Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19

Liu, Y., Du, X., Chen, J., Jin, Y., Peng, L., Wang, H. H.X. , Luo, M., Chen, L. and Zhao, Y. (2020) Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. Journal of Infection, 81(1), e6-e12. (doi: 10.1016/j.jinf.2020.04.002) (PMID:32283162) (PMCID:PMC7195072)

Abstract

Background: Several studies have described the clinical characteristics of patients with novel coronavirus (SARS-CoV-2) infected pneumonia (COVID-19), indicating severe patients tended to have higher neutrophil to lymphocyte ratio (NLR). Whether baseline NLR could be an independent predictor of in-hospital death in Chinese COVID-19 patients remains to be investigated. Methods: A cohort of patients with COVID-19 admitted to the Zhongnan Hospital of Wuhan University from January 1 to February 29 was retrospectively analyzed. The baseline data of laboratory examinations, including NLR, were collected. Univariate and multivariate logistic regression models were developed to assess the independent relationship between the baseline NLR and in-hospital all-cause death. A sensitivity analysis was performed by converting NLR from a continuous variable to a categorical variable according to tertile. Interaction and stratified analyses were conducted as well. Results: 245 COVID-19 patients were included in the final analyses, and the in-hospital mortality was 13.47%. Multivariate analysis demonstrated that there was 8% higher risk of in-hospital mortality for each unit increase in NLR (Odds ratio [OR] = 1.08; 95% confidence interval [95% CI], 1.01 to 1.14; P = 0.0147). Compared with patients in the lowest tertile, the NLR of patients in the highest tertile had a 15.04-fold higher risk of death (OR = 16.04; 95% CI, 1.14 to 224.95; P = 0.0395) after adjustment for potential confounders. Notably, the fully adjusted OR for mortality was 1.10 in males for each unit increase of NLR (OR = 1.10; 95% CI, 1.02 to 1.19; P = 0.016). Conclusions: NLR is an independent risk factor of the in-hospital mortality for COVID-19 patients especially for male. Assessment of NLR may help identify high risk individuals with COVID-19.

• Item Type: Articles
• Keywords: COVID-19, mortality, neutrophil-to-lymphocyte ratio, risk factors.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Wang, Professor Haoxiang
• Authors: Liu, Y., Du, X., Chen, J., Jin, Y., Peng, L., Wang, H. H.X., Luo, M., Chen, L., and Zhao, Y.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: Journal of Infection
• Publisher: Elsevier
• ISSN: 0163-4453
• ISSN (Online): 1532-2742
• Published Online: 10 April 2020
• Copyright Holders: Copyright © 2020 The British Infection Association
• First Published: First published in Journal of Infection 81(1): e6-e12
• Publisher Policy: Reproduced in accordance with the publisher copyright policy