effectiveness of neutrophil to lymphocyte ratio (NLR) in prognosticating patient outcomes, including but not limited to severe disease, hospitalization, intensive care unit (ICU) admission, intubation, and death. A few markers outperformed NLR in predicting outcomes, including 1) systemic immune-inflammation index (SII), 2) prognostic nutritional index (PNI), 3) C-reactive protein (CRP) to albumin ratio (CAR) and high-sensitivity CAR (hsCAR), and 4) CRP to prealbumin ratio (CPAR) and high-sensitivity CPAR (hsCPAR). However, there are a limited number of studies comparing NLR with these markers, and such conclusions require larger validation studies. Overall, the evidence suggests that most of the studied markers are able to predict COVID-19 prognosis, however NLR seems to be the most robust marker.

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  • ICRs have been repeatedly proposed as solid prognostic markers for various additional conditions including low-grade inflammation, rheumatic diseases, sepsis, myocarditis, thrombosis, ischemic and cardiovascular events, autoimmune and systemic diseases, cancer incidence, progression, response and outcome, COVID-19 severity and prognosis, critical illness, and overall mortality.

    “Since then, IRCs have been repeatedly proposed as solid prognostic markers for various additional conditions including low-grade inflammation, rheumatic diseases, sepsis, myocarditis, thrombosis, ischemic and cardiovascular events, autoimmune and systemic diseases, cancer incidence, progression, response and outcome, COVID-19 severity and prognosis, critical illness, and overall mortality [26,27,2”

    From Immune Cell Ratios Are Higher in Bipolar Affective than Unipolar Depressive Disorder and Modulated by Mood Episode: A Retrospective, Cross-Sectional Study (2023) · cites this paper as [35]

    The Introduction says inflammatory markers have been used to prognosticate inflammatory diseases and cancers, and the review reports evidence for predicting COVID-19 severity and outcomes, including death. It does not establish the claimed prognostic uses across the full list of conditions, such as rheumatic diseases, myocarditis, thrombosis, and autoimmune diseases; the Conclusion also notes that some markers need further study. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

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  1. [1]Lambert H Gupte J Fletcher H Hammond L Lowe N Pelling M. COVID-19 as a Global Challenge: Towards an Inclusive and Sustainable Future. Lancet Planet Health (2020) 4(8): e312–e4. doi: 10.1016/S2542-5196(20)30168-6 32702296 · DOI
  2. [2]Mehraeen E Karimi A Barzegary A Vahedi F Afsahi AM Dadras O. Predictors of Mortality in Patients With COVID-19-a Systematic Review. Eur J Integr Med (2020) 40: 101226. doi: 10.1016/j.eujim.2020.101226 33101547 PMC7568488 · DOI
  3. [4]Shafi AMA Shaikh SA Shirke MM Iddawela S Harky A. Cardiac Manifestations in COVID-19 Patients—A Systematic Review. J Cardiac Surg (2020) 35(8): 1988– 2008. doi: 10.1111/jocs.14808 PMC7404674 32652713 · DOI
  4. [5]Mehraeen E Seyed Alinaghi SA Nowroozi A Dadras O Alilou S Shobeiri P. A Systematic Review of ECG Findings in Patients With COVID-19. Indian Heart J (2020) 72(6): 500–7. doi: 10.1016/j.ihj.2020.11.007 PMC7661958 33357637 · DOI
  5. [6]Qiu Y He J-S Tan J-Y Lin S-N Mao R. Gastrointestinal and Liver Involvement in Patients With COVID-19 – Authors' Reply. Lancet Gastroenterol Hepatol (2020) 5(9): 799– 800. doi: 10.1016/S2468-1253(20)30240-5 PMC7431177 32818457 · DOI
  6. [7]Thaweerat W. Current Evidence on Pancreatic Involvement in SARS-CoV-2 Infection. Pancreatology (2020) 20(5): 1013–4. doi: 10.1016/j.pan.2020.05.015 PMC7251394 32498973 · DOI
  7. [8]Momtazmanesh S Shobeiri P Hanaei S Mahmoud-Elsayed H Dalvi B Rad EM. Cardiovascular Disease in COVID-19: A Systematic Review and Meta-Analysis of 10,898 Patients and Proposal of a Triage Risk Stratification Tool. Egypt Heart J (2020) 72(1): 1– 17. doi: 10.1186/s43044-020-00075-z PMC7356124 32661796 · DOI
