Prognostic and predictive significance of neutrophils lymphocytes ratio (NLR), lymphocytes monocytes ratio (LMR), Platelets lymphocytes ratio (PLR) and C-reactive protein (CRP) in patients with confirmed COVID-19 infection

Abstract

Background and objectives: Pneumonia cases of unknown origin were recorded and reported by several local health facilities in Wuhan, China, in December 2019. The etiological agent was identified to be the SARS-CoV-2; COVID-19. Laboratory tests reveal normal or increased total leukocyte count, reduced lymphocyte count has been seen in some severe cases. PLR between severe and non-severe cases has been studied and said to have prognostic significance. NLRis another significant indicator of detecting inflammation in routine laboratory tests among Covid-19 patients which can be utilized in the diagnosis, treatment and evaluation of prognosis. In addition to NLR, CRP levels have been found to be deranged in moderate and severe Covid-19 infections. Material and Methods: 82 laboratory confirmed Covid -19 cases, diagnosed by positive RT-PCR for SARS CoV-19 RNA on nasal/ oropharyngeal swabs were included in the study. Results: The optimal cut-off values for NLR and PLR were 4.63 and 0.167 respectively. For NLR curve, the results showed that AUC was 0.848 (95% CI, 0.766 - 0.931), the Youden index was the largest 0.543, corresponding to the best cut-off value of 4.63, the sensitivity was 0.787, and the specificity was 0. 755. Similarly, for PLR the area under the curve (AUS) was 0.772 (95% CI, 0.666 – 0.879), the Youden index was the largest 0.493, corresponding to the best cut-off value of 0.167, the sensitivity was 0.636, and the specificity was 0.857.Conclusion:The present study has re-emphasized the prognostic and predictive significance of routine hematological investigations and CRP in Covid-19 patients.