中性粒细胞与淋巴细胞比值作为新型冠状病毒肺炎院内病情恶化的标志物：资源受限环境下的观察结果
Neutrophil Lymphocyte Ratio as a Marker of In-Hospital Deterioration in COVID-19: Observations From a Resource Constraint Setting.
作者信息
Perera Nilanka, de Silva Ashani, Kumbukage Mahesh, Rambukwella Roshan, Indrakumar Jegarajah
机构信息
Department of Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Western Province, Sri Lanka.
Research unit, Family Health Bureau, Colombo, Western Province, Sri Lanka.
出版信息
Clin Pathol. 2022 Apr 13;15:2632010X221090898. doi: 10.1177/2632010X221090898. eCollection 2022 Jan-Dec.
INTRODUCTION AND OBJECTIVES
The study was conducted to assess the association of neutrophil lymphocyte ratio (NLR) in COVID-19 and to identify the cut-off value that predicts mortality, need of respiratory support and admission to high-dependency or intensive care.
METHODS
A retrospective observational study was conducted to collect demographic data, clinical variables, the neutrophil-lymphocyte ratio on-admission and the outcome of confirmed COVID-19 patients admitted to a tertiary care center in Sri Lanka.
RESULTS
There were 208 patients with a median age of 56 years (IQR 43-67) and 98 (47.1%) males. The median neutrophil count was 4.07 × 10/µL (IQR 2.97-6.79) and the median lymphocyte count was 1.74 × 10/µL (IQR 1.36-4.75). The calculated NLR ranged from 0.12 to 48.28 with a median value of 2.32 (IQR 1.37-4.76). A NLR value >3.6 predicted development of severe disease requiring respiratory support, transfer to a high-dependency or an intensive care unit and/or succumbing to the illness with a sensitivity 80% and specificity 80% (area under the curve 0.8, 95% CI 0.72-0.88, < .0001). The adjusted odds ratio of NLR > 3.6 on predicting severe disease was 11.1, 95% CI 4.5- 27.0, < .0001.
CONCLUSIONS
A NLR > 3.6 is a useful variable to be included in risk prediction scores in Sri Lanka.
引言与目的
本研究旨在评估新冠病毒病（COVID-19）中中性粒细胞淋巴细胞比值（NLR）的相关性，并确定预测死亡率、呼吸支持需求以及入住高依赖或重症监护病房的临界值。
方法
开展一项回顾性观察性研究，收集斯里兰卡一家三级医疗中心收治的确诊COVID-19患者的人口统计学数据、临床变量、入院时的中性粒细胞淋巴细胞比值及转归情况。
结果
共208例患者，中位年龄56岁（四分位间距43 - 67岁），男性98例（47.1%）。中性粒细胞计数中位数为4.07×10⁹/µL（四分位间距2.97 - 6.79），淋巴细胞计数中位数为1.74×10⁹/µL（四分位间距1.36 - 4.75）。计算得出的NLR范围为0.12至48.28，中位值为2.32（四分位间距1.37 - 4.76）。NLR值>3.6预测需要呼吸支持、转至高依赖或重症监护病房及/或死于该病的重症发生情况，敏感性为80%，特异性为80%（曲线下面积0.8，95%置信区间0.72 - 0.88，P<0.0001）。NLR>3.6预测重症疾病的校正比值比为11.1，95%置信区间4.5 - 27.0，P<0.0001。
结论
在斯里兰卡，NLR>3.6是一个有助于纳入风险预测评分的有用变量。
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