  8. [9]Seyed ASA Karimi A Shobeiri P Nowroozi A Mehraeen E Afsahi AM. Psychological Symptoms of COVID-19 Epidemic: A Systematic Review of Current Evidence. Psihologija (2020) 54(2) 173–92. doi: 10.2298/PSI200703035S · DOI
  9. [10]SeyedAlinaghi S Mehrtak M MohsseniPour M Mirzapour P Barzegary A Habibi P. Genetic Susceptibility of COVID-19: A Systematic Review of Current Evidence. Eur J Med Res (2021) 26(1): 46. doi: 10.1186/s40001-021-00516-8 34016183 PMC8135169 · DOI
  10. [12]Mollica V Rizzo A Massari F. The Pivotal Role of TMPRSS2 in Coronavirus Disease 2019 and Prostate Cancer. Future Oncol (London England) (2020) 16(27): 2029–33. doi: 10.2217/fon-2020-0571 PMC7359420 32658591 · DOI
  11. [13]Deng Q Rasool RU Russell RM Natesan R Asangani IA. Targeting Androgen Regulation of TMPRSS2 and ACE2 as a Therapeutic Strategy to Combat COVID-19. iScience (2021) 24(3): 102254. doi: 10.1016/j.isci.2021.102254 33681723 PMC7919514 · DOI
  12. [15]Vabret N Samstein R Fernandez N Merad M. Advancing Scientific Knowledge in Times of Pandemics. Nat Rev Immunol (2020) 20(6): 338. doi: 10.1038/s41577-020-0319-0 32327718 PMC7187143 · DOI · Paper page
  13. [16]Del Valle DM Kim-Schulze S Huang H-H Beckmann ND Nirenberg S Wang B. An Inflammatory Cytokine Signature Predicts COVID-19 Severity and Survival. Nat Med (2020) 26(10): 1636–43. doi: 10.1038/s41591-020-1051-9 PMC7869028 32839624 · DOI · Paper page
  14. [17]Ali N. Elevated Level of C-Reactive Protein May Be an Early Marker to Predict Risk for Severity of COVID-19. J Med Virol (2020) 92(11): 2409–11. doi: 10.1002/jmv.26097 PMC7301027 32516845 · DOI
  15. [18]Ghahramani S Tabrizi R Lankarani KB Kashani SMA Rezaei S Zeidi N. Laboratory Features of Severe vs.Non-Severe COVID-19 Patients Asian Populations: syst Rev meta-anal. Eur J Med Res (2020) 25(1): 30. doi: 10.1186/s40001-020-00432-3 32746929 PMC7396942 · DOI
  16. [19]Tavakolpour S Rakhshandehroo T Wei EX Rashidian M. Lymphopenia During the COVID-19 Infection: What It Shows and What Can Be Learned. Immunol Lett (2020) 225: 31–2. doi: 10.1016/j.imlet.2020.06.013 PMC7305732 32569607 · DOI
  17. [21]Wang C He W Yuan Y Zhang Y Li K Zou R. Comparison of the Prognostic Value of Inflammation-Based Scores in Early Recurrent Hepatocellular Carcinoma After Hepatectomy. Liver Int Off J Int Assoc Study Liver (2020) 40(1): 229–39. doi: 10.1111/liv.14281 31652394 · DOI
  18. [22]Yamamoto M Kobayashi T Kuroda S Hamaoka M Okimoto S Honmyo N. Verification of Inflammation-Based Prognostic Marker as a Prognostic Indicator in Hepatocellular Carcinoma. Ann gastroenterol Surg (2019) 3(6): 667–75. doi: 10.1002/ags3.12286 PMC6875930 31788655 · DOI
  19. [23]Cui K Ou Y Shen Y Li S Sun Z. Clinical Value of Circulating Tumor Cells for the Diagnosis and Prognosis of Hepatocellular Carcinoma (HCC): A Systematic Review and Meta-Analysis. Medicine (2020) 99(40): e22242. doi: 10.1097/MD.0000000000022242 33019399 PMC7535562 · DOI
  20. [24]Tang M Jia Z Zhang J. The Prognostic Role of Prognostic Nutritional Index in Nasopharyngeal Carcinoma: A Systematic Review and Meta-Analysis. Int J Clin Oncol (2021) 26(1): 66– 77. doi: 10.1007/s10147-020-01791-x 33029749 · DOI
  21. [25]Sirin MC Korkmaz S Erturan I Filiz B Aridogan BC Cetin ES. Evaluation of Monocyte to HDL Cholesterol Ratio and Other Inflammatory Markers in Patients With Psoriasis. Anais brasileiros dermatol (2020) 95(5): 575–82. doi: 10.1016/j.abd.2020.02.008 PMC7562997 32711928 · DOI
  22. [26]Russell CD Parajuli A Gale HJ Bulteel NS Schuetz P de Jager CPC. The Utility of Peripheral Blood Leucocyte Ratios as Biomarkers in Infectious Diseases: A Systematic Review and Meta-Analysis. J Infect (2019) 78(5): 339–48. doi: 10.1016/j.jinf.2019.02.006 PMC7173077 30802469 · DOI
