Department of Transfusion Medicine, General Hospital of Central Theater Command of the PLA, Wuhan, China.
CAS Key Laboratory of Infection and Immunity, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China.
Int J Lab Hematol. 2021 Apr;43(2):329-335. doi: 10.1111/ijlh.13374. Epub 2020 Oct 25.
Monitoring of laboratory indicators is important for predicting changes in disease severity and clinical outcomes. We aimed to identify the critical predictors that can effectively assess the disease conditions of patients with COVID-19 by analyzing the clinical characteristics and laboratory findings of patients with SARS-CoV-2 infection.
All consecutive patients (n = 294) with confirmed SARS-CoV-2 infection admitted to the General Hospital of Central Theater Command of the PLA from February 6 to February 21, 2020, were enrolled. These patients were divided into the severe group and the nonsevere group according to disease severity during hospitalization.
The median neutrophil-to-lymphocyte ratio (NLR) value of the severe patients was dramatically higher than that of the nonsevere patients (10.4 vs 2.6; P < .001). The NLR value equal to 5 was a boundary value worthy of reference, because more than 80% severe patients had an NLR value greater than 5 and over 80% nonsevere patients had an NLR value less than 5. The NLR value of these COVID-19 patients was positively and respectively correlated with the values of C-reactive protein (R = .5921, P < .001), lactate dehydrogenase (R = .4509, P < .001), procalcitonin (R = .5504, P < .001), fibrinogen (R = .4710, P < .001), and D-dimers (R = .4425, P < .001). However, the NLR value was merely and positively correlated with the interleukin-6 value (R = .3594, P < .05), but had no correlations with the values of interleukin-10, interleukin-4, interleukin-17, interferon-γ, and tumor necrosis factor-α (P > .05).
Neutrophil-to-lymphocyte ratio is a critical predictor for assessment of disease severity in patients with COVID-19, and it has a close relation with the laboratory indicators related to disease conditions.
监测实验室指标对于预测疾病严重程度和临床结局的变化很重要。我们旨在通过分析 SARS-CoV-2 感染患者的临床特征和实验室发现，确定能够有效评估 COVID-19 患者病情的关键预测因素。
纳入 2020 年 2 月 6 日至 2 月 21 日期间在解放军中部战区总医院连续收治的 294 例确诊 SARS-CoV-2 感染患者，根据住院期间的疾病严重程度将患者分为重症组和非重症组。
重症患者的中性粒细胞与淋巴细胞比值（NLR）中位数明显高于非重症患者（10.4 比 2.6；P<.001）。NLR 值等于 5 是一个值得参考的边界值，因为超过 80%的重症患者 NLR 值大于 5，超过 80%的非重症患者 NLR 值小于 5。这些 COVID-19 患者的 NLR 值与 C 反应蛋白（R=.5921，P<.001）、乳酸脱氢酶（R=.4509，P<.001）、降钙素原（R=.5504，P<.001）、纤维蛋白原（R=.4710，P<.001）和 D-二聚体（R=.4425，P<.001）的值呈正相关，而与白细胞介素-6 值（R=.3594，P<.05）呈正相关，与白细胞介素-10、白细胞介素-4、白细胞介素-17、干扰素-γ和肿瘤坏死因子-α的值无相关性（P>.05）。
中性粒细胞与淋巴细胞比值是评估 COVID-19 患者疾病严重程度的关键预测因素，与疾病状况相关的实验室指标密切相关。
