Neutrophil/Lymphocyte Ratio (NLR) and Lymphocyte/Monocyte Ratio (LMR) – Risk of Death Inflammatory Biomarkers in Patients with COVID-19

References

• WHO COVID-19 dashboard. Geneva: World Health Organization; 2020. Available from: https://covid19.who.int/. Accessed May 15, 2023.
   Google Scholar
• Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395(10229):1033–1034. doi:10.1016/S0140-6736(20)30628-0
   PubMed Web of Science ®Google Scholar
• Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506. doi:10.1016/S0140-6736(20)30183-5
   PubMed Web of Science ®Google Scholar
• Rodrigues PRS, Alrubayyi A, Pring E, et al. Innate immunology in COVID-19-a living review. Part II: dysregulated inflammation drives immunopathology. Oxf Open Immunol. 2020;1(1). doi:10.1093/OXFIMM/IQAA005
   Google Scholar
• Coveney C, Tellier M, Lu F, et al. Innate immunology in COVID-19-a living review. Part I: viral entry, sensing and evasion. Oxf Open Immunol. 2020;1(1). doi:10.1093/OXFIMM/IQAA004
   Google Scholar
• Pfortmueller CA, Spinetti T, Urman RD, Luedi MM, Schefold JC. COVID-19-associated acute respiratory distress syndrome (CARDS): current knowledge on pathophysiology and ICU treatment - a narrative review. Best Pract Res Clin Anaesthesiol. 2021;35(3):351–368. doi:10.1016/J.BPA.2020.12.011
   PubMed Web of Science ®Google Scholar
• Min CK, Cheon S, Ha NY, et al. Comparative and kinetic analysis of viral shedding and immunological responses in MERS patients representing a broad spectrum of disease severity. Sci Rep. 2016;6. doi:10.1038/SREP25359
   Web of Science ®Google Scholar
• Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020;46(5):846–848. doi:10.1007/S00134-020-05991-X
   PubMed Web of Science ®Google Scholar
• Liu X, Shen Y, Wang H, Ge Q, Fei A, Pan S. Prognostic significance of neutrophil-to-lymphocyte ratio in patients with sepsis: a prospective observational study. Mediators Inflamm. 2016;2016:1–8. doi:10.1155/2016/8191254
   Web of Science ®Google Scholar
• Ascierto PA, Fu B, Wei H. IL-6 modulation for COVID-19: the right patients at the right time? J Immunother Cancer. 2021;9(4):e002285. doi:10.1136/JITC-2020-002285
   PubMed Web of Science ®Google Scholar
• Satici C, Demirkol MA, Sargin Altunok E, et al. Performance of pneumonia severity index and CURB-65 in predicting 30-day mortality in patients with COVID-19. Int J Infect Dis. 2020;98:84–89. doi:10.1016/J.IJID.2020.06.038
   PubMed Web of Science ®Google Scholar
• Kaeley N, Mahala P, Kabi A, Choudhary S, Hazra AG, Vempalli S. Utility of early warning scores to predict mortality in COVID-19 patients: a retrospective observational study. Int J Crit Illn Inj Sci. 2021;11(3):161–166. doi:10.4103/IJCIIS.IJCIIS_64_21
   PubMedGoogle Scholar
• García Clemente MM, Herrero Huertas J, Fernández Fernández A, et al. Assessment of risk scores in Covid-19. Int J Clin Pract. 2021;75(12):12. doi:10.1111/IJCP.13705
   Web of Science ®Google Scholar
• Flisiak R, Horban A, Jaroszewicz J, et al. Management of SARS-CoV-2 infection: recommendations of the Polish association of epidemiologists and infectiologists as of February 23, 2022. Pol Arch Intern Med. 2022;132(3):16230. doi:10.20452/PAMW.16230
   PubMedGoogle Scholar
• Misiewicz A, Dymicka-Piekarska V. Fashionable, but what is their real clinical usefulness? NLR, LMR, and PLR as a promising indicator in colorectal cancer prognosis: a systematic review. J Inflamm Res. 2023;16:69. doi:10.2147/JIR.S391932