  23. [27]Templeton AJ McNamara MG Šeruga B Vera-Badillo FE Aneja P Ocaña A. Prognostic Role of Neutrophil-to-Lymphocyte Ratio in Solid Tumors: A Systematic Review and Meta-Analysis. JNCI: J National Cancer Institute (2014) 106:(6): dju124. doi: 10.1093/jnci/dju124 24875653 · DOI
  24. [28]Tokgoz S Kayrak M Akpinar Z Seyithanoğlu A Güney F Yürüten B. Neutrophil Lymphocyte Ratio as a Predictor of Stroke. J Stroke Cerebrovascular Dis (2013) 22(7): 1169–74. doi: 10.1016/j.jstrokecerebrovasdis.2013.01.011 23498372 · DOI
  25. [29]Balta S Celik T Mikhailidis DP Ozturk C Demirkol S Aparci M. The Relation Between Atherosclerosis and the Neutrophil–Lymphocyte Ratio. Clin Appl Thrombosis/Hemostasis (2016) 22(5): 405–11. doi: 10.1177/1076029615569568 25667237 · DOI
  26. [30]Yang A-P Liu J-P Tao W-Q Li H-M. The Diagnostic and Predictive Role of NLR, D-NLR and PLR in COVID-19 Patients. Int Immunopharmacol (2020) 84: 106504. doi: 10.1016/j.intimp.2020.106504 32304994 PMC7152924 · DOI · Paper page
  27. [31]Karaman M Balta S Ahmet AYS Cakar M Naharci I Demirkol S. The Comparative Effects of Valsartan and Amlodipine on vWf Levels and N/L Ratio in Patients With Newly Diagnosed Hypertension. Clin Exp Hypertens (2013) 35(7): 516–22. doi: 10.3109/10641963.2012.758734 23289969 · DOI
  28. [32]Balta S Kurtoglu E Kucuk U Demirkol S Ozturk C. Neutrophil–lymphocyte Ratio as an Important Assessment Tool. Expert Rev Cardiovascular Ther (2014) 12: (5): 537–8. doi: 10.1586/14779072.2014.902309 24745892 · DOI
  29. [33]Caputo D Caricato M Coppola A La Vaccara V Fiore M Coppola R. Neutrophil to Lymphocyte Ratio (NLR) and Derived Neutrophil to Lymphocyte Ratio (D-NLR) Predict Non-Responders and Postoperative Complications in Patients Undergoing Radical Surgery After Neo-Adjuvant Radio-Chemotherapy for Rectal Adenocarcinoma. Cancer Invest (2016) 34(9): 440–51. doi: 10.1080/07357907.2016.1229332 27740855 · DOI
  30. [34]Zheng Z Peng F Xu B Zhao J Liu H Peng J. Risk Factors of Critical & Mortal COVID-19 Cases: A Systematic Literature Review and Meta-Analysis. J Infect (2020) 81(2): e16–25. doi: 10.1016/j.jinf.2020.04.021 PMC7177098 32335169 · DOI · Paper page
  31. [35]Meng Y Lu W Guo E Liu J Yang B Wu P. Cancer History is an Independent Risk Factor for Mortality in Hospitalized COVID-19 Patients: A Propensity Score-Matched Analysis. J Hematol Oncol (2020) 13(1): 75. doi: 10.1186/s13045-020-00907-0 32522278 PMC7286218 · DOI
  32. [36]Tatum D Taghavi S Houghton A Stover J Toraih E Duchesne JJS. Neutrophil-To-Lymphocyte Ratio and Outcomes in Louisiana Covid-19 Patients. Shock (2020) 54(5): 652–8. doi: 10.1097/SHK.0000000000001585 PMC7326320 32554992 · DOI
  33. [37]Cheng B Hu J Zuo X Chen J Li X Chen Y. Predictors of Progression From Moderate to Severe Coronavirus Disease 2019: A Retrospective Cohort. Clin Microbiol Infect (2020) 26(10): 1400–5. doi: 10.1016/j.cmi.2020.06.033 PMC7331556 32622952 · DOI
  34. [38]Yan X Li F Wang X Yan J Zhu F Tang S. Neutrophil to Lymphocyte Ratio as Prognostic and Predictive Factor in Patients With Coronavirus Disease 2019: A Retrospective Cross-Sectional Study. J Medical Virol (2020) 92(11): 2573–81. doi: 10.1002/jmv.26061 PMC7283791 32458459 · DOI
  35. [39]Asghar MS Kazmi SJH Khan NA Akram M Khan SA Rasheed U. Clinical Profiles, Characteristics, and Outcomes of the First 100 Admitted COVID-19 Patients in Pakistan: A Single-Center Retrospective Study in a Tertiary Care Hospital of Karachi. Cureus (2020) 12(6): e8712. doi: 10.7759/cureus.c34 32699707 PMC7372235 · DOI
  36. [40]Basbus L Lapidus MI Martingano I Puga MC Pollán JJM. Neutrophil to Lymphocyte Ratio as a Prognostic Marker in COVID-19. Medicina (Buenos Aires) (2020) 80: 31–6. 32658845
  37. [41]Li H Zhao M Xu Y. Biochemical Analysis Between Common Type and Critical Type of COVID-19 and Clinical Value of Neutrophil/Lymphocyte Ratio. Nan Fang Yi Ke Da Xue Xue Bao (2020) 40(7): 965–71. doi: 10.12122/j.issn.1673-4254.2020.07.08 PMC7386214 32895161 · DOI
