Papanikolopoulou Amalia, Rapti Vasiliki, Alexiou Polyxeni, Charalampous Charalampos M, Livanou Maria Effrosyni, Sakka Vissaria, Syrigos Konstantinos N, Poulakou Garyfallia
Third Department of Internal Medicine and Laboratory, School of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece.
Pathogens. 2025 Jun 1;14(6):550. doi: 10.3390/pathogens14060550.
Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been studied as predictors for severe COVID-19 outcomes. The aim of the present study is to identify prognostic cut-off values of NLR and PLR for intubation and death in hospitalized COVID-19 patients, with or without immunosuppression. From June 2021 to December 2022, we retrospectively analyzed 393 consecutively admitted COVID-19 patients, who were divided in two cohorts according to immunosuppression status (hematological malignancy and/or autoimmune condition vs. non-immunocompromised), using a propensity score-matching in 1:2 ratio. Higher NLR and PLR values were observed on days 1 and 4 for severe COVID-19, irrespective of immunosuppression status. NLR on day 1 >5.06 and day 4 >6.40 ( < 0.001), as well as PLR on day 1 >262.2 and day 4 >217.3 ( = 0.003), were associated with a greater probability for intubation. Similarly, a higher probability for death was found in the subset of patients with NLR on day 1 >4.82 ( < 0.001) and day 4 >6.41 ( < 0.001) and PLR on day 1 >229 ( = 0.009) and day 4 >205.4 ( = 0.003). Both PLR and NLR exhibited consistently higher negative predictive values (NPVs) (>93%) compared to positive predictive values (PPVs) for intubation and death. NLR and PLR displayed strong prognostic potential in hospitalized COVID-19 patients regarding intubation and death, irrespective of immunosuppression status, thus the surveillance of these biomarkers may help clinicians identify high-risk COVID-19 patients at an early stage.
中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）已被作为预测重症 COVID-19 结局的指标进行研究。本研究的目的是确定住院 COVID-19 患者（无论有无免疫抑制）插管和死亡的 NLR 和 PLR 预后临界值。2021 年 6 月至 2022 年 12 月，我们回顾性分析了 393 例连续收治的 COVID-19 患者，根据免疫抑制状态（血液系统恶性肿瘤和/或自身免疫性疾病与非免疫功能低下）将其分为两个队列，采用 1:2 比例的倾向评分匹配法。无论免疫抑制状态如何，重症 COVID-19 患者在第 1 天和第 4 天观察到较高的 NLR 和 PLR 值。第 1 天 NLR>5.06 和第 4 天 NLR>6.40（<0.001），以及第 1 天 PLR>262.2 和第 4 天 PLR>217.3（=0.003）与插管可能性增加相关。同样，在第 1 天 NLR>4.82（<0.001）和第 4 天 NLR>6.41（<0.001）以及第 1 天 PLR>229（=0.009）和第 4 天 PLR>205.4（=0.003）的患者亚组中发现死亡可能性更高。与插管和死亡的阳性预测值（PPV）相比，PLR 和 NLR 均始终表现出较高的阴性预测值（NPV）（>93%）。无论免疫抑制状态如何，NLR 和 PLR 在住院 COVID-19 患者的插管和死亡方面均显示出强大的预后潜力，因此对这些生物标志物的监测可能有助于临床医生在早期识别高危 COVID-19 患者。
