Parthasarathi Ashwaghosha, Padukudru Sunag, Arunachal Sumalata, Basavaraj Chetak Kadabasal, Krishna Mamidipudi Thirumala, Ganguly Koustav, Upadhyay Swapna, Anand Mahesh Padukudru
Allergy, Asthma, and Chest Centre, Krishnamurthypuram, Mysore 570004, India.
Yenepoya Medical College, Yenepoya University, Mangalore 575018, India.
Vaccines (Basel). 2022 Aug 1;10(8):1233. doi: 10.3390/vaccines10081233.
Several studies have proposed that the neutrophil−lymphocyte ratio (NLR) is one of the various biomarkers that can be useful in assessing COVID-19 disease-related outcomes. Our systematic review analyzes the relationship between on-admission NLR values and COVID-19 severity and mortality. Six different severity criteria were used. A search of the literature in various databases was conducted from 1 January 2020 to 1 May 2021. We calculated the pooled standardized mean difference (SMD) for the collected NLR values. A meta-regression analysis was performed, looking at the length of hospitalization and other probable confounders, such as age, gender, and comorbidities. A total of sixty-four studies were considered, which included a total of 15,683 patients. The meta-analysis showed an SMD of 3.12 (95% CI: 2.64−3.59) in NLR values between severe and non-severe patients. A difference of 3.93 (95% CI: 2.35−5.50) was found between survivors and non-survivors of the disease. Upon summary receiver operating characteristics analysis, NLR showed 80.2% (95% CI: 74.0−85.2%) sensitivity and 75.8% (95% CI: 71.3−79.9%) specificity for the prediction of severity and 78.8% (95% CI: 73.5−83.2%) sensitivity and 73.0% (95% CI: 68.4−77.1%) specificity for mortality, and was not influenced by age, gender, or co-morbid conditions. Conclusion: On admission, NLR predicts both severity and mortality in COVID-19 patients, and an NLR > 6.5 is associated with significantly greater the odds of mortality.
多项研究表明，中性粒细胞与淋巴细胞比值（NLR）是可用于评估COVID-19疾病相关结局的多种生物标志物之一。我们的系统评价分析了入院时NLR值与COVID-19严重程度及死亡率之间的关系。采用了六种不同的严重程度标准。于2020年1月1日至2021年5月1日在多个数据库中进行文献检索。我们计算了收集到的NLR值的合并标准化均值差（SMD）。进行了meta回归分析，考察住院时间以及年龄、性别和合并症等其他可能的混杂因素。共纳入64项研究，总计15683例患者。meta分析显示，重症患者与非重症患者的NLR值的SMD为3.12（95%CI：2.64−3.59）。该疾病幸存者与非幸存者之间的差异为3.93（95%CI：2.35−5.50）。经汇总受试者工作特征分析，NLR预测严重程度的敏感性为80.2%（95%CI：74.0−85.2%），特异性为75.8%（95%CI：71.3−79.9%）；预测死亡率的敏感性为78.8%（95%CI：73.5−83.2%），特异性为73.0%（95%CI：68.4−77.1%），且不受年龄、性别或合并症的影响。结论：入院时，NLR可预测COVID-19患者的严重程度和死亡率，NLR>6.5与显著更高的死亡几率相关。
