key: cord-0955742-1993o0eo authors: Yang, Ai-Ping; Liu, Jianping; Tao, Wenqiang; Li, Hui-ming title: The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients date: 2020-04-13 journal: Int Immunopharmacol DOI: 10.1016/j.intimp.2020.106504 sha: 69bf2f5911510379e84d3bfcaad144a7baf1be82 doc_id: 955742 cord_uid: 1993o0eo Abstract Aim To accumulate evidence that indicates the key role played by virus-triggered inflammation in the 2019-novel coronavirus disease (COVID-19) which emerged in Wuhan City and rapidly spread throughout China. Methods Age, neutrophil(NEU)-to-lymphocyte (LYM) ratio (NLR), lymphocyte-to-monocyte(MON) ratio, platelet-to-lymphocyte ratio(PLR), and C-reactive protein(CRP) of 93 patients with laboratory confirmed COVID-19 were investigated and compared. The receiver operating characteristic curve was applied to determine the thresholds for five bio-markers, and their prognostic values were assessed via the Kaplan–Meier curve and multivariate COX regression models. Results The median age was 46.4 years old, and 37cases were females. A total of 26.8% of patients had been to Wuhan, and 73.1% had contacted with people from Wuhan. Fever (83.8%) and cough (70.9%) were the two most common symptoms. Elevated NLR and age were significantly associated with illness severity. The binary logistic analysis identified elevated NLR (hazard risk [HR] 2.46, 95% confidence interval [CI] 1.98–4.57) and age (HR 2.52, 95% CI 1.65–4.83) as independent factors for poor clinical outcome of COVID-19. NLR exhibited the largest area under the curve at 0.841, with the highest specificity (63.6%) and sensitivity (88%). Conclusions Elevated age and NLR can be considered independent biomarkers for indicating poor clinical outcomes. The demographics and clinical characteristics in the study subjects are shown in Table 118 1. 190 To identify the factors that may affect COVID-19 progression, we obtained the crude odds 191 ratio (OR) after conducting the logistic regression analysis ( showed that NLR was positively correlated with the risk of COVID-19 (Table 4) . 195 Nevertheless, the risks of WBC, CRP, PLR, and d-NLR were unclear. 196 that NLR was an early new marker of aiv-h7n9 infection in patients [31] .However, 259 the application of NLR in other viral pneumonia was rarely reported.In our study, we 260 found that NLR can be used as a prognostic factor for covid-19. Finally, the findings 261 of this study indicate that elevated NLR is an independent prognostic biomarker for 262 COVID-19 patients. NLR can increase evaluated capacity for COVID-19 patients. 263 Therefore, the usable NLR and age are recommended as practical tools to assess conclusions of this study support that elevated NLR is an independent prognostic 279 biomarker for COVID-19 patients. 280 The authors declared that they have no competing interest. MERS-CoV) infection is suspected: interim guidance Management of severe acute respiratory infection when novel coronavirus (ncov) infection Is 309 suspected MERS, SARS and other coronaviruses as causes of pneumonia A 313 Novel Coronavirus from Patients with Pneumonia in China Use 316 of national pneumonia surveillance to describe influenza A(H7N9) virus epidemiology The prognostic 319 value of preoperative NLR, d-NLR, PLR and LMR for predicting clinical outcome in surgical 320 colorectal cancer patients What to do next to control the 2019-nCoV epidemic? 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