The use of neutrophil-to-lymphocyte ratio (NLR) as a marker for COVID-19 infection in Saudi Arabia: A case-control retrospective multicenter study
File(s)
Published version
Author(s)
Sayed, Anwar Abdulfattah A
Allam, Asem A
Sayed, Ayman I
Alraey, Abdullah A
Joseph, Mercy V
Type
Journal Article
Abstract
Objectives: 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. Methods: 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. Results: 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. Conclusion: 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.
Date Issued
2021-04
Date Acceptance
2021-02-22
Citation
Saudi Medical Journal, 2021, 42 (4), pp.370-376
ISSN
0379-5284
Publisher
Ministry of Defence And Aviation
Start Page
370
End Page
376
Journal / Book Title
Saudi Medical Journal
Volume
42
Issue
4
Copyright Statement
© Saudi Medical Journal
This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
License URL
Identifier
https://smj.org.sa/content/42/4/370/
Subjects
Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
complete blood count
COVID-19
NLR
prognosis
Saudi Arabia
COVID-19
NLR
Saudi Arabia
complete blood count
prognosis
Adult
Blood Cell Count
COVID-19
Case-Control Studies
Female
Hospitalization
Humans
Intensive Care Units
Leukocyte Count
Lymphocyte Count
Male
Middle Aged
Neutrophils
Platelet Count
Predictive Value of Tests
Prognosis
Retrospective Studies
SARS-CoV-2
Saudi Arabia
Sensitivity and Specificity
Severity of Illness Index
Neutrophils
Humans
Blood Cell Count
Leukocyte Count
Lymphocyte Count
Platelet Count
Prognosis
Hospitalization
Severity of Illness Index
Sensitivity and Specificity
Case-Control Studies
Retrospective Studies
Predictive Value of Tests
Adult
Middle Aged
Intensive Care Units
Saudi Arabia
Female
Male
COVID-19
SARS-CoV-2
General & Internal Medicine
11 Medical and Health Sciences
Publication Status
Published
Date Publish Online
2021-03-31