Mehr Muhammad Imran1, Umair Ahmad2,3, Umer Usman1,3, Majid Ali4,5, Aamir Shaukat1, Noor Gul1. 1. Department of Pulmonology, District Headquarter Hospital, Faisalabad, Pakistan. 2. Department of Medicine, Allied Hospital, Faisalabad, Pakistan. 3. Medical Unit II, Faisalabad Medical University, Faisalabad, Pakistan. 4. College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia. 5. Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.
Abstract
AIM: To determine the efficacy of neutrophil/lymphocyte ratio (NLR) as a marker of the severity of COVID-19 pneumonia in the South-Asian population. METHODS: This was a prospective, cross-sectional, analytic study conducted at HDU/ICU of District Headquarter Hospital, Faisalabad, Pakistan, from May through July 2020. Sixty-three eligible patients, admitted to the HDU/ICU, were prospectively enrolled in the study. Their NLR, C-reactive protein, serum albumin and serum fibrinogen were measured. Patients' demographic characteristics, comorbidities, clinical manifestations of COVID-19 infection, medication use and history of lung malignancy were retrieved from their medical history. Patients were categorised into either a general group (with mild COVID-19) or a heavy group (with moderate to severe COVID-19). RESULTS: There were significant differences between the two groups in diabetes prevalence, NLR, C-reactive protein and serum albumin. NLR and C-reactive protein were positively correlated (P < .001, P = .04, respectively) whereas serum albumin was negatively correlated (P = .009) with severe COVID-19. NLR was found to be an independent risk factor for severe COVID-19 pneumonia in the heavy group (OR = 1.264, 95% CI: 1.046~1.526, P = .015). The calculated AUC using ROC for NLR was 0.831, with an optimal limit of 4.795, sensitivity of 0.83 and specificity of 0.75, which is highly suggestive of NLR being a marker for the early detection of deteriorating severe COVID-19 infection. CONCLUSION: NLR can be used as an early warning signal for deteriorating severe COVID-19 infection and can provide an objective basis for early identification and management of severe COVID-19 pneumonia.
AIM: To determine the efficacy of neutrophil/lymphocyte ratio (NLR) as a marker of the severity of COVID-19 pneumonia in the South-Asian population. METHODS: This was a prospective, cross-sectional, analytic study conducted at HDU/ICU of District Headquarter Hospital, Faisalabad, Pakistan, from May through July 2020. Sixty-three eligible patients, admitted to the HDU/ICU, were prospectively enrolled in the study. Their NLR, C-reactive protein, serum albumin and serum fibrinogen were measured. Patients' demographic characteristics, comorbidities, clinical manifestations of COVID-19infection, medication use and history of lung malignancy were retrieved from their medical history. Patients were categorised into either a general group (with mild COVID-19) or a heavy group (with moderate to severe COVID-19). RESULTS: There were significant differences between the two groups in diabetes prevalence, NLR, C-reactive protein and serum albumin. NLR and C-reactive protein were positively correlated (P < .001, P = .04, respectively) whereas serum albumin was negatively correlated (P = .009) with severe COVID-19. NLR was found to be an independent risk factor for severe COVID-19 pneumonia in the heavy group (OR = 1.264, 95% CI: 1.046~1.526, P = .015). The calculated AUC using ROC for NLR was 0.831, with an optimal limit of 4.795, sensitivity of 0.83 and specificity of 0.75, which is highly suggestive of NLR being a marker for the early detection of deteriorating severe COVID-19infection. CONCLUSION: NLR can be used as an early warning signal for deteriorating severe COVID-19infection and can provide an objective basis for early identification and management of severe COVID-19 pneumonia.
Authors: Afroza Akter; Tasnuva Ahmed; Imam Tauheed; Marjahan Akhtar; Sadia Isfat Ara Rahman; Fatema Khaton; Faisal Ahmmed; Jannatul Ferdous; Mokibul Hassan Afrad; Zannat Kawser; Mohabbat Hossain; Rabeya Khondaker; Mohammad Abul Hasnat; Mostafa Aziz Sumon; Asif Rashed; Shuvro Ghosh; Stephen B Calderwood; Richelle C Charles; Edward T Ryan; Purvesh Khatri; Holden Terry Maecker; Gerlinde Obermoser; Bali Pulendran; John D Clemens; Sayera Banu; Tahmina Shirin; Regina C LaRocque; Jason B Harris; Taufiqur Rahman Bhuiyan; Fahima Chowdhury; Firdausi Qadri Journal: PLoS Negl Trop Dis Date: 2022-01-04