Neutrophil‐to‐lymphocyte ratio as a predictor of clinical outcomes in critically ill COVID‐19 patients: A retrospective observational study
Abstract Background Timely identification of patients at risk of worse clinical outcomes is vital in managing coronavirus disease 2019 (COVID‐19). The neutrophil‐to‐lymphocyte ratio (NLR) calculated from complete blood count can predict the degree of systemic inflammation and guide therapy according...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-09-01
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| Series: | Health Science Reports |
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| Online Access: | https://doi.org/10.1002/hsr2.844 |
| _version_ | 1797772360877604864 |
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| author | Husain S. Ali Dore C. Ananthegowda Ebrahim M. A. Ebrahim Nevin Kannappilly Mohammad Al Wraidat Ahmed S. Mohamed Mohamad Y. Khatib |
| author_facet | Husain S. Ali Dore C. Ananthegowda Ebrahim M. A. Ebrahim Nevin Kannappilly Mohammad Al Wraidat Ahmed S. Mohamed Mohamad Y. Khatib |
| author_sort | Husain S. Ali |
| collection | DOAJ |
| description | Abstract Background Timely identification of patients at risk of worse clinical outcomes is vital in managing coronavirus disease 2019 (COVID‐19). The neutrophil‐to‐lymphocyte ratio (NLR) calculated from complete blood count can predict the degree of systemic inflammation and guide therapy accordingly. Hence, we did a study to investigate the role of NLR value on intensive care unit (ICU) admission in predicting clinical outcomes of critically ill COVID‐19 patients. Methods We conducted a retrospective analysis of electronic health records of COVID‐19 patients admitted to ICUs at Hazm Mebaireek General Hospital, Qatar, from March 7, 2020 to July 18, 2020. Patients with an NLR equal to or higher than the cut‐off value derived from the receiver operating characteristic curve were compared to those with an NLR value below the cut‐off. The primary outcome studied was all‐cause ICU mortality. The secondary outcomes evaluated were the requirement of mechanical ventilation and ICU length of stay (LOS). Results Five hundred and nineteen patients were admitted to ICUs with severe COVID‐19 infection during the study period. Overall, ICU mortality in the study population was 14.6% (76/519). NLR on ICU admission of ≥6.55 was obtained using Youden's index to predict ICU mortality, with a sensitivity of 81% and specificity of 41%. Mortality was significantly higher in patients with age ≥60 years (p < 0.001), chronic kidney disease (p = 0.03), malignancy (p < 0.002), and NLR ≥ 6.55 (p < 0.003). There was also a significant association between the requirement of mechanical ventilation (34.7% vs. 51.8%, p < 0.001) and increased ICU LOS (8 vs. 10 days, p < 0.01) in patients with ICU admission NLR ≥ 6.55. Conclusion Higher NLR values on ICU admission are associated with worse clinical outcomes in critically ill COVID‐19 patients. |
| first_indexed | 2024-03-12T21:50:45Z |
| format | Article |
| id | doaj.art-fbf260375c1d4535b54a282e36089601 |
| institution | Directory Open Access Journal |
| issn | 2398-8835 |
| language | English |
| last_indexed | 2024-03-12T21:50:45Z |
| publishDate | 2022-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Health Science Reports |
