Rizo-Téllez Salma A, Méndez-García Lucia A, Flores-Rebollo Cruz, Alba-Flores Fernando, Alcántara-Suárez Raúl, Manjarrez-Reyna Aarón N, Baltazar-López Neyla, Hernández-Guzmán Verónica A, León-Pedroza José I, Zapata-Arenas Rogelio, González-Chávez Antonio, Hernández-Ruíz Joselín, Carrillo-Ruíz José D, Serrano-Loyola Raúl, Guerrero-Avendaño Guadalupe M L, Escobedo Galileo
Laboratory of Immunometabolism, Research Division, General Hospital of Mexico "Dr. Eduardo Liceaga", Mexico City 06720, Mexico.
PECEM, Facultad de Medicina, Universidad Nacional Autónoma de México, Coyoacán, Mexico City 04510, Mexico.
Microorganisms. 2020 Oct 10;8(10):1560. doi: 10.3390/microorganisms8101560.
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.
目前迫切需要能够让临床医生在收治2019年冠状病毒病（Covid-19）重症患者时迅速将其分诊至重症监护病房的死亡率预测指标。因此，我们研究了淋巴细胞与中性粒细胞比值（LNR）和中性粒细胞与单核细胞比值（NMR）作为重症Covid-19患者入院时院内死亡预测指标的有效性。我们回顾性纳入了54名符合住院标准的墨西哥成年Covid-19患者，每天进行随访直至出院或死亡，然后将其分为存活组和非存活组。记录入院时的临床、人口统计学和实验室参数。共有20名重症Covid-19患者死亡，其中75%为男性，平均年龄62.90±14.18岁。2型糖尿病、高血压和冠心病在非存活者中更为常见。与存活者相比，LNR显著降低了四倍，而NMR增加了两倍。LNR≤0.088预测院内死亡率的敏感度为85.00%，特异度为74.19%。NMR≥17.75是更好的独立死亡风险因素，敏感度为89.47%，特异度为80.00%。本研究首次证明，NMR和LNR是重症Covid-19患者入院时院内死亡的准确预测指标。
