TY - JOUR
T1 - Prognostic value of neutrophil-to-lymphocyte ratio in COVID-19 patients
T2 - A systematic review and meta-analysis
AU - Ulloque-Badaracco, Juan R.
AU - Ivan Salas-Tello, W.
AU - Al-kassab-Córdova, Ali
AU - Alarcón-Braga, Esteban A.
AU - Maguiña, Jorge L.
AU - Benites Zapata, Vicente Aleixandre
AU - Hernández Diaz, Adrian Vladimir
N1 - Publisher Copyright:
© 2021 John Wiley & Sons Ltd
PY - 2021/11
Y1 - 2021/11
N2 - BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) is an accessible and widely used biomarker. NLR may be used as an early marker of poor prognosis in patients with COVID-19.OBJECTIVE: To evaluate the prognostic value of the NLR in patients diagnosed with COVID-19.METHODS: We conducted a systematic review and meta-analysis. Observational studies that reported the association between baseline NLR values (ie, at hospital admission) and severity or all-cause mortality in COVID-19 patients were included. The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS). Random effects models and inverse variance method were used for meta-analyses. The effects were expressed as odds ratios (ORs) and their 95% confidence intervals (CIs). Small study effects were assessed with the Egger's test.RESULTS: We analysed 61 studies (n = 15 522 patients), 58 cohorts, and 3 case-control studies. An increase of one unit of NLR was associated with higher odds of severity (OR 6.22; 95%CI 4.93 to 7.84; P < .001) and higher odds of all-cause mortality (OR 12.6; 95%CI 6.88 to 23.06; P < .001). In our sensitivity analysis, we found that 41 studies with low risk of bias and moderate heterogeneity (I
2 = 53% and 58%) maintained strong association between NLR values and both outcomes (severity: OR 5.36; 95% CI 4.45 to 6.45; P < .001; mortality: OR 10.42 95% CI 7.73 to 14.06; P = .005).
CONCLUSIONS: Higher values of NLR were associated with severity and all-cause mortality in hospitalised COVID-19 patients.
AB - BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) is an accessible and widely used biomarker. NLR may be used as an early marker of poor prognosis in patients with COVID-19.OBJECTIVE: To evaluate the prognostic value of the NLR in patients diagnosed with COVID-19.METHODS: We conducted a systematic review and meta-analysis. Observational studies that reported the association between baseline NLR values (ie, at hospital admission) and severity or all-cause mortality in COVID-19 patients were included. The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS). Random effects models and inverse variance method were used for meta-analyses. The effects were expressed as odds ratios (ORs) and their 95% confidence intervals (CIs). Small study effects were assessed with the Egger's test.RESULTS: We analysed 61 studies (n = 15 522 patients), 58 cohorts, and 3 case-control studies. An increase of one unit of NLR was associated with higher odds of severity (OR 6.22; 95%CI 4.93 to 7.84; P < .001) and higher odds of all-cause mortality (OR 12.6; 95%CI 6.88 to 23.06; P < .001). In our sensitivity analysis, we found that 41 studies with low risk of bias and moderate heterogeneity (I
2 = 53% and 58%) maintained strong association between NLR values and both outcomes (severity: OR 5.36; 95% CI 4.45 to 6.45; P < .001; mortality: OR 10.42 95% CI 7.73 to 14.06; P = .005).
CONCLUSIONS: Higher values of NLR were associated with severity and all-cause mortality in hospitalised COVID-19 patients.
KW - COVID-19
KW - Humans
KW - Lymphocytes
KW - Neutrophils
KW - Prognosis
KW - SARS-CoV-2
UR - http://www.scopus.com/inward/record.url?scp=85111363882&partnerID=8YFLogxK
U2 - 10.1111/ijcp.14596
DO - 10.1111/ijcp.14596
M3 - Artículo
C2 - 34228867
AN - SCOPUS:85111363882
SN - 1368-5031
VL - 75
SP - e14596
JO - International Journal of Clinical Practice
JF - International Journal of Clinical Practice
IS - 11
M1 - e14596
ER -