Academic Journal
Prognostic Significance of NLR and PLR in COVID-19: A Multi-Cohort Validation Study
| Title: | Prognostic Significance of NLR and PLR in COVID-19: A Multi-Cohort Validation Study |
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| Authors: | Marta Colaneri, Camilla Genovese, Federico Fassio, Marta Canuti, Andrea Giacomelli, Anna Lisa Ridolfo, Erika Asperges, Giuseppe Albi, Raffaele Bruno, Spinello Antinori, Antonio Muscatello, Bianca Mariani, Ciro Canetta, Francesco Blasi, Alessandra Bandera, Andrea Gori |
| Source: | Infectious Diseases and Therapy, Vol 13, Iss 5, Pp 1147-1157 (2024) |
| Publisher Information: | Adis, Springer Healthcare, 2024. |
| Publication Year: | 2024 |
| Collection: | LCC:Infectious and parasitic diseases |
| Subject Terms: | COVID-19, Neutrophil-to-lymphocyte ratio, Platelet-to-lymphocyte ratio, Prognostic indicators, Validation study, Infectious and parasitic diseases, RC109-216 |
| More Details: | Abstract Introduction Recent studies have highlighted the prognostic value of easily accessible inflammatory markers, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) for predicting severe outcomes in patients affected by Coronavirus disease 2019 (COVID-19). Our study validates NLR and PLR cut-off values from a prior cohort at IRCCS Policlinico San Matteo (OSM) of Pavia, Italy, across two new cohorts from different hospitals. This aims to enhance the generalizability of these prognostic indicators. Methods In this retrospective cohort study, conducted at Milan’s Ospedale Luigi Sacco (OLS) and IRCCS Ospedale Maggiore Policlinico (OMP) hospitals, we assess the predictive capacity of NLR and PLR for three main outcomes—non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP) usage, invasive ventilation (IV), and death—in patients with COVID-19 at admission. For each outcome, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were computed separately for male and female cohorts. Distinct NLR and PLR cut-off values were used for men (7.00, 7.29, 7.00 for NLR; 239.22, 248.00, 250.39 for PLR) and women (6.36, 7.00, 6.28 for NLR; 233.00, 246.45, 241.54 for PLR), retrieved from the first cohort at OSM. Results A total of 3599 patients were included in our study, 1842 from OLS and 1757 from OMP. OLS and OMP sensitivity values for both NLR and PLR (NLR: 24–67%, PLR: 40–64%) were inferior to specificity values (NLR: 64–76%, PLR: 55–72%). Additionally, PPVs generally remained lower ( 82%) compared to NPVs for CPAP/NIV. Conclusions Consistent findings across diverse patient populations validate the reliability and applicability of NLR and PLR cut-off values. High NPVs emphasize their role in identifying individuals less likely to experience severe outcomes. These markers not only aid in risk stratification but also guide resource allocation in emergencies or limited-resource situations. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 2193-8229 2193-6382 |
| Relation: | https://doaj.org/toc/2193-8229; https://doaj.org/toc/2193-6382 |
| DOI: | 10.1007/s40121-024-00967-6 |
| Access URL: | https://doaj.org/article/fcf5d8b718884876949e3eb7e1f62934 |
| Accession Number: | edsdoj.fcf5d8b718884876949e3eb7e1f62934 |
| Database: | Directory of Open Access Journals |
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| ISSN: | 21938229 21936382 |
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| DOI: | 10.1007/s40121-024-00967-6 |
| Published in: | Infectious Diseases and Therapy |
| Language: | English |