Juan R Ulloque-Badaracco1, W Ivan Salas-Tello1, Ali Al-Kassab-Córdova1, Esteban A Alarcón-Braga1, Vicente A Benites-Zapata2, Jorge L Maguiña1,3, Adrian V Hernandez4,5. 1. Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru. 2. Vicerrectorado de Investigación Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru. 3. Instituto de Evaluación de Tecnologías en Salud e Investigación - IETSI, EsSalud, Lima, Peru. 4. Unidad de Revisiones Sistemáticas y Meta-análisis, Guías de Práctica Clínica y Evaluaciones de Tecnología Sanitaria, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru. 5. Health Outcomes, Policy, and Evidence Synthesis (HOPES) Group, University of Connecticut School of Pharmacy, Mansfield, CT, USA.
Abstract
BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) is an accessible and widely used biomarker. NLR may be used as an early marker of poor prognosis in patients with COVID-19. OBJECTIVE: To evaluate the prognostic value of the NLR in patients diagnosed with COVID-19. METHODS: We conducted a systematic review and meta-analysis. Observational studies that reported the association between baseline NLR values (ie, at hospital admission) and severity or all-cause mortality in COVID-19 patients were included. The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS). Random effects models and inverse variance method were used for meta-analyses. The effects were expressed as odds ratios (ORs) and their 95% confidence intervals (CIs). Small study effects were assessed with the Egger's test. RESULTS: We analysed 61 studies (n = 15 522 patients), 58 cohorts, and 3 case-control studies. An increase of one unit of NLR was associated with higher odds of severity (OR 6.22; 95%CI 4.93 to 7.84; P < .001) and higher odds of all-cause mortality (OR 12.6; 95%CI 6.88 to 23.06; P < .001). In our sensitivity analysis, we found that 41 studies with low risk of bias and moderate heterogeneity (I2 = 53% and 58%) maintained strong association between NLR values and both outcomes (severity: OR 5.36; 95% CI 4.45 to 6.45; P < .001; mortality: OR 10.42 95% CI 7.73 to 14.06; P = .005). CONCLUSIONS: Higher values of NLR were associated with severity and all-cause mortality in hospitalised COVID-19 patients.
BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) is an accessible and widely used biomarker. NLR may be used as an early marker of poor prognosis in patients with COVID-19. OBJECTIVE: To evaluate the prognostic value of the NLR in patients diagnosed with COVID-19. METHODS: We conducted a systematic review and meta-analysis. Observational studies that reported the association between baseline NLR values (ie, at hospital admission) and severity or all-cause mortality in COVID-19patients were included. The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS). Random effects models and inverse variance method were used for meta-analyses. The effects were expressed as odds ratios (ORs) and their 95% confidence intervals (CIs). Small study effects were assessed with the Egger's test. RESULTS: We analysed 61 studies (n = 15 522 patients), 58 cohorts, and 3 case-control studies. An increase of one unit of NLR was associated with higher odds of severity (OR 6.22; 95%CI 4.93 to 7.84; P < .001) and higher odds of all-cause mortality (OR 12.6; 95%CI 6.88 to 23.06; P < .001). In our sensitivity analysis, we found that 41 studies with low risk of bias and moderate heterogeneity (I2 = 53% and 58%) maintained strong association between NLR values and both outcomes (severity: OR 5.36; 95% CI 4.45 to 6.45; P < .001; mortality: OR 10.42 95% CI 7.73 to 14.06; P = .005). CONCLUSIONS: Higher values of NLR were associated with severity and all-cause mortality in hospitalised COVID-19patients.
Authors: Denise Battaglini; Miquéias Lopes-Pacheco; Hugo C Castro-Faria-Neto; Paolo Pelosi; Patricia R M Rocco Journal: Front Immunol Date: 2022-04-27 Impact factor: 8.786
Authors: Juan R Ulloque-Badaracco; Melany D Mosquera-Rojas; Enrique A Hernandez-Bustamante; Esteban A Alarcón-Braga; Percy Herrera-Añazco; Vicente A Benites-Zapata Journal: Heliyon Date: 2022-05-18
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Authors: M Cyrus Maher; Leah B Soriaga; Anil Gupta; Yi-Pei Chen; Julia di Iulio; Sarah Ledoux; Megan J Smithey; Andrea L Cathcart; Kathleen McKusick; David Sun; Melissa Aldinger; Elizabeth Alexander; Lisa Purcell; Xiao Ding; Amanda Peppercorn; Daren Austin; Erik Mogalian; Wendy W Yeh; Adrienne E Shapiro; Davide Corti; Herbert W Virgin; Phillip S Pang; Amalio Telenti Journal: Cell Rep Med Date: 2022-08-16
Authors: Hernán J Zavalaga-Zegarra; Juan J Palomino-Gutierrez; Juan R Ulloque-Badaracco; Melany D Mosquera-Rojas; Enrique A Hernandez-Bustamante; Esteban A Alarcon-Braga; Vicente A Benites-Zapata; Percy Herrera-Añazco; Adrian V Hernandez Journal: Trop Med Infect Dis Date: 2022-08-16
Authors: Juan R Ulloque-Badaracco; Esteban A Alarcon-Braga; Enrique A Hernandez-Bustamante; Ali Al-Kassab-Córdova; Melany D Mosquera-Rojas; Ricardo R Ulloque-Badaracco; Miguel A Huayta-Cortez; Sherelym H Maita-Arauco; Percy Herrera-Añazco; Vicente A Benites-Zapata Journal: Trop Med Infect Dis Date: 2022-07-27