   PubMed Web of Science ®Google Scholar
• Eissa M, Shaarawy S, Abdellateif MS. The role of different inflammatory indices in the diagnosis of COVID-19. Int J Gen Med. 2021;14:7843–7853. doi:10.2147/IJGM.S337488
   PubMed Web of Science ®Google Scholar
• Kosidło JW, Wolszczak-Biedrzycka B, Matowicka-Karna J, Dymicka-Piekarska V, Dorf J. Clinical significance and diagnostic utility of NLR, LMR, PLR and SII in the course of COVID-19: a literature review. J Inflamm Res. 2023;16:539–562. doi:10.2147/JIR.S395331
   PubMed Web of Science ®Google Scholar
• Winther-Larsen A, Aggerholm-Pedersen N, Sandfeld-Paulsen B. Inflammation scores as prognostic biomarkers in small cell lung cancer: a systematic review and meta-analysis. Syst Rev. 2021;10(1):1. doi:10.1186/S13643-021-01585-W
   PubMed Web of Science ®Google Scholar
• Mercan R, Bitik B, Tufan A, et al. The association between neutrophil/lymphocyte ratio and disease activity in rheumatoid arthritis and ankylosing spondylitis. J Clin Lab Anal. 2016;30(5):597–601. doi:10.1002/JCLA.21908
   PubMed Web of Science ®Google Scholar
• Li J, Wang L, Liu C, et al. Exploration of prognostic factors for critical COVID-19 patients using a nomogram model. Sci Rep. 2021;11(1):8192. doi:10.1038/s41598-021-87373-x
   PubMed Web of Science ®Google Scholar
• Açıksarı G, Koçak M, Çağ Y, et al. Prognostic value of inflammatory biomarkers in patients with severe COVID-19: a single-center retrospective study. Biomark Insights. 2021;16:117727192110270. doi:10.1177/11772719211027022
   Web of Science ®Google Scholar
• Yang A-P, Liu J-P, Tao W-Q, Li H-M. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol. 2020;84:106504. doi:10.1016/J.INTIMP.2020.106504
   PubMed Web of Science ®Google Scholar
• Citu C, Gorun F, Motoc A, et al. The predictive role of NLR, d-NLR, MLR, and SIRI in COVID-19 mortality. Diagnostics. 2022;12(1):122. doi:10.3390/diagnostics12010122
   Web of Science ®Google Scholar
• Nooh HA, Abdellateif MS, Refaat L, et al. The role of inflammatory indices in the outcome of COVID-19 cancer patients. Med Oncol. 2021;39(1). doi:10.1007/S12032-021-01605-8
   PubMed Web of Science ®Google Scholar
• Ben Jemaa A, Salhi N, Ben Othmen M, et al. Evaluation of individual and combined NLR, LMR and CLR ratio for prognosis disease severity and outcomes in patients with COVID-19. Int Immunopharmacol. 2022;109:108781. doi:10.1016/J.INTIMP.2022.108781
   PubMed Web of Science ®Google Scholar
• Buonacera A, Stancanelli B, Colaci M, Malatino L. Neutrophil to lymphocyte ratio: an emerging marker of the relationships between the immune system and diseases. Int J Mol Sci. 2022;23(7):3636. doi:10.3390/IJMS23073636
   PubMed Web of Science ®Google Scholar
• Xiao Q, Zhang B, Deng X, et al. The preoperative neutrophil-to-lymphocyte ratio is a novel immune parameter for the prognosis of esophageal basaloid squamous cell carcinoma. PLoS One. 2016;11(12):e0168299. doi:10.1371/JOURNAL.PONE.0168299
   PubMed Web of Science ®Google Scholar
• Liang W, Liang H, Ou L, et al. Development and validation of a clinical risk score to predict the occurrence of critical illness in hospitalized patients with COVID-19. JAMA Intern Med. 2020;180(8):1081–1089. doi:10.1001/JAMAINTERNMED.2020.2033
   PubMed Web of Science ®Google Scholar
• Wani FA, Mahajan A, Parotra A. Neutrophilic lymphocyte ratio and lymphocyte monocyte ratio: prognostic significance in COVID 19. Eur J Mol Clin Med. 2022;9:2809–2818.