  38. [42]Ok F Erdogan O Durmus E Carkci S Canik A. Predictive Values of Blood Urea Nitrogen/Creatinine Ratio and Other Routine Blood Parameters on Disease Severity and Survival of COVID-19 Patients. J Medical Virol (2020) 93(2): 786–93. doi: 10.1002/jmv.26300 PMC7405288 32662893 · DOI
  39. [43]Zhang B Zhou X Zhu C Song Y Feng F Qiu Y. Immune Phenotyping Based on the Neutrophil-to-Lymphocyte Ratio and IgG Level Predicts Disease Severity and Outcome for Patients With COVID-19. Front Mol Biosci (2020) 7: 157. doi: 10.3389/fmolb.2020.00157 32719810 PMC7350507 · DOI
  40. [44]Zhang J-J Cao Y-Y Tan G Dong X Wang B-C Lin J. Clinical, Radiological, and Laboratory Characteristics and Risk Factors for Severity and Mortality of 289 Hospitalized COVID-19 Patients. Allergy (2020) 76(2): 533–50. doi: 10.22541/au.159164076.65659447 PMC7404752 32662525 · DOI
  41. [45]Liu Y Du X Chen J Jin Y Peng L Wang HH. Neutrophil-To-Lymphocyte Ratio as an Independent Risk Factor for Mortality in Hospitalized Patients With COVID-19. J Infect (2020) 81(1): e6–12. doi: 10.1016/j.jinf.2020.04.002 PMC7195072 32283162 · DOI
  42. [46]Liu Y-P Li G-M He J Liu Y Li M Zhang R. Combined Use of the Neutrophil-to-Lymphocyte Ratio and CRP to Predict 7-Day Disease Severity in 84 Hospitalized Patients With COVID-19 Pneumonia: A Retrospective Cohort Study. Ann Transl Med (2020) 8(10): 635. doi: 10.21037/atm-20-2372 32566572 PMC7290615 · DOI
  43. [47]Xia X Wen M Zhan S He J Chen W. [An Increased Neutrophil/Lymphocyte Ratio Is an Early Warning Signal of Severe COVID-19]. Nan fang yi ke da xue xue bao = J South Med Univ (2020) 40(3): 333–6. doi: 10.12122/j.issn.1673-4254.2020.03.06 PMC7167308 32376581 · DOI
  44. [48]Vafadar Moradi E Teimouri A Rezaee R Morovatdar N Foroughian M Layegh P. Increased Age, Neutrophil-to-Lymphocyte Ratio (NLR) and White Blood Cells Count Are Associated With Higher COVID-19 Mortality. Am J Emergency Med (2021) 40: 11–4. doi: 10.1016/j.ajem.2020.12.003 PMC7717776 33333477 · DOI
  45. [49]Lissoni P Rovelli F Monzon A Privitera C Messina G Porro GJJIA. Evidence of Abnormally Low Lymphocyte-to-Monocyte Ratio in Covid-19-Induced Severe Acute Respiratory Syndrome. J Immunol Allergy (2020) 1(2): 1– 6. doi: 10.37191/Mapsci-2582-6549-1(2)-011 · DOI
  46. [50]Fei M Tong F Tao X Wang J. Value of Neutrophil-to-Lymphocyte Ratio in the Classification Diagnosis of Coronavirus Disease 2019. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue (2020) 32(5): 554–8. doi: 10.3760/cma.j.cn121430-20200413-00506 32576346 · DOI
  47. [51]Liu J Liu Y Xiang P Pu L Xiong H Li C. Neutrophil-To-Lymphocyte Ratio Predicts Critical Illness Patients With 2019 Coronavirus Disease in the Early Stage. J Transl Med (2020) 18: 1– 12. doi: 10.1186/s12967-020-02374-0 32434518 PMC7237880 · DOI
  48. [52]Shang W Dong J Ren Y Tian M Li W Hu J. The Value of Clinical Parameters in Predicting the Severity of COVID-19. J Medical Virol (2020) 92(10): 2188–92. doi: 10.1002/jmv.26031 PMC7280691 32436996 · DOI
  49. [53]Sun S Cai X Wang H He G Lin Y Lu B. Abnormalities of Peripheral Blood System in Patients With COVID-19 in Wenzhou, China. Clin Chimica Acta (2020) 507: 174–80. doi: 10.1016/j.cca.2020.04.024 PMC7194694 32339487 · DOI
  50. [54]Wang C Deng R Gou L Fu Z Zhang X Shao F. Preliminary Study to Identify Severe From Moderate Cases of COVID-19 Using Combined Hematology Parameters. Ann Transl Med (2020) 8(9): 593. doi: 10.21037/atm-20-3391 32566620 PMC7290538 · DOI
  51. [55]Zha Q Feng B Li X Zhou D Kang Y Qin HJLM. Study on Early Laboratory Warning of Severe COVID-19. Lab Med (2020) 35(06): 557–60.
  52. [56]Chen F-F Zhong M Liu Y Zhang Y Zhang K Su D-Z. The Characteristics and Outcomes of 681 Severe Cases With COVID-19 in China. J Crit Care (2020) 60: 32–7. doi: 10.1016/j.jcrc.2020.07.003 PMC7340593 32736197 · DOI
  53. [57]Song H Bai T Shi J Yang J. Predictive Value of Multiple Inflammatory Indexes on the Prognosis of Patients With Corona Virus Disease 2019. Pract J Cardiac Cereb Pneumal Vascular Dis (2020) 28(06): 13–6.