| spelling | doaj.art-fbf260375c1d4535b54a282e360896012023-07-26T04:11:54ZengWileyHealth Science Reports2398-88352022-09-0155n/an/a10.1002/hsr2.844Neutrophil‐to‐lymphocyte ratio as a predictor of clinical outcomes in critically ill COVID‐19 patients: A retrospective observational studyHusain S. Ali0Dore C. Ananthegowda1Ebrahim M. A. Ebrahim2Nevin Kannappilly3Mohammad Al Wraidat4Ahmed S. Mohamed5Mohamad Y. Khatib6Department of Medical ICU/Medicine Hamad General Hospital Doha QatarIntensive Care Unit, Hazm Mebaireek General Hospital Doha QatarDepartment of Medical Education Hamad General Hospital Doha QatarIntensive Care Unit, Hazm Mebaireek General Hospital Doha QatarIntensive Care Unit, Hazm Mebaireek General Hospital Doha QatarIntensive Care Unit, Hazm Mebaireek General Hospital Doha QatarIntensive Care Unit, Hazm Mebaireek General Hospital Doha QatarAbstract Background Timely identification of patients at risk of worse clinical outcomes is vital in managing coronavirus disease 2019 (COVID‐19). The neutrophil‐to‐lymphocyte ratio (NLR) calculated from complete blood count can predict the degree of systemic inflammation and guide therapy accordingly. Hence, we did a study to investigate the role of NLR value on intensive care unit (ICU) admission in predicting clinical outcomes of critically ill COVID‐19 patients. Methods We conducted a retrospective analysis of electronic health records of COVID‐19 patients admitted to ICUs at Hazm Mebaireek General Hospital, Qatar, from March 7, 2020 to July 18, 2020. Patients with an NLR equal to or higher than the cut‐off value derived from the receiver operating characteristic curve were compared to those with an NLR value below the cut‐off. The primary outcome studied was all‐cause ICU mortality. The secondary outcomes evaluated were the requirement of mechanical ventilation and ICU length of stay (LOS). Results Five hundred and nineteen patients were admitted to ICUs with severe COVID‐19 infection during the study period. Overall, ICU mortality in the study population was 14.6% (76/519). NLR on ICU admission of ≥6.55 was obtained using Youden's index to predict ICU mortality, with a sensitivity of 81% and specificity of 41%. Mortality was significantly higher in patients with age ≥60 years (p < 0.001), chronic kidney disease (p = 0.03), malignancy (p < 0.002), and NLR ≥ 6.55 (p < 0.003). There was also a significant association between the requirement of mechanical ventilation (34.7% vs. 51.8%, p < 0.001) and increased ICU LOS (8 vs. 10 days, p < 0.01) in patients with ICU admission NLR ≥ 6.55. Conclusion Higher NLR values on ICU admission are associated with worse clinical outcomes in critically ill COVID‐19 patients.https://doi.org/10.1002/hsr2.844COVID‐19ICU mortalitymechanical ventilationneutrophil‐to‐lymphocyte ratioSARS‐CoV‐2 |
| spellingShingle | Husain S. Ali Dore C. Ananthegowda Ebrahim M. A. Ebrahim Nevin Kannappilly Mohammad Al Wraidat Ahmed S. Mohamed Mohamad Y. Khatib Neutrophil‐to‐lymphocyte ratio as a predictor of clinical outcomes in critically ill COVID‐19 patients: A retrospective observational study Health Science Reports COVID‐19 ICU mortality mechanical ventilation neutrophil‐to‐lymphocyte ratio SARS‐CoV‐2 |
| title | Neutrophil‐to‐lymphocyte ratio as a predictor of clinical outcomes in critically ill COVID‐19 patients: A retrospective observational study |
| title_full | Neutrophil‐to‐lymphocyte ratio as a predictor of clinical outcomes in critically ill COVID‐19 patients: A retrospective observational study |
| title_fullStr | Neutrophil‐to‐lymphocyte ratio as a predictor of clinical outcomes in critically ill COVID‐19 patients: A retrospective observational study |
| title_full_unstemmed | Neutrophil‐to‐lymphocyte ratio as a predictor of clinical outcomes in critically ill COVID‐19 patients: A retrospective observational study |
| title_short | Neutrophil‐to‐lymphocyte ratio as a predictor of clinical outcomes in critically ill COVID‐19 patients: A retrospective observational study |
| title_sort | neutrophil to lymphocyte ratio as a predictor of clinical outcomes in critically ill covid 19 patients a retrospective observational study |
| topic | COVID‐19 ICU mortality mechanical ventilation neutrophil‐to‐lymphocyte ratio SARS‐CoV‐2 |
| url | https://doi.org/10.1002/hsr2.844 |
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