Department of Infectious Diseases and Clinical Microbiology, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey.
Department of Biochemistry, Sanliurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey.
Int J Clin Pract. 2021 Nov;75(11):e14781. doi: 10.1111/ijcp.14781. Epub 2021 Sep 12.
Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), eosinophil/lymphocyte ratio (ELR), and C-reactive protein (CRP)/lymphocyte ratio (CLR) are well-established inflammatory indices. This study aimed to examine whether NLR, PLR, MLR, ELR and CLR could differentiate coronavirus disease 2019 (COVID-19) patients with pneumonia from those of without.
We retrospectively examined the laboratory parameters including CRP, D-dimer, procalcitonin and complete blood count of 306 COVID-19 patients (pneumonic = 152 and non-pneumonic = 154). NLR, PLR, MLR, ELR and CLR values of each patient were calculated. The ability of these indices to distinguish COVID-19 patients with and without pneumonia was determined by receiver operating characteristic (ROC) analysis.
NLR, PLR and CLR values were higher while ELR value was lower in pneumonic COVID-19 patients compared with patients with non-pneumonic COVID-19 infection. MLR value was similar in the two groups. NLR, PLR and CLR were positively correlated with CRP and procalcitonin. ELR was negatively correlated with CRP. The ROC analysis revealed that the optimal cut-off value of CLR for discriminating COVID-19 patients with pneumonia from those without pneumonia was 1.14 and the area under curve (AUC) for CLR was 0.731 (sensitivity = 81.5% and specificity = 55.6%), which was markedly higher than the AUCs of NLR (0.622), PLR (0.585) and ELR (0.613). However, no statistical differences were observed between AUC values of NLR, PLR and ELR (P > .05).
Our findings showed that NLR, PLR, ELR and CLR indices can be used in differentiating COVID-19 patients with or without pneumonia. Among them, the CLR index was the best predictor of pneumonia in COVID-19 patients.
中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）、单核细胞/淋巴细胞比值（MLR）、嗜酸性粒细胞/淋巴细胞比值（ELR）和 C 反应蛋白/淋巴细胞比值（CLR）均为成熟的炎症指标。本研究旨在探讨 NLR、PLR、MLR、ELR 和 CLR 是否能区分合并肺炎的 2019 冠状病毒病（COVID-19）患者与不合并肺炎的患者。
我们回顾性分析了 306 例 COVID-19 患者（合并肺炎 152 例，不合并肺炎 154 例）的实验室参数，包括 C 反应蛋白（CRP）、D-二聚体、降钙素原和全血细胞计数。计算每位患者的 NLR、PLR、MLR、ELR 和 CLR 值。采用受试者工作特征（ROC）曲线分析这些指标区分 COVID-19 患者合并肺炎与不合并肺炎的能力。
与不合并肺炎的 COVID-19 患者相比，合并肺炎的 COVID-19 患者的 NLR、PLR 和 CLR 值更高，而 ELR 值更低。两组患者的 MLR 值相似。NLR、PLR 和 CLR 与 CRP 和降钙素原呈正相关，ELR 与 CRP 呈负相关。ROC 分析显示，CLR 区分 COVID-19 患者合并肺炎与不合并肺炎的最佳截断值为 1.14，其曲线下面积（AUC）为 0.731（敏感性 81.5%，特异性 55.6%），明显高于 NLR（0.622）、PLR（0.585）和 ELR（0.613）的 AUC。然而，NLR、PLR 和 ELR 的 AUC 值之间无统计学差异（P>.05）。
我们的研究结果表明，NLR、PLR、ELR 和 CLR 等指标可用于区分合并肺炎与不合并肺炎的 COVID-19 患者。其中，CLR 指数是 COVID-19 患者肺炎的最佳预测指标。