  54. [58]Li X Liu C Mao Z Xiao M Wang L Qi S. Predictive Values of Neutrophil-to-Lymphocyte Ratio on Disease Severity and Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis. Crit Care (2020) 24(1): 647. doi: 10.1186/s13054-020-03374-8 33198786 PMC7667659 · DOI
  55. [59]Chan AS Rout A. Use of Neutrophil-To-Lymphocyte and Platelet-To-Lymphocyte Ratios in COVID-19. J Clin Med Res (2020) 12(7): 448–53. doi: 10.14740/jocmr4240 PMC7331861 32655740 · DOI
  56. [60]Ma J Yin J Qian Y Wu Y. Clinical Characteristics and Prognosis in Cancer Patients With COVID-19: A Single Center's Retrospective Study. J Infect (2020) 81(2): 318–56. doi: 10.1016/j.jinf.2020.04.006 PMC7194544 32298677 · DOI
  57. [61]Dettorre G Diamantis N Loizidou A Piccart M Chester J Jackson A. 319o The Systemic Pro-Inflammatory Response Identifies Cancer Patients With Adverse Outcomes From SARS-CoV-2 Infection. Ann Oncol (2020) 31: S1366–S. doi: 10.1016/j.annonc.2020.10.313 · DOI
  58. [62]Khourssaji M Chapelle V Evenepoel A Belkhir L Yombi JC van Dievoet M-A. A Biological Profile for Diagnosis and Outcome of COVID-19 Patients. Clin Chem Lab Med (CCLM) (2020) 58(12): 2141–50. doi: 10.1515/cclm-2020-0626 33064667 · DOI
  59. [63]Jimeno S Ventura PS Castellano JM García-Adasme SI Miranda M Touza P. Prognostic Implications of Neutrophil-Lymphocyte Ratio in COVID-19. Eur J Clin Invest (2021) 51(1): e13404. doi: 10.1111/eci.13404 32918295 · DOI
  60. [64]Ullah W Basyal B Tariq S Almas T Saeed R Roomi S. Lymphocyte-To-C-Reactive Protein Ratio: A Novel Predictor of Adverse Outcomes in COVID-19. J Clin Med Res (2020) 12(7): 415–22. doi: 10.14740/jocmr4227 PMC7331862 32655735 · DOI
  61. [65]Peng J Qi D Yuan G Deng X Mei Y Feng L. Diagnostic Value of Peripheral Hematologic Markers for Coronavirus Disease 2019 (COVID-19): A Multicenter, Cross-Sectional Study. J Clin Lab Anal (2020) 34(10): e23475. doi: 10.1002/jcla.23475 32681559 PMC7404368 · DOI
  62. [66]Eslamijouybari M Heydari K Maleki I Moosazadeh M Hedayatizadeh-Omran A Vahedi L. Neutrophil-To-Lymphocyte and Platelet-To-Lymphocyte Ratios in COVID-19 Patients and Control Group and Relationship With Disease Prognosis. Caspian J Intern Med (2020) 11(Suppl 1): 531–5. doi: 10.22088/cjim.11.0.531 PMC7780872 33425271 · DOI
  63. [67]Seyit M Avci E Nar R Senol H Yilmaz A Ozen M. Neutrophil to Lymphocyte Ratio, Lymphocyte to Monocyte Ratio and Platelet to Lymphocyte Ratio to Predict the Severity of COVID-19. Am J Emergency Med (2021) 40: 110–4. doi: 10.1016/j.ajem.2020.11.058 PMC7719281 33309506 · DOI
  64. [68]Usul E Şan İ Bekgöz B Şahin A. Role of Hematological Parameters in COVID-19 Patients in the Emergency Room. Biomarkers Med (2020) 14(13): 1207–15. doi: 10.2217/bmm-2020-0317 PMC7372996 32692248 · DOI
  65. [69]Kazancioglu S Yilmaz FM Bastug A Sakallı A Ozbay BO Buyuktarakci C. Lymphocyte Subset Alteration and Monocyte CD4 Expression Reduction in Patients With Severe COVID-19. Viral Immunol (2020) 34(5): 342–51. doi: 10.1089/vim.2020.0166 33264073 · DOI
  66. [70]Doganci S Ince M Ors N Yildirim A Sir E Karabacak K. A New COVID-19 Prediction Scoring Model for in-Hospital Mortality: Experiences From Turkey, Single Center Retrospective Cohort Analysis. Eur Rev Med Pharmacol Sci (2020) 24(19): 10247–57. doi: 10.26355/eurrev_202010_23249 33090436 · DOI
  67. [71]Xue G Gan X Wu Z Xie D Xiong Y Hua L. Novel Serological Biomarkers for Inflammation in Predicting Disease Severity in Patients With COVID-19. International Immunopharmacology. Int Immunopharmacol (2020) 89(Pt A): 107065. doi: 10.1016/j.intimp.2020.107065 33045571 PMC7532789 · DOI
  68. [72]Liu G Zhang S Hu H Liu T Huang J. The Role of Neutrophil-Lymphocyte Ratio and Lymphocyte–Monocyte Ratio in the Prognosis of Type 2 Diabetics With COVID-19. Scottish Med J (2020) 65(4): 154–60. doi: 10.1177/0036933020953516 32865157 · DOI
  69. [73]Noor A Akhtar F Tashfeen S Anwar N Saleem B Khan SA. Neutrophil-To-Lymphocyte Ratio, Derived Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio and Lymphocyte-to-Monocyte Ratio as Risk Factors in Critically Ill Covid-19 Patients, a Single Centered Study. J Ayub Med Coll Abbottabad (2020) 32(4-sup): S595–601. 33754514
