Xisheng Yan , MD, PhD 1 , Fen Li , MD 2 , Xiao Wang , MD, PhD 3 , Jie Yan , MD, PhD 4 , Fen Zhu , MD 1 , Shifan Tang , MD 1 , Yingzhong Deng , MD 1 , Hua Wang , MD, PhD 1 , Rui Chen , MD 1 , Zhili Yu , MD 1 , Yaping Li , MD 1 , Jingzhou Shang , MD 1 , Lingjun Zeng , MD 1 , Jie Zhao , MD 1 , Chaokun Guan , MD 1 , Qiaomei Liu , MD 5 , Haifeng Chen , MD 6 , Wei Gong , MD, PhD 3 , Xin Huang , MD 3 , Yu‐Jiao Zhang , MD, PhD 7 , Jianguang Liu , MD 2 , Xiaoyan Dong , MD, PhD 1 , Wen Zheng , MD, PhD , 3 , Shaoping Nie , MD, PhD , 3 , Dongsheng Li , MD , 1
09 June 2020
This retrospective study was designed to explore whether neutrophil to lymphocyte ratio (NLR) is a prognostic factor in patients with coronavirus disease 2019 (COVID‐19). A cohort of patients with COVID‐19 admitted to the Tongren Hospital of Wuhan University from 11 January 2020 to 3 March 2020 was retrospectively analyzed. Patients with hematologic malignancy were excluded. The NLR was calculated by dividing the neutrophil count by the lymphocyte count. NLR values were measured at the time of admission. The primary outcome was all‐cause in‐hospital mortality. A multivariate logistic analysis was performed. A total of 1004 patients with COVID‐19 were included in this study. The mortality rate was 4.0% (40 cases). The median age of nonsurvivors (68 years) was significantly older than survivors (62 years). Male sex was more predominant in nonsurvival group (27; 67.5%) than in the survival group (466; 48.3%). NLR value of nonsurvival group (median: 49.06; interquartile range [IQR]: 25.71‐69.70) was higher than that of survival group (median: 4.11; IQR: 2.44‐8.12; P < .001). In multivariate logistic regression analysis, after adjusting for confounding factors, NLR more than 11.75 was significantly correlated with all‐cause in‐hospital mortality (odds ratio = 44.351; 95% confidence interval = 4.627‐425.088). These results suggest that the NLR at hospital admission is associated with in‐hospital mortality among patients with COVID‐19. Therefore, the NLR appears to be a significant prognostic biomarker of outcomes in critically ill patients with COVID‐19. However, further investigation is needed to validate this relationship with data collected prospectively.
NLR is a significant prognostic biomarker of outcomes in critically ill patients with COVID‐19.
COVID‐19 is more likely to infected those elder men with chronic comorbidities.
NLR may also help in the early identification of older patients at higher risk of COVID‐19.
Close monitoring and timely intervention are needed for elderly patients with COVID‐19.