Altern Ther Health Med. 2021 Jun;27(S1):18-24.
Inflammation is a significant factor driving the rise of multiple cases of viral pneumonia, including COVID-19 infection. Peripheral white blood cells (WBCs), the neutrophil (NEU)-to-lymphocyte (LYM) ratio (NLR), the platelet-to-lymphocyte (PLR) ratio, and hemoglobin (Hb) are markers of systematic inflammatory reaction and often predict disease severity.
The current study intended to examine the prognostic importance of hemoglobin (Hb), total leukocyte count (TLC), absolute neutrophile count (ANC), absolute lymphocyte count (ALC), NLR, d-NLR [derived NLR = ANC/(WBC-ANC)], absolute platelet count (APC), and PLR, based on complete blood counts (CBCs) for COVID-19 patients.
The research team designed a retrospective that was conducted between March 27 and June 5, 2020, after the first COVID-19 case was reported in Ajmer, Rajasthan, India on March 27.
The study took place at Jawaharlal Nehru (JLN) Medical College in Ajmer, Rajasthan, India.
The study included 364 participants who were all COVID-positive patients who came to the hospital during the study's period, including patients from various age groups and of both genders.
Using the results of the CBC, the research team measured: (1) Hb in g/dl, (2) ANC, (3) ALC, and (4) APC. The neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) were calculated from measurements of the levels of the circulating biomarkers, as cells × 103/μl.
For participants who were severely symptomatic, the mean age was 57.86 ± 8.92. Males were more likely to experience severe symptoms. Participants' Hb values were significantly different between groups, and TLC, ANC, NLR, d-NLR, and PLR were highest in the severely symptomatic group and lowest in the asymptomatic group. NLR was positively associated with a risk of COVID-19 pneumonia, while Hb was negatively associated with development of pneumonia.
Disease severity and age are independent predictors of poor outcomes. The NLR should be used as a routine blood test that can help in the diagnosis of disease severity in COVID-19. NLR is very simple tool that can be used as a fast and low-cost test that is easily available, even in small centers where the facilities for other tests, such as tests of LDH, CRP, and IL-6, and high resolution CT scans aren't available. Thus, NLR can be used as single independent predictor of COVID-19 disease severity.
炎症是导致多种病毒性肺炎病例上升的一个重要因素，包括 COVID-19 感染。外周血白细胞（WBC）、中性粒细胞（NEU）与淋巴细胞（LYM）比值（NLR）、血小板与淋巴细胞比值（PLR）和血红蛋白（Hb）是全身炎症反应的标志物，常可预测疾病严重程度。
本研究旨在探讨基于全血细胞计数（CBC）的血红蛋白（Hb）、白细胞总数（TLC）、绝对中性粒细胞计数（ANC）、绝对淋巴细胞计数（ALC）、NLR、d-NLR（衍生 NLR = ANC/（WBC-ANC））、绝对血小板计数（APC）和 PLR 对 COVID-19 患者的预后意义。
研究团队设计了一项回顾性研究，于 2020 年 3 月 27 日在印度拉贾斯坦邦阿杰梅尔报告首例 COVID-19 病例后，于 3 月 27 日至 6 月 5 日进行。
该研究在印度拉贾斯坦邦阿杰梅尔的贾瓦哈拉尔尼赫鲁（JLN）医学院进行。
该研究纳入了 364 名 COVID-19 阳性患者，均为研究期间来院就诊的患者，包括来自不同年龄组和性别的患者。
研究团队使用 CBC 结果测量：（1）g/dl 单位的 Hb，（2）ANC，（3）ALC，和（4）APC。循环生物标志物水平的中性粒细胞-淋巴细胞比值（NLR）和血小板-淋巴细胞比值（PLR）是通过细胞计数计算得出的，单位为细胞×103/μl。
对于症状严重的患者，平均年龄为 57.86±8.92 岁。男性更易出现严重症状。各组间患者的 Hb 值存在显著差异，TLC、ANC、NLR、d-NLR 和 PLR 在症状严重组最高，无症状组最低。NLR 与 COVID-19 肺炎风险呈正相关，而 Hb 与肺炎的发生呈负相关。
疾病严重程度和年龄是不良结局的独立预测因素。NLR 应作为常规血液检查用于 COVID-19 疾病严重程度的诊断。NLR 是一种非常简单的工具，可以作为一种快速、低成本的检测方法，即使在没有其他检测设施的小型中心，如乳酸脱氢酶（LDH）、C 反应蛋白（CRP）和白细胞介素-6（IL-6）检测以及高分辨率 CT 扫描，也可用于检测。因此，NLR 可作为 COVID-19 疾病严重程度的单一独立预测因子。