  70. [74]Huang S Huang M Li X Zhang T Lu H. Significance of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio for Predicting Clinical Outcomes in COVID-19. Medrxiv (2020). doi: 10.1101/2020.05.04.20090431 · DOI
  71. [75]Bastug A Bodur H Erdogan S Gokcinar D Kazancioglu S Kosovali BD. Clinical and Laboratory Features of COVID-19: Predictors of Severe Prognosis. Int Immunopharmacol (2020) 88: 106950. doi: 10.1016/j.intimp.2020.106950 32919217 PMC7480980 · DOI
  72. [76]Nair PR Maitra S Ray BR Anand RK Baidya DK Subramaniam R. Neutrophil-To-Lymphocyte Ratio and Platelet-To-Lymphocyte Ratio as Predictors of the Early Requirement of Mechanical Ventilation in COVID-19 Patients. Indian J Crit Care Med (2020) 24(11): 1143–4. doi: 10.5005/jp-journals-10071-23663 PMC7751036 33384528 · DOI
  73. [77]Panagiotis P Angelo Z Valentina S Giulia M Giacomo De R Rosa MP. Laboratory Test Alterations in Patients With COVID-19 and non COVID-19 Interstitial Pneumonia: A Preliminary Report. J Infect Developing Countries (2020) 14(07): 685–90. doi: 10.3855/jidc.12879 32794454 · DOI
  74. [78]Wang X Li X Shang Y Wang J Zhang X Su D. Ratios of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Predict All-Cause Mortality in Inpatients With Coronavirus Disease 2019 (COVID-19): A Retrospective Cohort Study in a Single Medical Centre. Epidemiol Infect (2020) 148: e211. doi: 10.1017/S0950268820002071 32900409 PMC7506174 · DOI
  75. [79]Wang X Xu Y Huang H Jiang D Zhou C Liao H. Increased Pretreatment C-Reactive Protein-to-Albumin Ratio Predicts Severe Coronavirus Disease 2019. Researchsquare (2020). doi: 10.21203/rs.3.rs-31723/v2 · DOI
  76. [80]Lagunas-Rangel FA. Neutrophil-To-Lymphocyte Ratio and Lymphocyte-to-C-Reactive Protein Ratio in Patients With Severe Coronavirus Disease 2019 (COVID-19): A Meta-Analysis. J Med Virol (2020) 92(10): 1733–4. doi: 10.1002/jmv.25819 PMC7228336 32242950 · DOI
  77. [81]Fois AG Paliogiannis P Scano V Cau S Babudieri S Perra R. The Systemic Inflammation Index on Admission Predicts In-Hospital Mortality in COVID-19 Patients. Molecules (2020) 25(23): 5725. doi: 10.3390/molecules25235725 PMC7731255 33291581 · DOI
  78. [82]Wang R He M Yin W Liao X Wang B Jin X. The Prognostic Nutritional Index Is Associated With Mortality of COVID-19 Patients in Wuhan, China. J Clin Lab Anal (2020) 34(10): e23566. doi: 10.1002/jcla.23566 32914892 PMC7595894 · DOI
  79. [83]Simadibrata DM Pandhita BAW Ananta ME Tango T. Platelet-To-Lymphocyte Ratio, a Novel Biomarker to Predict the Severity of COVID-19 Patients: A Systematic Review and Meta-Analysis. J Intensive Care Soc (2020), 1751143720969587. doi: 10.1177/1751143720969587 PMC7649648 38603090 · DOI
  80. [84]Qu R Ling Y Zhang Y-H-Z Wei L-Y Chen X Li X-M. Platelet-To-Lymphocyte Ratio Is Associated With Prognosis in Patients With Coronavirus Disease-19. J Med Virol (2020) 92(9): 1533–41. doi: 10.1002/jmv.25767 PMC7228291 32181903 · DOI
  81. [85]Zheng Y Huang Z Ying G Zhang X Ye W Hu Z. Comparative Study of the Lymphocyte Change Between COVID-19 and non-COVID-19 Pneumonia Cases Suggesting Uncontrolled Inflammation Might Not be the Main Reason of Tissue Injury. Medrxiv (2020). doi: 10.1101/2020.02.19.20024885 · DOI
  82. [86]Rizo-Téllez SA Méndez-García LA Flores-Rebollo C Alba-Flores F Alcántara-Suárez R Manjarrez-Reyna AN. The Neutrophil-To-Monocyte Ratio and Lymphocyte-To-Neutrophil Ratio at Admission Predict In-Hospital Mortality in Mexican Patients With Severe SARS-CoV-2 Infection (Covid-19). Microorganisms (2020) 8(10). doi: 10.3390/microorganisms8101560 PMC7600553 33050487 · DOI
  83. [87]Sun D-W An L Lv G-Y. Albumin-Fibrinogen Ratio and Fibrinogen-Prealbumin Ratio as Promising Prognostic Markers for Cancers: An Updated Meta-Analysis. World J Surg Oncol (2020) 18(1): 9. doi: 10.1186/s12957-020-1786-2 31931816 PMC6958612 · DOI
  84. [88]Yue W Liu Y Ding W Jiang W Huang J Zhang J. The Predictive Value of the Prealbumin-to-Fibrinogen Ratio in Patients With Acute Pancreatitis. Int J Clin Pract (2015) 69(10): 1121–8. doi: 10.1111/ijcp.12682 26133088 · DOI
  85. [89]Shufei Z Lei S Jinying Z Min Y Jun L Heyuan D. Prealbumin to Fibrinogen Ratio is Closely Associated With Diabetic Peripheral Neuropathy. Endocr Connections (2020) 9(8): 858–63. doi: 10.1530/EC-20-0316 PMC7487192 32880377 · DOI
