Sayed Anwar A, Allam Assem A, Sayed Ayman I, Alraey Mohammed A, Joseph Mercy V
From the Department of Medical Microbiology and Immunology (Sayed AA), Faculty of Medicine, Taibah University; from the Department of Internal Medicine (Sayed AI), Nojood Medical Center, Madinah; Department of Infection Control (Allam, Alraey, Joseph), King Abdullah Bin Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia; and form the Department of Surgery and Cancer (Sayed AA), Imperial College London, London, United Kingdom.
Saudi Med J. 2021 Apr;42(4):370-376. doi: 10.15537/smj.2021.42.4.20200818.
To assess the neutrophil-to-lymphocyte ratio (NLR) diagnostic and prognostic value in the context of Coronavirus disease-2019 (COVID-19) infection in Saudi Arabia.
A case-control study in which 701 confirmed COVID-19 patients (of which 41 were intensive care unit [ICU]-admitted) and 250 control subjects were enrolled. The study was conducted retrospectively in October on patients admitted to 3 separate hospitals in Saudi Arabia namely: King Abdullah Bin Abdulaziz University Hospital (Riyadh), Ohud Hospital (Madinah), and Nojood Medical Center (Madinah) between May and September 2020. Neutrophil-to-lymphocyte ratio was calculated based on absolute neutrophil and lymphocyte count. Institutional ethical approval was obtained prior to the study.
Patients (median age 35 years), of which 54.8% were females, were younger than the control cohort (median age 48 years). Patients had significantly higher NLR compared to the control group. Intensive care unit admitted patients had significantly higher platelet, WBC and neutrophil counts. The ICU patients' NLR was almost twice as of the non-intensive patients. The NLR value of 5.5 was found to be of high specificity (96.4%) and positive predictive value (91.4%) in diagnosing COVID-19. Furthermore, it had a very good sensitivity (86.4%) in predicting severe forms of disease, such as, ICU admission.
Neutrophil-to-lymphocyte ratio is an important tool in determining the COVID-19 clinical status. This study further confirms the prognostic value of NLR in detecting severe infection, and those patients with high NLR should be closely monitored and managed.
评估中性粒细胞与淋巴细胞比值（NLR）在沙特阿拉伯2019冠状病毒病（COVID-19）感染中的诊断和预后价值。
一项病例对照研究，纳入了701例确诊的COVID-19患者（其中41例入住重症监护病房[ICU]）和250例对照受试者。该研究于10月对2020年5月至9月期间在沙特阿拉伯3家不同医院住院的患者进行回顾性研究，这3家医院分别是：阿卜杜拉国王本·阿卜杜勒阿齐兹大学医院（利雅得）、乌胡德医院（麦地那）和诺朱德医疗中心（麦地那）。中性粒细胞与淋巴细胞比值根据绝对中性粒细胞和淋巴细胞计数计算得出。研究前获得了机构伦理批准。
患者（中位年龄35岁）中54.8%为女性，比对照组队列（中位年龄48岁）年轻。与对照组相比，患者的NLR显著更高。入住重症监护病房的患者血小板、白细胞和中性粒细胞计数显著更高。ICU患者的NLR几乎是非重症患者的两倍。发现NLR值为5.5时，在诊断COVID-19方面具有高特异性（96.4%）和阳性预测值（91.4%）。此外，它在预测严重疾病形式（如入住ICU）方面具有非常好的敏感性（86.4%）。
中性粒细胞与淋巴细胞比值是确定COVID-19临床状态的重要工具。本研究进一步证实了NLR在检测严重感染中的预后价值，应密切监测和管理NLR高的患者。
