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Article

Neutrophile-to-Lymphocyte Ratio (NLR) Identifies Patients with Coronavirus Infectious Disease 2019 (COVID-19) at High Risk for Deterioration and Mortality—A Retrospective, Monocentric Cohort Study

by
Jutta Rose
1,2,3,*,
Flurina Suter
4,
Eva Furrer
5,
Ataman Sendoel
2,3,
Melina Stüssi-Helbling
1,† and
Lars C. Huber
1,†
1
Department of Internal Medicine, Clinic for Internal Medicine, City Hospital Zurich Triemli, 8063 Zurich, Switzerland
2
Faculty of Medicine, University of Zurich (UZH), 8006 Zurich, Switzerland
3
Institute for Regenerative Medicine, University of Zurich (UZH), 8952 Schlieren, Switzerland
4
Master Program in Biostatistics, University of Zurich (UZH), 8006 Zurich, Switzerland
5
Department Biostatistics, Institute for Epidemiology, Biostatistics and Prevention, University of Zurich (UZH), 8006 Zurich, Switzerland
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this manuscript.
Diagnostics 2022, 12(5), 1109; https://doi.org/10.3390/diagnostics12051109
Submission received: 24 March 2022 / Revised: 25 April 2022 / Accepted: 27 April 2022 / Published: 28 April 2022
(This article belongs to the Special Issue SARS-CoV-2 Identification by Diagnostic/Medical Laboratory: Methods, Statistics, Interesting Cases)
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Abstract

Among people infected with SARS-CoV-2, the determination of clinical features associated with poor outcome is essential to identify those at high risk of deterioration. Here, we aimed to investigate clinical phenotypes of patients hospitalized due to COVID-19 and to examine the predictive value of the neutrophil-to-lymphocyte ratio (NLR) in a representative patient collective of the Swiss population. We conducted a retrospective monocentriccohort study with patients hospitalized due to COVID-19 between 27 February and 31 December 2020. Data were analyzed descriptively, using the binary logistic regression model, proportional odds logistic regression model, competing risk analysis, and summary measure analysis. A total of 454 patients were included in our study. Dyspnea, elevated respiratory rate, low oxygen saturation at baseline, age, and presence of multiple comorbidities were associated with a more severe course of the disease. A high NLR at baseline was significantly associated with disease severity, unfavorable outcome, and mortality. In non-survivors, NLR further increased during hospital stay, whereas in survivors, NLR decreased. In conclusion, our data emphasize the importance of accurate history taking and clinical examination upon admission and confirm the role of baseline NLR as a surrogate marker for increased disease severity, unfavorable outcome, and mortality in patients hospitalized due to infection with SARS-CoV-2.
Keywords: COVID-19; SARS-CoV-2; neutrophile-to-lymphocyte ratio; NLR; disease severity; mortality COVID-19; SARS-CoV-2; neutrophile-to-lymphocyte ratio; NLR; disease severity; mortality

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MDPI and ACS Style

Rose, J.; Suter, F.; Furrer, E.; Sendoel, A.; Stüssi-Helbling, M.; Huber, L.C. Neutrophile-to-Lymphocyte Ratio (NLR) Identifies Patients with Coronavirus Infectious Disease 2019 (COVID-19) at High Risk for Deterioration and Mortality—A Retrospective, Monocentric Cohort Study. Diagnostics 2022, 12, 1109. https://doi.org/10.3390/diagnostics12051109

AMA Style

Rose J, Suter F, Furrer E, Sendoel A, Stüssi-Helbling M, Huber LC. Neutrophile-to-Lymphocyte Ratio (NLR) Identifies Patients with Coronavirus Infectious Disease 2019 (COVID-19) at High Risk for Deterioration and Mortality—A Retrospective, Monocentric Cohort Study. Diagnostics. 2022; 12(5):1109. https://doi.org/10.3390/diagnostics12051109

Chicago/Turabian Style

Rose, Jutta, Flurina Suter, Eva Furrer, Ataman Sendoel, Melina Stüssi-Helbling, and Lars C. Huber. 2022. "Neutrophile-to-Lymphocyte Ratio (NLR) Identifies Patients with Coronavirus Infectious Disease 2019 (COVID-19) at High Risk for Deterioration and Mortality—A Retrospective, Monocentric Cohort Study" Diagnostics 12, no. 5: 1109. https://doi.org/10.3390/diagnostics12051109

APA Style

Rose, J., Suter, F., Furrer, E., Sendoel, A., Stüssi-Helbling, M., & Huber, L. C. (2022). Neutrophile-to-Lymphocyte Ratio (NLR) Identifies Patients with Coronavirus Infectious Disease 2019 (COVID-19) at High Risk for Deterioration and Mortality—A Retrospective, Monocentric Cohort Study. Diagnostics, 12(5), 1109. https://doi.org/10.3390/diagnostics12051109

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