The use of neutrophil-to-lymphocyte ratio (NLR) as a marker for COVID-19 infection in Saudi Arabia A case-control retrospective multicenter study

To assess the neutrophil-to-lymphocyte ratio (NLR) diagnostic and prognostic value in the context of Coronavirus disease-2019 (COVID-19) infection in Saudi Arabia. A case-control study in which 701 confirmed COVID-19 patients (of which 41 were intensive care unit [ICU]-admitted) and 250 control subj...

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Published in:Saudi medical journal Vol. 42; no. 4; pp. 370 - 376
Main Authors: Sayed, Anwar A., Allam, Assem A., Sayed, Ayman I., Alraey, Mohammed A., Joseph, Mercy V.
Format: Journal Article
Language:English
Published: Saudi Arabia Saudi Medical Journal 01.04.2021
Subjects:
Adult
Blood Cell Count
Case-Control Studies
COVID-19 - blood
COVID-19 - diagnosis
Female
Health aspects
Hospitalization
Humans
Intensive Care Units
Leukocyte Count
Lymphocyte Count
Lymphocytes
Male
Measurement
Middle Aged
Neutrophils
Original
Platelet Count
Predictive Value of Tests
Prognosis
Retrospective Studies
SARS-CoV-2
Saudi Arabia
Sensitivity and Specificity
Severity of Illness Index
Saudi Arabia
COVID-19
Saudi Arabia
NLR
prognosis
complete blood count
ISSN:0379-5284, 1658-3175, 1658-3175
Online Access:Get full text
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Summary:To assess the neutrophil-to-lymphocyte ratio (NLR) diagnostic and prognostic value in the context of Coronavirus disease-2019 (COVID-19) infection in Saudi Arabia. A case-control study in which 701 confirmed COVID-19 patients (of which 41 were intensive care unit [ICU]-admitted) and 250 control subjects were enrolled. The study was conducted retrospectively in October on patients admitted to 3 separate hospitals in Saudi Arabia namely: King Abdullah Bin Abdulaziz University Hospital (Riyadh), Ohud Hospital (Madinah), and Nojood Medical Center (Madinah) between May and September 2020. Neutrophil-to-lymphocyte ratio was calculated based on absolute neutrophil and lymphocyte count. Institutional ethical approval was obtained prior to the study. Patients (median age 35 years), of which 54.8% were females, were younger than the control cohort (median age 48 years). Patients had significantly higher NLR compared to the control group. Intensive care unit admitted patients had significantly higher platelet, WBC and neutrophil counts. The ICU patients' NLR was almost twice as of the non-intensive patients. The NLR value of 5.5 was found to be of high specificity (96.4%) and positive predictive value (91.4%) in diagnosing COVID-19. Furthermore, it had a very good sensitivity (86.4%) in predicting severe forms of disease, such as, ICU admission. Neutrophil-to-lymphocyte ratio is an important tool in determining the COVID-19 clinical status. This study further confirms the prognostic value of NLR in detecting severe infection, and those patients with high NLR should be closely monitored and managed.
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ISSN:0379-5284
1658-3175
1658-3175
DOI:10.15537/smj.2021.42.4.20200818