Sara Jimeno1,2,3, Paula S Ventura3,4, Jose M Castellano5, Salvador I García-Adasme3,6, Mario Miranda3,7, Paula Touza1,3, Isabel Lllana1,3, Alejandro López-Escobar1,2,3. 1. Pediatrics Department, Hospital Universitario HM Puerta del Sur, Móstoles, Madrid, Spain. 2. Facultad de Medicina, Universidad CEU San Pablo, Madrid, Spain. 3. Fundación de Investigación HM Hospitales, Madrid, Spain. 4. Pediatrics Department, Hospital Universitario HM Nens, Barcelona, Spain. 5. Cardiology Department, Facultad de Medicina, Centro Nacional de Investigaciones Cardiovasculares, Hospital Universitario HM Montepríncipe, Grupo HM Hospitales, Fundación de Investigación HM Hospitales, Universidad CEU San Pablo, Instituto de Salud Carlos III, Madrid, Spain. 6. Escuela de Enfermería, Universidad CEU San Pablo, Madrid, Spain. 7. Internal Medicine Department, Hospital Universitario HM Puerta del Sur, Móstoles, Madrid, Spain.
Abstract
BACKGROUND: The clinical presentation of COVID-19 ranges from a mild, self-limiting disease, to multiple organ failure and death. Most severe COVID-19 cases present low lymphocytes counts and high leukocytes counts, and accumulated evidence suggests that in a subgroup of patients presenting severe COVID-19, there may be a hyperinflammatory response driving a severe hypercytokinaemia which may be, at least in part, signalling the presence of an underlying endothelial dysfunction. In this context, available data suggest a prognostic role of neutrophil-lymphocyte ratio (NLR) in various inflammatory diseases and oncological processes. Following this rationale, we hypothesized that NLR, as a marker of endothelial dysfunction, may be useful in identifying patients with a poor prognosis in hospitalized COVID-19 cases. DESIGN: A retrospective observational study performed at Hospital Universitario HM Puerta del Sur, Madrid, Spain, which included 119 patients with COVID-19 from 1 March to 31 March 2020. Patients were categorized according to WHO R&D Expert Group. RESULTS: Forty-five (12.1%) patients experienced severe acute respiratory failure requiring respiratory support. Forty-seven (12.6%) patients died. Those with worse outcomes were older (P = .002) and presented significantly higher NLR at admission (P = .001), greater increase in Peak NLR (P < .001) and higher increasing speed of NLR (P = .003) compared with follow-up patients. In a multivariable logistic regression, age, cardiovascular disease and C-reactive protein at admission and Peak NLR were significantly associated with death. CONCLUSIONS: NLR is an easily measurable, available, cost-effective and reliable parameter, which continuous monitoring could be useful for the diagnosis and treatment of COVID-19.
BACKGROUND: The clinical presentation of COVID-19 ranges from a mild, self-limiting disease, to multiple organ failure and death. Most severe COVID-19 cases present low lymphocytes counts and high leukocytes counts, and accumulated evidence suggests that in a subgroup of patients presenting severe COVID-19, there may be a hyperinflammatory response driving a severe hypercytokinaemia which may be, at least in part, signalling the presence of an underlying endothelial dysfunction. In this context, available data suggest a prognostic role of neutrophil-lymphocyte ratio (NLR) in various inflammatory diseases and oncological processes. Following this rationale, we hypothesized that NLR, as a marker of endothelial dysfunction, may be useful in identifying patients with a poor prognosis in hospitalized COVID-19 cases. DESIGN: A retrospective observational study performed at Hospital Universitario HM Puerta del Sur, Madrid, Spain, which included 119 patients with COVID-19 from 1 March to 31 March 2020. Patients were categorized according to WHO R&D Expert Group. RESULTS: Forty-five (12.1%) patients experienced severe acute respiratory failure requiring respiratory support. Forty-seven (12.6%) patientsdied. Those with worse outcomes were older (P = .002) and presented significantly higher NLR at admission (P = .001), greater increase in Peak NLR (P < .001) and higher increasing speed of NLR (P = .003) compared with follow-up patients. In a multivariable logistic regression, age, cardiovascular disease and C-reactive protein at admission and Peak NLR were significantly associated with death. CONCLUSIONS: NLR is an easily measurable, available, cost-effective and reliable parameter, which continuous monitoring could be useful for the diagnosis and treatment of COVID-19.
Authors: Yilin Yoshida; Scott A Gillet; Margo I Brown; Yuanhao Zu; Sarah M Wilson; Sabreen J Ahmed; Saritha Tirumalasetty; Dragana Lovre; Marie Krousel-Wood; Joshua L Denson; Franck Mauvais-Jarvis Journal: Biol Sex Differ Date: 2021-02-05 Impact factor: 5.027
Authors: Alejandro López-Escobar; Rodrigo Madurga; José María Castellano; Sara Velázquez; Rafael Suárez Del Villar; Justo Menéndez; Alejandro Peixoto; Sara Jimeno; Paula Sol Ventura; Santiago Ruiz de Aguiar Journal: Diagnostics (Basel) Date: 2021-03-26