Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage

BACKGROUND: Patients with critical illness due to infection with the 2019 coronavirus disease (COVID-19) show rapid disease progression to acute respiratory failure. The study aimed to screen the most useful predictive factor for critical illness caused by COVID-19.

METHODS: The study prospectively involved 61 patients with COVID-19 infection as a derivation cohort, and 54 patients as a validation cohort. The predictive factor for critical illness was selected using LASSO regression analysis. A nomogram based on non-specific laboratory indicators was built to predict the probability of critical illness.

RESULTS: The neutrophil-to-lymphocyte ratio (NLR) was identified as an independent risk factor for critical illness in patients with COVID-19 infection. The NLR had an area under receiver operating characteristic of 0.849 (95% confidence interval [CI], 0.707 to 0.991) in the derivation cohort and 0.867 (95% CI 0.747 to 0.944) in the validation cohort, the calibration curves fitted well, and the decision and clinical impact curves showed that the NLR had high standardized net benefit. In addition, the incidence of critical illness was 9.1% (1/11) for patients aged ≥ 50 and having an NLR < 3.13, and 50% (7/14) patients with age ≥ 50 and NLR ≥ 3.13 were predicted to develop critical illness. Based on the risk stratification of NLR according to age, this study has developed a COVID-19 pneumonia management process.

CONCLUSIONS: We found that NLR is a predictive factor for early-stage prediction of patients infected with COVID-19 who are likely to develop critical illness. Patients aged ≥ 50 and having an NLR ≥ 3.13 are predicted to develop critical illness, and they should thus have rapid access to an intensive care unit if necessary.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:18

Enthalten in:

Journal of translational medicine - 18(2020), 1 vom: 20. Mai, Seite 206

Sprache:

Englisch

Beteiligte Personen:

Liu, Jingyuan [VerfasserIn]
Liu, Yao [VerfasserIn]
Xiang, Pan [VerfasserIn]
Pu, Lin [VerfasserIn]
Xiong, Haofeng [VerfasserIn]
Li, Chuansheng [VerfasserIn]
Zhang, Ming [VerfasserIn]
Tan, Jianbo [VerfasserIn]
Xu, Yanli [VerfasserIn]
Song, Rui [VerfasserIn]
Song, Meihua [VerfasserIn]
Wang, Lin [VerfasserIn]
Zhang, Wei [VerfasserIn]
Han, Bing [VerfasserIn]
Yang, Li [VerfasserIn]
Wang, Xiaojing [VerfasserIn]
Zhou, Guiqin [VerfasserIn]
Zhang, Ting [VerfasserIn]
Li, Ben [VerfasserIn]
Wang, Yanbin [VerfasserIn]
Chen, Zhihai [VerfasserIn]
Wang, Xianbo [VerfasserIn]

Links:

Volltext

Themen:

2019-nCoV
COVID-19
Historical Article
Journal Article
Model
NLR
Prognosis
SARS-CoV

Anmerkungen:

Date Completed 28.05.2020

Date Revised 18.12.2020

published: Electronic

Citation Status MEDLINE

doi:

10.1186/s12967-020-02374-0

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM310168481