Prognostic implications of neutrophil-lymphocyte ratio inCOVID-19

Background: The clinical presentation of COVID-19 ranges from a mild, self-lim-iting disease, to multiple organ failure and death. Most severe COVID-19 cases pre-sent low lymphocytes counts and high leukocytes counts, and accumulated evidencesuggests that in a subgroup of patients presenting severe...

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Authors: López Escobar, Alejandro, Jimeno, Sara, Ventura Wichner, Paula Sol, Castellano, José María, García Adasme, Salvador I., Miranda, Mario, Touza Pol, P., Lllana, Isabel
Format: article
Publication Date:2020
Country:España
Institution:Universidad Alfonso X el Sabio
Repository:Repositorio Institucional de la Universidad Alfonso X el Sabio
Language:English
OAI Identifier:oai:archive.uax.com:20.500.12080/44597
Online Access:https://hdl.handle.net/20.500.12080/44597
Access Level:Open access
Keyword:COVID-19, endothelial dysfunction, hyperinflammatory response, Neutrophil-lymphocyte ratio
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spelling Prognostic implications of neutrophil-lymphocyte ratio inCOVID-19López Escobar, AlejandroJimeno, SaraVentura Wichner, Paula SolCastellano, José MaríaGarcía Adasme, Salvador I.Miranda, MarioTouza Pol, P.Lllana, IsabelCOVID-19, endothelial dysfunction, hyperinflammatory response, Neutrophil-lymphocyte ratioBackground: The clinical presentation of COVID-19 ranges from a mild, self-lim-iting disease, to multiple organ failure and death. Most severe COVID-19 cases pre-sent low lymphocytes counts and high leukocytes counts, and accumulated evidencesuggests that in a subgroup of patients presenting severe COVID-19, there may bea hyperinflammatory response driving a severe hypercytokinaemia which may be,at least in part, signalling the presence of an underlying endothelial dysfunction. Inthis context, available data suggest a prognostic role of neutrophil-lymphocyte ratio(NLR) in various inflammatory diseases and oncological processes. Following thisrationale, we hypothesized that NLR, as a marker of endothelial dysfunction, may beuseful in identifying patients with a poor prognosis in hospitalized COVID-19 cases.Design: A retrospective observational study performed at Hospital Universitario HMPuerta del Sur, Madrid, Spain, which included 119 patients with COVID-19 from 1March to 31 March 2020. Patients were categorized according to WHO R&D ExpertGroup.Results: Forty-five (12.1%) patients experienced severe acute respiratory failure re-quiring respiratory support. Forty-seven (12.6%) patients died. Those with worseoutcomes were older (P = .002) and presented significantly higher NLR at admission(P = .001), greater increase in Peak NLR (P < .001) and higher increasing speed ofNLR (P = .003) compared with follow-up patients. In a multivariable logistic regres-sion, age, cardiovascular disease and C-reactive protein at admission and Peak NLRwere significantly associated with death.Conclusions: NLR is an easily measurable, available, cost-effective and reliable pa-rameter, which continuous monitoring could be useful for the diagnosis and treat-ment of COVID-19.K E Y W O R D SCOVID-19, endothelial dysfunction, hyperinflammatory response, Neutrophil¿lymphocyte ratioUAX Archive20202020-01-0120202020-01-01journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.12080/44597reponame:Repositorio Institucional de la Universidad Alfonso X el Sabioinstname:Universidad Alfonso X el SabioInglésengopen accesshttp://purl.org/coar/access_right/c_abf2CC-BYhttp://creativecommons.org/licenses/by/4.0/deed.esinfo:eu-repo/semantics/openAccessoai:archive.uax.com:20.500.12080/445972026-05-28T12:40:21Z
dc.title.none.fl_str_mv Prognostic implications of neutrophil-lymphocyte ratio inCOVID-19
title Prognostic implications of neutrophil-lymphocyte ratio inCOVID-19
spellingShingle Prognostic implications of neutrophil-lymphocyte ratio inCOVID-19
López Escobar, Alejandro
COVID-19, endothelial dysfunction, hyperinflammatory response, Neutrophil-lymphocyte ratio
title_short Prognostic implications of neutrophil-lymphocyte ratio inCOVID-19
title_full Prognostic implications of neutrophil-lymphocyte ratio inCOVID-19
title_fullStr Prognostic implications of neutrophil-lymphocyte ratio inCOVID-19
title_full_unstemmed Prognostic implications of neutrophil-lymphocyte ratio inCOVID-19
title_sort Prognostic implications of neutrophil-lymphocyte ratio inCOVID-19
dc.creator.none.fl_str_mv López Escobar, Alejandro
Jimeno, Sara
Ventura Wichner, Paula Sol
Castellano, José María
García Adasme, Salvador I.