  86. [90]Bi X Su Z Yan H Du J Wang J Chen L. Prediction of Severe Illness Due to COVID-19 Based on an Analysis of Initial Fibrinogen to Albumin Ratio and Platelet Count. Platelets (2020) 31(5): 674–9. doi: 10.1080/09537104.2020.1760230 PMC7212543 32367765 · DOI
  87. [91]Karakoyun I Colak A Turken M Altin Z Arslan FD Iyilikci V. Diagnostic Utility of C-Reactive Protein to Albumin Ratio as an Early Warning Sign in Hospitalized Severe COVID-19 Patients. Int Immunopharmacol (2021) 91: 107285. doi: 10.1016/j.intimp.2020.107285 33348293 PMC7833970 · DOI
  88. [92]Oh J Kim SH Park KN Oh SH Kim YM Kim HJ. High-Sensitivity C-Reactive Protein/Albumin Ratio as a Predictor of in-Hospital Mortality in Older Adults Admitted to the Emergency Department. Clin Exp Emerg Med (2017) 4(1): 19– 24. doi: 10.15441/ceem.16.158 28435898 PMC5385513 · DOI
  89. [93]Guo X-L Zhang Y Zeng Y-H Zhao F-Y Liu W-P Xiao L. Serum Prealbumin Deserves More Significance in the Early Triage of COVID-19 Patients. Clin Chem Lab Med (CCLM) (2020) 58(10): e209–e11. doi: 10.1515/cclm-2020-0663 32681771 · DOI
  90. [94]Zheng C Liu S Feng J Zhao X. Prognostic Value of Inflammation Biomarkers for Survival of Patients With Neuroblastoma. Cancer Manag Res (2020) 12: 2415–25. doi: 10.2147/CMAR.S245622 PMC7132027 32280277 · DOI
  91. [95]Fang E Wang X Feng J Zhao X. The Prognostic Role of Glasgow Prognostic Score and C-Reactive Protein to Albumin Ratio for Sarcoma: A System Review and Meta-Analysis. Dis Markers (2020) 2020: 8736509. doi: 10.1155/2020/8736509 31998420 PMC6969993 · DOI
  92. [96]Onodera T Goseki N Kosaki G. Prognostic Nutritional Index in Gastrointestinal Surgery of Malnourished Cancer Patients. Nihon Geka Gakkai Zasshi (1984) 85(9): 1001. 6438478
  93. [97]Jiang N Deng J-Y Ding X-W Ke B Liu N Zhang R-P. Prognostic Nutritional Index Predicts Postoperative Complications and Long-Term Outcomes of Gastric Cancer. World J Gastroenterol (2014) 20(30): 10537. doi: 10.3748/wjg.v20.i30.10537 25132773 PMC4130864 · DOI
  94. [98]Sun K Chen S Xu J Li G He Y. The Prognostic Significance of the Prognostic Nutritional Index in Cancer: A Systematic Review and Meta-Analysis. J Cancer Res Clin Oncol (2014) 140(9): 1537–49. doi: 10.1007/s00432-014-1714-3 PMC11823704 24878931 · DOI
  95. [99]Hu B Yang XR Xu Y Sun YF Sun C Guo W. Systemic Immune-Inflammation Index Predicts Prognosis of Patients After Curative Resection for Hepatocellular Carcinoma. Clin Cancer Res an Off J Am Assoc Cancer Res (2014) 20(23): 6212–22. doi: 10.1158/1078-0432.CCR-14-0442 25271081 · DOI · Paper page
  96. [100]Chiang K-C Huang S-T Wu R-C Huang S-C Yeh T-S Chen M-H. Interferon α-Inducible Protein 27 is an Oncogene and Highly Expressed in Cholangiocarcinoma Patients With Poor Survival. Cancer Manag Res (2019) 11: 1893–905. doi: 10.2147/CMAR.S196485 PMC6400119 30881116 · DOI
  97. [101]Suomela S Cao L Bowcock A Saarialho-Kere U. Interferon Alpha-Inducible Protein 27 (IFI27) Is Upregulated in Psoriatic Skin and Certain Epithelial Cancers. J Invest Dermatol (2004) 122(3): 717–21. doi: 10.1111/j.0022-202X.2004.22322.x 15086558 · DOI
  98. [102]Wang H Qiu X Lin S Chen X Wang T Liao T. Knockdown of IFI27 Inhibits Cell Proliferation and Invasion in Oral Squamous Cell Carcinoma. World J Surg Oncol (2018) 16(1): 64. doi: 10.1186/s12957-018-1371-0 29580248 PMC5870725 · DOI
  99. [103]Hadjadj J Yatim N Barnabei L Corneau A Boussier J Smith N. Impaired Type I Interferon Activity and Inflammatory Responses in Severe COVID-19 Patients. Science (2020) 369(6504): 718. doi: 10.1126/science.abc6027 32661059 PMC7402632 · DOI · Paper page
  100. [104]Wilk AJ Rustagi A Zhao NQ Roque J Martínez-Colón GJ McKechnie JL. A Single-Cell Atlas of the Peripheral Immune Response in Patients With Severe COVID-19. Nat Med (2020) 26(7): 1070–6. doi: 10.1038/s41591-020-0944-y PMC7382903 32514174 · DOI · Paper page
  101. [105]Zhang N Zhao YD Wang XM. CXCL10 an Important Chemokine Associated With Cytokine Storm in COVID-19 Infected Patients. Eur Rev Med Pharmacol Sci (2020) 24(13): 7497–505. doi: 10.26355/eurrev_202007_21922 32706090 · DOI
