» Articles » PMID: 33050487

The Neutrophil-to-Monocyte Ratio and Lymphocyte-to-Neutrophil Ratio at Admission Predict In-Hospital Mortality in Mexican Patients with Severe SARS-CoV-2 Infection (Covid-19)

Abstract

There is a deep need for mortality predictors that allow clinicians to quickly triage patients with severe coronavirus disease 2019 (Covid-19) into intensive care units at the time of hospital admission. Thus, we examined the efficacy of the lymphocyte-to-neutrophil ratio (LNR) and neutrophil-to-monocyte ratio (NMR) as predictors of in-hospital death at admission in patients with severe Covid-19. A total of 54 Mexican adult patients with Covid-19 that met hospitalization criteria were retrospectively enrolled, followed-up daily until hospital discharge or death, and then assigned to survival or non-survival groups. Clinical, demographic, and laboratory parameters were recorded at admission. A total of 20 patients with severe Covid-19 died, and 75% of them were men older than 62.90 ± 14.18 years on average. Type 2 diabetes, hypertension, and coronary heart disease were more prevalent in non-survivors. As compared to survivors, LNR was significantly fourfold decreased while NMR was twofold increased. LNR ≤ 0.088 predicted in-hospital mortality with a sensitivity of 85.00% and a specificity of 74.19%. NMR ≥ 17.75 was a better independent risk factor for mortality with a sensitivity of 89.47% and a specificity of 80.00%. This study demonstrates for the first time that NMR and LNR are accurate predictors of in-hospital mortality at admission in patients with severe Covid-19.

Citing Articles

Use of convalescent plasma in COVID-19 treatment: is clinical severity more important than the intervention?.

Dutra V, Andrade H, Nunes V, Elia G, Torres J, Bub C Einstein (Sao Paulo). 2024; 22:eAO0563.

PMID: 39699400 PMC: 11634348. DOI: 10.31744/einstein_journal/2024AO0563.


Association between Hematological Parameters and Severity of COVID-19 disease.

Krishnan G, Karanth S, Vidyasagar S, Aggarwal A, Udupi A, Karanth S F1000Res. 2024; 13:517.

PMID: 39403681 PMC: 11472279. DOI: 10.12688/f1000research.148734.2.


Macrophage Activation Syndrome in Coinciding Pandemics of Obesity and COVID-19: Worse than Bad.

Engin A, Engin E, Engin A Adv Exp Med Biol. 2024; 1460:919-954.

PMID: 39287877 DOI: 10.1007/978-3-031-63657-8_31.


Prognostic Value of Dynamic Segmented Neutrophil to Monocyte (SeMo) Ratio Changes in Patients with Moderate to Severe Traumatic Brain Injury.

Chang L, Lin Y, Tsai C, Rau C, Hsu S, Hsieh C Diagnostics (Basel). 2024; 14(16).

PMID: 39202324 PMC: 11353917. DOI: 10.3390/diagnostics14161836.


Predictivity of the Prognostic Nutritional Index and Systemic Inflammation Index for All-Cause In-Hospital Mortality in Geriatric and Adult COVID-19 Inpatients.

Cavdar S, Savas S, Tasbakan S, Sayiner A, Basoglu O, Korkmaz P J Clin Med. 2024; 13(15).

PMID: 39124732 PMC: 11313282. DOI: 10.3390/jcm13154466.


References
1.
Arango Duque G, Descoteaux A . Macrophage cytokines: involvement in immunity and infectious diseases. Front Immunol. 2014; 5:491. PMC: 4188125. DOI: 10.3389/fimmu.2014.00491. View

2.
Lin Z, Long F, Yang Y, Chen X, Xu L, Yang M . Serum ferritin as an independent risk factor for severity in COVID-19 patients. J Infect. 2020; 81(4):647-679. PMC: 7313486. DOI: 10.1016/j.jinf.2020.06.053. View

3.
Hemmat N, Derakhshani A, Baghi H, Silvestris N, Baradaran B, De Summa S . Neutrophils, Crucial, or Harmful Immune Cells Involved in Coronavirus Infection: A Bioinformatics Study. Front Genet. 2020; 11:641. PMC: 7296827. DOI: 10.3389/fgene.2020.00641. View

4.
Feng X, Li S, Sun Q, Zhu J, Chen B, Xiong M . Immune-Inflammatory Parameters in COVID-19 Cases: A Systematic Review and Meta-Analysis. Front Med (Lausanne). 2020; 7:301. PMC: 7295898. DOI: 10.3389/fmed.2020.00301. View

5.
Lai C, Shih T, Ko W, Tang H, Hsueh P . Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020; 55(3):105924. PMC: 7127800. DOI: 10.1016/j.ijantimicag.2020.105924. View