Department of Pathology, All India Institute of Medical Sciences, Patna, Bihar, India.
Indian J Pathol Microbiol. 2023 Jan-Mar;66(1):111-117. doi: 10.4103/ijpm.ijpm_658_21.
The epidemic of coronavirus disease 2019 (COVID-19) has been rapidly spreading on a global scale affecting many countries and territories. There is rapid onset of generalized inflammation resulting in acute respiratory distress syndrome. We, thus, aimed to explore the potential of immune-inflammatory parameters in predicting the severity of COVID-19.
Age, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), Lactate Dehydrogenase (LDH), C-reaction protein (CRP), and procalcitonin (PCT) of 611 patients with laboratory-confirmed COVID-19 were investigated and compared. Patients were divided on the basis of severity and survival into two groups. Data were expressed as mean or median values and percentages. The receiver operating characteristic curve was applied to determine the optimal cut-off values of these biomarkers.
The median age was 50 years and the male to female ratio was 3.7:1. The mean NLR, LMR, PLR, LDH, CRP, and Procalcitonin for the non-severe group were 4.16, 10.8, 133.7, 666.1, 49.9, and 0.15, respectively. In the severe group mean values of the above-mentioned immune-inflammatory markers were 17.8, 4.69, 268.2, 1277, 158.6, and 3.05, respectively. Elevated levels were significantly associated with disease severity. In ROC curve analysis, NLR had the largest area under the curve at 0.923 with the highest specificity (0.83) and sensitivity (0.88).
This study shows that NLR, PLR, LDH, CRP, and Procalcitonin may be a rapid, widely available, useful predictive factor for determining the severity of COVID-19 patients.
2019 年冠状病毒病（COVID-19）疫情在全球范围内迅速蔓延，影响了许多国家和地区。其具有迅速发生的全身性炎症，导致急性呼吸窘迫综合征。因此，我们旨在探索免疫炎症参数在预测 COVID-19 严重程度方面的潜力。
对 611 例经实验室确诊的 COVID-19 患者的年龄、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）、血小板与淋巴细胞比值（PLR）、乳酸脱氢酶（LDH）、C 反应蛋白（CRP）和降钙素原（PCT）进行了研究和比较。根据严重程度和存活情况将患者分为两组。数据表示为平均值或中位数和百分比。应用受试者工作特征曲线确定这些生物标志物的最佳截断值。
中位年龄为 50 岁，男女比例为 3.7:1。非重症组的平均 NLR、LMR、PLR、LDH、CRP 和 Procalcitonin 分别为 4.16、10.8、133.7、666.1、49.9 和 0.15。在重症组中，上述免疫炎症标志物的平均值分别为 17.8、4.69、268.2、1277、158.6 和 3.05。升高的水平与疾病严重程度显著相关。在 ROC 曲线分析中，NLR 的曲线下面积最大，为 0.923，特异性（0.83）和敏感性（0.88）最高。
本研究表明，NLR、PLR、LDH、CRP 和 Procalcitonin 可能是一种快速、广泛可用、有用的预测因子，可用于确定 COVID-19 患者的严重程度。
