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Neutrophil-to-Lymphocyte Ratio and Early Variation of NLR to Predict In-Hospital Mortality and Severity in ED Patients with SARS-CoV-2 Infection

(1) Introduction: The neutrophil-to lymphocyte ratio is valued as a predictive marker in several inflammatory diseases. For example, an increasing NLR is a risk factor of mortality in sepsis. It also appears to be helpful in other settings such as cancer. The aim of our work was to study the prognos...

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Autores principales: Abensur Vuillaume, Laure, Le Borgne, Pierrick, Alamé, Karine, Lefebvre, François, Bérard, Lise, Delmas, Nicolas, Cipolat, Lauriane, Gennai, Stéphane, Bilbault, Pascal, Lavoignet, Charles-Eric
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8229672/
https://www.ncbi.nlm.nih.gov/pubmed/34207918
http://dx.doi.org/10.3390/jcm10122563
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author Abensur Vuillaume, Laure
Le Borgne, Pierrick
Alamé, Karine
Lefebvre, François
Bérard, Lise
Delmas, Nicolas
Cipolat, Lauriane
Gennai, Stéphane
Bilbault, Pascal
Lavoignet, Charles-Eric
author_facet Abensur Vuillaume, Laure
Le Borgne, Pierrick
Alamé, Karine
Lefebvre, François
Bérard, Lise
Delmas, Nicolas
Cipolat, Lauriane
Gennai, Stéphane
Bilbault, Pascal
Lavoignet, Charles-Eric
author_sort Abensur Vuillaume, Laure
collection PubMed
description (1) Introduction: The neutrophil-to lymphocyte ratio is valued as a predictive marker in several inflammatory diseases. For example, an increasing NLR is a risk factor of mortality in sepsis. It also appears to be helpful in other settings such as cancer. The aim of our work was to study the prognostic value of NLR for disease severity and mortality in patients infected with SARS-CoV-2 upon their admission to the Emergency Department (ED) and its early variation (ΔNLR) in the first 24 h of management (H-24). (2) Methods: Between 1 March and 30 April 2020, we conducted a multicenter and retrospective cohort study of patients with moderate or severe coronavirus disease 19 (COVID-19), who were all hospitalized after presenting to the ED. (3) Results: A total of 1035 patients were included in our study. Factors associated with infection severity were C-reactive protein level (OR: 1.007, CI 95%: [1.005–1.010], p < 0.001), NLR at H-24 (OR: 1.117, CI 95%: [1.060–1.176], p < 0.001), and ΔNLR (OR: 1.877, CI 95%: [1.160–3.036], p: 0.01). The best threshold of ΔNLR to predict the severity of infection was 0.222 (sensitivity 56.1%, specificity 68.3%). In multivariate analysis, the only biochemical factor significantly associated with mortality was again ΔNLR (OR: 2.142, CI 95%: ([1.132–4.056], p: 0.019). The best threshold of ΔNLR to predict mortality was 0.411 (sensitivity 53.3%; specificity 67.3%). (4) Conclusion: The NLR and its early variation (ΔNLR) could help physicians predict both severity and mortality associated with SARS-CoV-2 infection, hence contributing to optimized patient management (accurate triage and treatment).
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spelling pubmed-82296722021-06-26 Neutrophil-to-Lymphocyte Ratio and Early Variation of NLR to Predict In-Hospital Mortality and Severity in ED Patients with SARS-CoV-2 Infection Abensur Vuillaume, Laure Le Borgne, Pierrick Alamé, Karine Lefebvre, François Bérard, Lise Delmas, Nicolas Cipolat, Lauriane Gennai, Stéphane Bilbault, Pascal Lavoignet, Charles-Eric J Clin Med Article (1) Introduction: The neutrophil-to lymphocyte ratio is valued as a predictive marker in several inflammatory diseases. For example, an increasing NLR is a risk factor of mortality in sepsis. It also appears to be helpful in other settings such as cancer. The aim of our work was to study the prognostic value of NLR for disease severity and mortality in patients infected with SARS-CoV-2 upon their admission to the Emergency Department (ED) and its early variation (ΔNLR) in the first 24 h of management (H-24). (2) Methods: Between 1 March and 30 April 2020, we conducted a multicenter and retrospective cohort study of patients with moderate or severe coronavirus disease 19 (COVID-19), who were all hospitalized after presenting to the ED. (3) Results: A total of 1035 patients were included in our study. Factors associated with infection severity were C-reactive protein level (OR: 1.007, CI 95%: [1.005–1.010], p < 0.001), NLR at H-24 (OR: 1.117, CI 95%: [1.060–1.176], p < 0.001), and ΔNLR (OR: 1.877, CI 95%: [1.160–3.036], p: 0.01). The best threshold of ΔNLR to predict the severity of infection was 0.222 (sensitivity 56.1%, specificity 68.3%). In multivariate analysis, the only biochemical factor significantly associated with mortality was again ΔNLR (OR: 2.142, CI 95%: ([1.132–4.056], p: 0.019). The best threshold of ΔNLR to predict mortality was 0.411 (sensitivity 53.3%; specificity 67.3%). (4) Conclusion: The NLR and its early variation (ΔNLR) could help physicians predict both severity and mortality associated with SARS-CoV-2 infection, hence contributing to optimized patient management (accurate triage and treatment). MDPI 2021-06-09 /pmc/articles/PMC8229672/ /pubmed/34207918 http://dx.doi.org/10.3390/jcm10122563 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Abensur Vuillaume, Laure
Le Borgne, Pierrick
Alamé, Karine
Lefebvre, François
Bérard, Lise
Delmas, Nicolas
Cipolat, Lauriane
Gennai, Stéphane
Bilbault, Pascal
Lavoignet, Charles-Eric
Neutrophil-to-Lymphocyte Ratio and Early Variation of NLR to Predict In-Hospital Mortality and Severity in ED Patients with SARS-CoV-2 Infection
title Neutrophil-to-Lymphocyte Ratio and Early Variation of NLR to Predict In-Hospital Mortality and Severity in ED Patients with SARS-CoV-2 Infection
title_full Neutrophil-to-Lymphocyte Ratio and Early Variation of NLR to Predict In-Hospital Mortality and Severity in ED Patients with SARS-CoV-2 Infection
title_fullStr Neutrophil-to-Lymphocyte Ratio and Early Variation of NLR to Predict In-Hospital Mortality and Severity in ED Patients with SARS-CoV-2 Infection
title_full_unstemmed Neutrophil-to-Lymphocyte Ratio and Early Variation of NLR to Predict In-Hospital Mortality and Severity in ED Patients with SARS-CoV-2 Infection
title_short Neutrophil-to-Lymphocyte Ratio and Early Variation of NLR to Predict In-Hospital Mortality and Severity in ED Patients with SARS-CoV-2 Infection
title_sort neutrophil-to-lymphocyte ratio and early variation of nlr to predict in-hospital mortality and severity in ed patients with sars-cov-2 infection
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8229672/
https://www.ncbi.nlm.nih.gov/pubmed/34207918
http://dx.doi.org/10.3390/jcm10122563
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