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Yildiz H, Castanares-Zapatero D, Pierman G, et al. Validation of Neutrophil-to-Lymphocyte Ratio Cut-off Value Associated with High In-Hospital Mortality in COVID-19 Patients. Int J Gen Med. 2021;14:5111-5117doi: 10.2147/IJGM.S326666.
Yildiz, H., Castanares-Zapatero, D., Pierman, G., Pothen, L., De Greef, J., Aboubakar Nana, F., Rodriguez-Villalobos, H., Belkhir, L., & Yombi, J. C. (2021). Validation of Neutrophil-to-Lymphocyte Ratio Cut-off Value Associated with High In-Hospital Mortality in COVID-19 Patients. International journal of general medicine, 145111-5117. https://doi.org/10.2147/IJGM.S326666
Yildiz, Halil, et al. "Validation of Neutrophil-to-Lymphocyte Ratio Cut-off Value Associated with High In-Hospital Mortality in COVID-19 Patients." International journal of general medicine vol. 14 (2021): 5111-5117. doi: https://doi.org/10.2147/IJGM.S326666
Yildiz H, Castanares-Zapatero D, Pierman G, Pothen L, De Greef J, Aboubakar Nana F, Rodriguez-Villalobos H, Belkhir L, Yombi JC. Validation of Neutrophil-to-Lymphocyte Ratio Cut-off Value Associated with High In-Hospital Mortality in COVID-19 Patients. Int J Gen Med. 2021 Sep 01;14:5111-5117. doi: 10.2147/IJGM.S326666. eCollection 2021. PMID: 34511993; PMCID: PMC8420786.
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Int J Gen Med. 2021 Sep 01;14:5111-5117. doi: 10.2147/IJGM.S326666. eCollection 2021.

Validation of Neutrophil-to-Lymphocyte Ratio Cut-off Value Associated with High In-Hospital Mortality in COVID-19 Patients.

International journal of general medicine

Halil Yildiz, Diego Castanares-Zapatero, Guillaume Pierman, Lucie Pothen, Julien De Greef, Frank Aboubakar Nana, Hector Rodriguez-Villalobos, Leila Belkhir, Jean Cyr Yombi

Affiliations

  1. Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium.
  2. Department of Intensive Care Unit, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium.
  3. Department of Pneumology, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium.
  4. Department of Microbiology, Cliniques Universitaires Saint-Luc, UCLouvain, Brussels, Belgium.

PMID: 34511993 PMCID: PMC8420786 DOI: 10.2147/IJGM.S326666

Abstract

INTRODUCTION: The neutrophil-to-lymphocyte ratio (NLR) could be a predictive factor of severe COVID-19. However, most relevant studies are retrospective, and the optimal NLR cut-off point has not been determined. The objective of our research was identification and validation of the best NLR cut-off value on admission that could predict high in-hospital mortality in COVID-19 patients.

METHODS: Medical files of all patients admitted for COVID-19 pneumonia in our dedicated COVID-units between March and April 2020 (derivation cohort) and between October and December 2020 (validation cohort) were reviewed.

RESULTS: Two hundred ninety-nine patients were included in the study (198 in the derivation and 101 in the validation cohort, respectively). Youden's J statistic in the derivation cohort determined the optimal cut-off value for the performance of NLR at admission to predict mortality in hospitalized patients with COVID-19. The NLR cut-off value of 5.94 had a sensitivity of 62% and specificity of 64%. In ROC curve analysis, the AUC was 0.665 [95% CI 0.530-0.801, p= 0.025]. In the validation cohort, the best predictive cut-off value of NLR was 6.4, which corresponded to a sensitivity of 63% and a specificity of 64% with AUC 0.766 [95% CI 0.651-0.881, p <0.001]. When the NLR cut-off value of 5.94 was applied in the validation cohort, there was no significant difference in death and survival in comparison with the derivation NLR cut-off. Net reclassification improvement (NRI) analysis showed no significant classification change in outcome between both NLR cut-off values (NRI:0.012, p=0.31).

CONCLUSION: In prospective analysis, an NLR value of 5.94 predicted high in-hospital mortality upon admission in patients hospitalized for COVID-19 pneumonia.

© 2021 Yildiz et al.

Keywords: COVID-19; SARS-CoV-2 infection; coronavirus disease; laboratory markers; neutrophil-to-lymphocyte ratio; risk factors

Conflict of interest statement

Halil Yildiz and Diego Castanares-Zapatero are co-first authors for this study. The authors report no conflicts of interest in this work.

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