   Google Scholar
• Seyit M, Avci E, Nar R, et al. Neutrophil to lymphocyte ratio, lymphocyte to monocyte ratio and platelet to lymphocyte ratio to predict the severity of COVID-19. Am J Emerg Med. 2021;40:110–114. doi:10.1016/j.ajem.2020.11.058
   PubMed Web of Science ®Google Scholar
• Qin C, Zhou L, Hu Z, et al. Dysregulation of immune response in patients with Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71(15):762–768. doi:10.1093/CID/CIAA248
   PubMed Web of Science ®Google Scholar
• Sun S, Cai X, Wang H, et al. Abnormalities of peripheral blood system in patients with COVID-19 in Wenzhou, China. Clin Chim Acta. 2020;507:174–180. doi:10.1016/J.CCA.2020.04.024
   PubMed Web of Science ®Google Scholar
• Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061–1069. doi:10.1001/JAMA.2020.1585
   PubMed Web of Science ®Google Scholar
• Barnes BJ, Adrover JM, Baxter-Stoltzfus A, et al. Targeting potential drivers of COVID-19: neutrophil extracellular traps. J Exp Med. 2020;217(6). doi:10.1084/JEM.20200652
   PubMed Web of Science ®Google Scholar
• Peñaloza HF, Lee JS, Ray P, Morrison TE. Neutrophils and lymphopenia, an unknown axis in severe COVID-19 disease. PLoS Pathog. 2021;17(9):e1009850. doi:10.1371/JOURNAL.PPAT.1009850
   PubMed Web of Science ®Google Scholar
• Costa S, Bevilacqua D, Cassatella MA, Scapini P. Recent advances on the crosstalk between neutrophils and B or T lymphocytes. Immunology. 2019;156(1):23–32. doi:10.1111/IMM.13005
   PubMed Web of Science ®Google Scholar
• Giacalone VD, Margaroli C, Mall MA, Tirouvanziam R. Neutrophil adaptations upon recruitment to the lung: new concepts and implications for homeostasis and disease. Int J Mol Sci. 2020;21(3):851. doi:10.3390/IJMS21030851
   PubMed Web of Science ®Google Scholar
• Saitoh T, Komano J, Saitoh Y, et al. Neutrophil extracellular traps mediate a host defense response to human immunodeficiency virus-1. Cell Host Microbe. 2012;12(1):109–116. doi:10.1016/J.CHOM.2012.05.015
   PubMed Web of Science ®Google Scholar
• Borges L, Pithon-Curi TC, Curi R, Hatanaka E, Vago J. COVID-19 and neutrophils: the relationship between hyperinflammation and neutrophil extracellular traps. Mediators Inflamm. 2020;2020:1–7. doi:10.1155/2020/8829674
   Web of Science ®Google Scholar
• Wagner J, DuPont A, Larson S, Cash B, Farooq A. Absolute lymphocyte count is a prognostic marker in Covid-19: a retrospective cohort review. Int J Lab Hematol. 2020;42(6):761–765. doi:10.1111/IJLH.13288
   PubMed Web of Science ®Google Scholar
• Erdogan A, Can FE, Gönüllü H. Evaluation of the prognostic role of NLR, LMR, PLR, and LCR ratio in COVID-19 patients. J Med Virol. 2021;93(9):5555–5559. doi:10.1002/jmv.27097
   PubMed Web of Science ®Google Scholar
• Sacchi A, Grassi G, Bordoni V, et al. Early expansion of myeloid-derived suppressor cells inhibits SARS-CoV-2 specific T-cell response and may predict fatal COVID-19 outcome. Cell Death Dis. 2020;11(10):1–9. doi:10.1038/s41419-020-03125-1
   PubMed Web of Science ®Google Scholar
• Agrati C, Sacchi A, Bordoni V, et al. Expansion of myeloid-derived suppressor cells in patients with severe coronavirus disease (COVID-19). Cell Death Differ. 2020;27(11):3196–3207. doi:10.1038/s41418-020-0572-6
   PubMed Web of Science ®Google Scholar
• Drăgoescu AN, Pădureanu V, Stănculescu AD, et al. Neutrophil to Lymphocyte Ratio (NLR)—a useful tool for the prognosis of sepsis in the ICU. Biomedicines. 2022;10(1). doi:10.3390/BIOMEDICINES10010075
   Web of Science ®Google Scholar
• Al-Mazedi MS, Rajan R, Al-Jarallah M, et al. Neutrophil to lymphocyte ratio and in-hospital mortality among patients with SARS-CoV-2: a retrospective study. Ann Med Surg. 2022;82. doi:10.1016/J.AMSU.2022.104748
   PubMed Web of Science ®Google Scholar
• Pervaiz A, Pasha U, Bashir S, Arshad R, Waseem M, Qasim O. Neutrophil to lymphocyte ratio (NLR) can be a predictor of the outcome and the need for mechanical ventilation in patients with Covid-19 in Pakistan. Pak J Pathol. 2020;31(2):38–41.
