tetano
Editor, Senior Moderator
Expert Rev Mol Diagn
. 2021 Apr 10.
doi: 10.1080/14737159.2021.1915773. Online ahead of print.
The Diagnostic and Prognostic Role of Neutrophil-to-Lymphocyte Ratio in COVID-19: A Systematic Review and Meta-Analysis
Ahmed Abdelaal Ahmed Mahmoud M Alkhatip[SUP] 1 2 [/SUP], Mohamed Gomaa Kamel[SUP] 3 [/SUP], Mohamed Khaled Hamza[SUP] 4 [/SUP], Ehab Mohamed Farag[SUP] 2 [/SUP], Hany Mahmoud Yassin[SUP] 5 [/SUP], Mohamed Elayashy[SUP] 4 [/SUP], Amr Ahmed Naguib[SUP] 4 [/SUP], Mohamed Wagih[SUP] 4 [/SUP], Fatma Abd-Elshahed Abd-Elhay[SUP] 3 [/SUP], Haytham Zien Algameel[SUP] 6 [/SUP], Mohammed A Yousef[SUP] 7 [/SUP], Andrew Purcell[SUP] 8 [/SUP], Mohamed Helmy[SUP] 4 [/SUP]
Affiliations
Abstract
Background: The world urgently requires surrogate markers to diagnose COVID-19 and predict its progression. The severity is not easily predicted via currently used biomarkers. Critical COVID-19 patients need to be screened for hyperinflammation to improve mortality but expensive cytokine measurement is not routinely conducted in most laboratories. The neutrophil-to-lymphocyte ratio (NLR) is a novel biomarker in patients with various diseases. We evaluated the diagnostic and prognostic accuracy of the NLR in COVID-19 patients.
Methods: We searched for relevant articles in seven databases. The quantitative analysis was conducted if at least two studies were evaluating the NLR role in COVID-19.
Results: We included 8,120 individuals, including 7,482 COVID-19 patients, from 32 articles. Patients with COVID-19 had significantly higher levels of NLR compared to negative individuals. Advanced COVID-19 stages had significantly higher levels of NLR than earlier stages.
Conclusions: We found significantly higher levels of NLR in advanced stages compared to earlier stages of COVID-19 with good accuracy to diagnose and predict the disease outcome, especially mortality prediction. A close evaluation of critical SARS-CoV-2 patients and efficient early management are essential measures to decrease mortality. NLR could help in assessing the resource allocation in severe COVID-19 patients even in restricted settings.
Keywords: Neutrophil-to-Lymphocyte Ratio ? COVID-19 ? Coronavirus ? Diagnosis ? Prognosis ? Systematic Review ? Meta-analysis.
. 2021 Apr 10.
doi: 10.1080/14737159.2021.1915773. Online ahead of print.
The Diagnostic and Prognostic Role of Neutrophil-to-Lymphocyte Ratio in COVID-19: A Systematic Review and Meta-Analysis
Ahmed Abdelaal Ahmed Mahmoud M Alkhatip[SUP] 1 2 [/SUP], Mohamed Gomaa Kamel[SUP] 3 [/SUP], Mohamed Khaled Hamza[SUP] 4 [/SUP], Ehab Mohamed Farag[SUP] 2 [/SUP], Hany Mahmoud Yassin[SUP] 5 [/SUP], Mohamed Elayashy[SUP] 4 [/SUP], Amr Ahmed Naguib[SUP] 4 [/SUP], Mohamed Wagih[SUP] 4 [/SUP], Fatma Abd-Elshahed Abd-Elhay[SUP] 3 [/SUP], Haytham Zien Algameel[SUP] 6 [/SUP], Mohammed A Yousef[SUP] 7 [/SUP], Andrew Purcell[SUP] 8 [/SUP], Mohamed Helmy[SUP] 4 [/SUP]
Affiliations
- PMID: 33840351
- DOI: 10.1080/14737159.2021.1915773
Abstract
Background: The world urgently requires surrogate markers to diagnose COVID-19 and predict its progression. The severity is not easily predicted via currently used biomarkers. Critical COVID-19 patients need to be screened for hyperinflammation to improve mortality but expensive cytokine measurement is not routinely conducted in most laboratories. The neutrophil-to-lymphocyte ratio (NLR) is a novel biomarker in patients with various diseases. We evaluated the diagnostic and prognostic accuracy of the NLR in COVID-19 patients.
Methods: We searched for relevant articles in seven databases. The quantitative analysis was conducted if at least two studies were evaluating the NLR role in COVID-19.
Results: We included 8,120 individuals, including 7,482 COVID-19 patients, from 32 articles. Patients with COVID-19 had significantly higher levels of NLR compared to negative individuals. Advanced COVID-19 stages had significantly higher levels of NLR than earlier stages.
Conclusions: We found significantly higher levels of NLR in advanced stages compared to earlier stages of COVID-19 with good accuracy to diagnose and predict the disease outcome, especially mortality prediction. A close evaluation of critical SARS-CoV-2 patients and efficient early management are essential measures to decrease mortality. NLR could help in assessing the resource allocation in severe COVID-19 patients even in restricted settings.
Keywords: Neutrophil-to-Lymphocyte Ratio ? COVID-19 ? Coronavirus ? Diagnosis ? Prognosis ? Systematic Review ? Meta-analysis.