Kalabin Aleksandr, Mani Vishnu Raj Kumar, Valdivieso Sebastian Cristobal, Donaldson Brian
Columbia University College of Physicians and Surgeons at Harlem Hospital, New York, NY, USA.
Columbia University College of Physicians and Surgeons at Harlem Hospital, New York, NY, USA; Duke University Medical Center, Durham, North Carolina, USA.
Infez Med. 2021 Mar 1;29(1):46-53.
Direct viral damage and uncontrolled inflammation contribute to disease severity in SARS-CoV-2 infection. The aim of this study was to investigate the prognostic significance of neutrophil-to-lymphocyte [NLR], lymphocyte-to-monocyte [LMR] and platelet-to-lymphocyte [PLR] ratios in COVID-19 patients. All 184 COVID-19 patients hospitalized in our institution between March - April 2020 were retrospectively analyzed. The patients were grouped into intubated and non-intubated, and subgrouped into survived and deceased. An unpaired Student's t-test was used for continuous variables, and the Pearson Chi-square (χ2) test for categorical. Univariate and multivariate logistic regression models were developed to assess the independent relationship between NLR, LMR and PLR and unfavorable outcomes. Non-parametric correlations were calculated using Spearman's Rho correlation coefficient. The mean age of the patients was 64.7; mean BMI was 29.10; 73 (39.67%) were female and 111 male (60.33%). No statistical difference between groups was identified with regard to NLR (mean 8.29, standard deviation [SD] 7.86). On multivariate regression analysis, only PLR and LMR were shown to influence the ratio and it was positively correlated with PLR, lactate and C-reactive protein [CRP]. LMR for non-intubated survived [NI-S] (mean 2.29, SD 1.31) and non-intubated deceased [NI-D] (mean 1.79, SD 0.81) groups were statistically significant (p=0.03). LMR was influenced only by NLR on regression analysis. A positive correlation of LMR with body mass index [BMI] was ascertained. No statistical significance was found between groups for PLR (mean 269.85, SD 207.98) and the ratio was influenced by age and NLR on regression analysis, and positively correlated with NLR. To conclude, previously reported findings of a prognostic role of NLR, LMR and PLR in COVID-19 were not validated in our cohort and we would caution against using the ratios in question as independent markers for disease severity.
病毒的直接损伤和不受控制的炎症会加重新型冠状病毒2（SARS-CoV-2）感染的疾病严重程度。本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）、淋巴细胞与单核细胞比值（LMR）以及血小板与淋巴细胞比值（PLR）对新型冠状病毒肺炎（COVID-19）患者的预后意义。对2020年3月至4月期间在我院住院的184例COVID-19患者进行回顾性分析。患者分为插管组和非插管组，并进一步分为存活组和死亡组。连续变量采用独立样本t检验，分类变量采用Pearson卡方（χ2）检验。建立单因素和多因素逻辑回归模型，以评估NLR、LMR和PLR与不良预后之间的独立关系。使用Spearman秩相关系数计算非参数相关性。患者的平均年龄为64.7岁；平均体重指数为29.10；73例（39.67%）为女性，111例为男性（60.33%）。各组间NLR无统计学差异（平均值8.29，标准差[SD]7.86）。多因素回归分析显示，只有PLR和LMR对该比值有影响，且与PLR、乳酸和C反应蛋白[CRP]呈正相关。非插管存活[NI-S]组（平均值2.29，SD 1.31）和非插管死亡[NI-D]组（平均值1.79，SD 0.81）的LMR具有统计学意义（p=0.03）。回归分析显示LMR仅受NLR影响。确定LMR与体重指数[BMI]呈正相关。各组间PLR无统计学差异（平均值269.85，SD 207.98），回归分析显示该比值受年龄和NLR影响，并与NLR呈正相关。总之，先前报道的NLR、LMR和PLR对COVID-19预后作用的研究结果在我们的队列中未得到验证，我们提醒不要将上述比值用作疾病严重程度的独立标志物。
