| Summary: | <b>Background</b>: In COVID-19 patients, lymphocyte–CRP ratio (LCR) is a promising biomarker for predicting adverse clinical outcomes. How well LCR performs compared to conventional inflammatory markers for prognosticating COVID-19 patients remains unclear, which hinders the clinical translation of this novel biomarker. <b>Methods:</b> In a cohort of COVID-19 inpatients, we characterised the clinical applicability of LCR by comparing its prognostic value against conventional inflammatory markers for predicting inpatient mortality and a composite of mortality, invasive/non-invasive ventilation and intensive care unit admissions. <b>Results:</b> Of the 413 COVID-19 patients, 100 (24%) patients suffered inpatient mortality. On Receiver Operating Characteristics analysis, LCR performed similarly to CRP for predicting mortality (AUC 0.74 vs. 0.71, <i>p</i> = 0.049) and the composite endpoint (AUC 0.76 vs. 0.76, <i>p</i> = 0.812). LCR outperformed lymphocyte counts (AUC 0.74 vs. 0.66, <i>p</i> = 0.002), platelet counts (AUC 0.74 vs. 0.61, <i>p</i> = 0.003) and white cell counts (AUC 0.74 vs. 0.54, <i>p</i> < 0.001) for predicting mortality. On Kaplan–Meier analysis, patients with a low LCR (below a 58 cut-off) had worse inpatient survival than patients with other LCR values (<i>p</i> < 0.001). <b>Conclusion</b>: LCR appears comparable to CRP, but outperformed other inflammatory markers, for prognosticating COVID-19 patients. Further studies are required to improve the diagnostic value of LCR to facilitate clinical translation.
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