  102. [106]Al Heialy S Hachim MY Senok A Gaudet M Abou Tayoun A Hamoudi R. Regulation of Angiotensin- Converting Enzyme 2 in Obesity: Implications for COVID-19. Front Physiol (2020) 11: 555039–. doi: 10.3389/fphys.2020.555039 PMC7531362 33071815 · DOI
  103. [107]Patterson BK Seethamraju H Dhody K Corley MJ Kazempour K Lalezari JP. Disruption of the CCL5/RANTES-CCR5 Pathway Restores Immune Homeostasis and Reduces Plasma Viral Load in Critical COVID-19. medRxiv (2020). doi: 10.1101/2020.05.02.20084673 2020.05.02.20084673 · DOI
  104. [108]Zheng H-Y Xu M Yang C-X Tian R-R Zhang M Li J-J. Longitudinal Transcriptome Analyses Show Robust T Cell Immunity During Recovery From COVID-19. Signal Transduction Targeted Ther (2020) 5(1): 294. doi: 10.1038/s41392-020-00457-4 PMC7758413 33361761 · DOI
  105. [109]Trouillet-Assant S Viel S Gaymard A Pons S Richard J-C Perret M. Type I IFN Immunoprofiling in COVID-19 Patients. J Allergy Clin Immunol (2020) 146(1): 206– 8.e2. doi: 10.1016/j.jaci.2020.04.029 32360285 PMC7189845 · DOI
  106. [110]Huang L Shi Y Gong B Jiang L Liu X Yang J. Blood Single Cell Immune Profiling Reveals the Interferon-MAPK Pathway Mediated Adaptive Immune Response for COVID-19. Medrxiv (2020). doi: 10.1101/2020.03.15.20033472 · DOI
  107. [111]Loganathan T Ramachandran S Shankaran P Nagarajan DJP. Host Transcriptome-Guided Drug Repurposing for COVID-19 Treatment: A Meta-Analysis Based Approach. PeerJ (2020) 8: e9357. doi: 10.7717/peerj.9357 32566414 PMC7293190 · DOI
  108. [112]Shaath H Vishnubalaji R Elkord E Alajez NM. Single-Cell Transcriptome Analysis Highlights a Role for Neutrophils and Inflammatory Macrophages in the Pathogenesis of Severe COVID-19. Cells (2020) 9(11). doi: 10.3390/cells9112374 PMC7693119 33138195 · DOI
  109. [113]Mick E Kamm J Pisco AO Ratnasiri K Babik JM Castañeda CS. Upper Airway Gene Expression Differentiates COVID-19 From Other Acute Respiratory Illnesses and Reveals Suppression of Innate Immune Responses by SARS-CoV-2. Nat Commun (2020) 11(1): 5854. doi: 10.1038/s41467-020-19587-y. 33203890 PMC7673985 · DOI
  110. [114]Alsamman AM Zayed H. The Transcriptomic Profiling of COVID-19 Compared to SARS, MERS, Ebola, and H1N1. PLoS One (2020) 15(12): e0243270. doi: 10.1371/journal.pone.0243270 33301474 PMC7728291 · DOI
  111. [115]Hammadi AA Al Jubouri AM Ahmed G Hayyawi AH Kareem K Gorial FI. A New Hematological Prognostic Index For Covid-19 Severity. Medrxiv (2021). doi: 10.1101/2021.02.11.21251285 · DOI
  112. [116]Lidoriki I Frountzas M Schizas D. Could Nutritional and Functional Status Serve as Prognostic Factors for COVID-19 in the Elderly? Med Hypotheses (2020) 144: 109946. doi: 10.1016/j.mehy.2020.109946 32512494 PMC7264929 · DOI
  113. [117]SeyedAlinaghi S Mirzapour P Dadras O Pashaei Z Karimi A MohsseniPour M. Characterization of SARS-CoV-2 Different Variants and Related Morbidity and Mortality: A Systematic Review. Eur J Med Res (2021) 26(1): 51. doi: 10.1186/s40001-021-00524-8 34103090 PMC8185313 · DOI

Cited by

Sorted by citations

Authors
Karimi, A., Shobeiri, P., Kulasinghe, A., & Rezaei, N.
Affiliations
  • Universal Scientific Education and Research Network (IR)
  • Queensland University of Technology (AU)
Corresponding author
Rezaei, Nima
ORCID
Venue
Frontiers in Immunology
Publisher
Frontiers Media SA
Published
2021-10-22
Volume
12
Pages
741061-741061
ISSN
1664-3224 (ISSN-L)
DOI
10.3389/fimmu.2021.741061
PMC
PMC8569430
OpenAlex
W3208342532
Cited by
171
References
3
Citations by year
2026: 13 · 2025: 39 · 2024: 46 · 2023: 50 · 2022: 23
FWCI
3.48
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Immunology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
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, SARS-CoV-2, systemic inflammatory markers, prognostic factors, neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, prognostic nutritional index, C-reactive protein to albumin ratio, risk stratification, disease severity prediction
MeSH terms
COVID-19, SARS-CoV-2, C-Reactive Protein, Humans, Inflammation, Lymphocytes, Neutrophils, Prognosis, Severity of Illness Index, Biomarkers, Disease Progression

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