Miranda, Mario
Touza Pol, P.
Lllana, Isabel
author López Escobar, Alejandro
author_facet López Escobar, Alejandro
Jimeno, Sara
Ventura Wichner, Paula Sol
Castellano, José María
García Adasme, Salvador I.
Miranda, Mario
Touza Pol, P.
Lllana, Isabel
author_role author
author2 Jimeno, Sara
Ventura Wichner, Paula Sol
Castellano, José María
García Adasme, Salvador I.
Miranda, Mario
Touza Pol, P.
Lllana, Isabel
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv UAX Archive
dc.subject.none.fl_str_mv COVID-19, endothelial dysfunction, hyperinflammatory response, Neutrophil-lymphocyte ratio
topic COVID-19, endothelial dysfunction, hyperinflammatory response, Neutrophil-lymphocyte ratio
description Background: The clinical presentation of COVID-19 ranges from a mild, self-lim-iting disease, to multiple organ failure and death. Most severe COVID-19 cases pre-sent low lymphocytes counts and high leukocytes counts, and accumulated evidencesuggests that in a subgroup of patients presenting severe COVID-19, there may bea hyperinflammatory response driving a severe hypercytokinaemia which may be,at least in part, signalling the presence of an underlying endothelial dysfunction. Inthis context, available data suggest a prognostic role of neutrophil-lymphocyte ratio(NLR) in various inflammatory diseases and oncological processes. Following thisrationale, we hypothesized that NLR, as a marker of endothelial dysfunction, may beuseful in identifying patients with a poor prognosis in hospitalized COVID-19 cases.Design: A retrospective observational study performed at Hospital Universitario HMPuerta del Sur, Madrid, Spain, which included 119 patients with COVID-19 from 1March to 31 March 2020. Patients were categorized according to WHO R&D ExpertGroup.Results: Forty-five (12.1%) patients experienced severe acute respiratory failure re-quiring respiratory support. Forty-seven (12.6%) patients died. Those with worseoutcomes were older (P = .002) and presented significantly higher NLR at admission(P = .001), greater increase in Peak NLR (P < .001) and higher increasing speed ofNLR (P = .003) compared with follow-up patients. In a multivariable logistic regres-sion, age, cardiovascular disease and C-reactive protein at admission and Peak NLRwere significantly associated with death.Conclusions: NLR is an easily measurable, available, cost-effective and reliable pa-rameter, which continuous monitoring could be useful for the diagnosis and treat-ment of COVID-19.K E Y W O R D SCOVID-19, endothelial dysfunction, hyperinflammatory response, Neutrophil¿lymphocyte ratio
publishDate 2020
dc.date.none.fl_str_mv 2020
2020-01-01
2020
2020-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.12080/44597
url https://hdl.handle.net/20.500.12080/44597
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
CC-BY
http://creativecommons.org/licenses/by/4.0/deed.es
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
CC-BY
http://creativecommons.org/licenses/by/4.0/deed.es
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositorio Institucional de la Universidad Alfonso X el Sabio
instname:Universidad Alfonso X el Sabio
instname_str Universidad Alfonso X el Sabio
reponame_str Repositorio Institucional de la Universidad Alfonso X el Sabio
collection Repositorio Institucional de la Universidad Alfonso X el Sabio
repository.name.fl_str_mv
repository.mail.fl_str_mv
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