   Google Scholar
• Li X, Liu C, Mao Z, et al. Predictive values of neutrophil-to-lymphocyte ratio on disease severity and mortality in COVID-19 patients: a systematic review and meta-analysis. Crit Care. 2020;24(1):1. doi:10.1186/S13054-020-03374-8
   PubMed Web of Science ®Google Scholar
• Koval D, Pertseva T, Konopkina L, Bielosludtseva K, Krykhtina M. Lymphocyte-to-monocyte ratio (LMR) as a predictor of Covid-19 pneumonia progression. Eur Respir J. 2021;58(suppl 65):PA651. doi:10.1183/13993003.CONGRESS-2021.PA651
   Google Scholar
• Eraybar S, Yuksel M, Aygun H, Ay MO, Kaya H, Bulut M. Lymphocyte/mean platelet volume ratio, a new marker; is it effective in predicting the prognosis of COVID-19 cases? Bratisl Lek Listy. 2021;122(6):413–417. doi:10.4149/BLL_2021_068
   PubMed Web of Science ®Google Scholar
• Macedo A, Gonçalves N, Febra C. COVID-19 fatality rates in hospitalized patients: systematic review and meta-analysis. Ann Epidemiol. 2021;57:14–21. doi:10.1016/J.ANNEPIDEM.2021.02.012
   PubMed Web of Science ®Google Scholar
• Önal U, Gülhan M, Demirci N, et al. Prognostic value of neutrophile-to-lymphocyte ratio (NLR) and lactate dehydrogenase (LDH) levels for geriatric patients with COVID-19. BMC Geriatr. 2022;22(1):1–6. doi:10.1186/S12877-022-03059-7/TABLES/2
   PubMed Web of Science ®Google Scholar
• Damayanthi HDWT, Prabani KIP, Weerasekara I. Factors associated for mortality of older people with COVID 19: a systematic review and meta-analysis. Gerontol Geriatr Med. 2021;7:233372142110573. doi:10.1177/23337214211057392
   Web of Science ®Google Scholar
• Pimentel GD, Dela Vega MCM, Laviano A. High neutrophil to lymphocyte ratio as a prognostic marker in COVID-19 patients. Clin Nutr ESPEN. 2020;40:101–102. doi:10.1016/J.CLNESP.2020.08.004
   PubMed Web of Science ®Google Scholar
• Leung C. Risk factors for predicting mortality in elderly patients with COVID-19: a review of clinical data in China. Mech Ageing Dev. 2020;188:111255. doi:10.1016/J.MAD.2020.111255
   PubMed Web of Science ®Google Scholar
• Lithander FE, Neumann S, Tenison E, et al. COVID-19 in older people: a rapid clinical review. Age Ageing. 2020;49(4):501–515. doi:10.1093/AGEING/AFAA093
   PubMed Web of Science ®Google Scholar