Correlation Between Neutrophil-Lymphocyte Ratio, Platelets-Lymphocyte Ratio, and High-Resolution CT in Patients with COVID-19
Background: COVID-19 is a highly infectious disease that necessitates simple and rapid methods for recognising severe patients. Aims: To correlate between chest lesions in CT, neutrophil-lymphocyte ratio (NLR), and platelets-lymphocytes ratio in patients with COVID-19, and to detect their cut-off va...
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| Published in: | EMJ. Radiology (European ed.) |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
European Medical Journal
23-02-2023
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| Online Access: | Get full text |
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| Summary: | Background: COVID-19 is a highly infectious disease that necessitates simple and rapid methods for recognising severe patients.
Aims: To correlate between chest lesions in CT, neutrophil-lymphocyte ratio (NLR), and platelets-lymphocytes ratio in patients with COVID-19, and to detect their cut-off values as an early warning of severe COVID-19 in Egyptian patients.
Subjects and Methods: A cross-sectional study included 100 adult patients with COVID-19 attending Ahmed Maher Teaching Hospital, Cairo, Egypt. Clinical, laboratory, and radiological assessments were done. They were classified according to their CT grades into three groups: seven patients with a normal chest CT, 45 non-severe cases, and 48 severe cases.
Results: Dyspnoea was the most common symptom among the severe cases (79.2%) and fever among non-severe cases (71.1%), while cough (85.7%) was the most common among cases with a normal CT. The age, NLR, C-reactive protein (CRP), and D-dimer of severe cases were significantly the highest, while the absolute lymphocytes were significantly the lowest. Highly significant positive correlations were found between CT grades with D-dimer, NLR, and CRP; significant positive correlation was found with age; and significant negative correlation with CT. Using receiver operating characteristic analysis, areas under the curve of D-dimer, NLR, age, CRP, ferritin, and platelet-lymphocyte ratio were 0.760, 0.698, 0.640, 0.627, 0.614, and 0.595, respectively. The optimal cut-off value of NLR was 2.50 with 0.74 specificity, 0.61 sensitivity, and 67.5 accuracy.
Conclusion: NLR is a reliable and easy-to-use predictor of COVID-19 severity. NLR (>2.5) should prompt prescription of a chest CT as it could reveal essential lesions that influence further management. |
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| ISSN: | 2633-9978 2633-9978 |
| DOI: | 10.33590/emjradiol/10085604 |