Comparison of Lymphocyte–CRP Ratio to Conventional Inflammatory Markers for Predicting Clinical Outcomes in COVID-19
<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 tra...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-05-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/13/6/909 |
| _version_ | 1797593925631868928 |
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| author | Alexander Liu Robert Hammond Kenneth Chan Chukwugozie Chukwuenweniwe Rebecca Johnson Duaa Khair Eleanor Duck Oluwaseun Olubodun Kristian Barwick Winston Banya James Stirrup Peter D. Donnelly Juan Carlos Kaski Anthony R. M. Coates |
| author_facet | Alexander Liu Robert Hammond Kenneth Chan Chukwugozie Chukwuenweniwe Rebecca Johnson Duaa Khair Eleanor Duck Oluwaseun Olubodun Kristian Barwick Winston Banya James Stirrup Peter D. Donnelly Juan Carlos Kaski Anthony R. M. Coates |
| author_sort | Alexander Liu |
| collection | DOAJ |
| description | <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. |
| first_indexed | 2024-03-11T02:16:24Z |
| format | Article |
| id | doaj.art-6f0a83659b124f30a1a12b84f93faf46 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-11T02:16:24Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-6f0a83659b124f30a1a12b84f93faf462023-11-18T11:10:26ZengMDPI AGJournal of Personalized Medicine2075-44262023-05-0113690910.3390/jpm13060909Comparison of Lymphocyte–CRP Ratio to Conventional Inflammatory Markers for Predicting Clinical Outcomes in COVID-19Alexander Liu0Robert Hammond1Kenneth Chan2Chukwugozie Chukwuenweniwe3Rebecca Johnson4Duaa Khair5Eleanor Duck6Oluwaseun Olubodun7Kristian Barwick8Winston Banya9James Stirrup10Peter D. Donnelly11Juan Carlos Kaski12Anthony R. M. Coates13School of Medicine, University of St Andrews, St Andrews KY16 9TF, UKSchool of Medicine, University of St Andrews, St Andrews KY16 9TF, UKRoyal Berkshire NHS Foundation Trust, Reading RG1 5AN, UKRoyal Berkshire NHS Foundation Trust, Reading RG1 5AN, UKRoyal Berkshire NHS Foundation Trust, Reading RG1 5AN, UKRoyal Berkshire NHS Foundation Trust, Reading RG1 5AN, UKRoyal Berkshire NHS Foundation Trust, Reading RG1 5AN, UKRoyal Berkshire NHS Foundation Trust, Reading RG1 5AN, UKRoyal Berkshire NHS Foundation Trust, Reading RG1 5AN, UKRoyal Brompton Hospital, London SW3 6NP, UKRoyal Berkshire NHS Foundation Trust, Reading RG1 5AN, UKSchool of Medicine, University of St Andrews, St Andrews KY16 9TF, UKMolecular and Clinical Sciences Research Institute, St George’s University of London, London SW17 0QT, UKInstitute of Infection and Immunity, St George’s University of London, London SW17 0QT, UK<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.https://www.mdpi.com/2075-4426/13/6/909lymphocyte–CRP ratiocoronavirus disease 19C-reactive proteinrisk stratificationprognostic risk |
| spellingShingle | Alexander Liu Robert Hammond Kenneth Chan Chukwugozie Chukwuenweniwe Rebecca Johnson Duaa Khair Eleanor Duck Oluwaseun Olubodun Kristian Barwick Winston Banya James Stirrup Peter D. Donnelly Juan Carlos Kaski Anthony R. M. Coates Comparison of Lymphocyte–CRP Ratio to Conventional Inflammatory Markers for Predicting Clinical Outcomes in COVID-19 Journal of Personalized Medicine lymphocyte–CRP ratio coronavirus disease 19 C-reactive protein risk stratification prognostic risk |
| title | Comparison of Lymphocyte–CRP Ratio to Conventional Inflammatory Markers for Predicting Clinical Outcomes in COVID-19 |
| title_full | Comparison of Lymphocyte–CRP Ratio to Conventional Inflammatory Markers for Predicting Clinical Outcomes in COVID-19 |
| title_fullStr | Comparison of Lymphocyte–CRP Ratio to Conventional Inflammatory Markers for Predicting Clinical Outcomes in COVID-19 |
| title_full_unstemmed | Comparison of Lymphocyte–CRP Ratio to Conventional Inflammatory Markers for Predicting Clinical Outcomes in COVID-19 |
| title_short | Comparison of Lymphocyte–CRP Ratio to Conventional Inflammatory Markers for Predicting Clinical Outcomes in COVID-19 |
| title_sort | comparison of lymphocyte crp ratio to conventional inflammatory markers for predicting clinical outcomes in covid 19 |
| topic | lymphocyte–CRP ratio coronavirus disease 19 C-reactive protein risk stratification prognostic risk |
| url | https://www.mdpi.com/2075-4426/13/6/909 |
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