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- Title
Prognostic value of neutrophil-to-lymphocyte ratio in COVID-19 patients: A systematic review and meta-analysis.
- Authors
Ulloque‐Badaracco, Juan R.; Ivan Salas‐Tello, W.; Al‐kassab‐Córdova, Ali; Alarcón‐Braga, Esteban A.; Benites‐Zapata, Vicente A.; Maguiña, Jorge L.; Hernandez, Adrian V.; Ulloque-Badaracco, Juan R; Salas-Tello, W Ivan; Al-Kassab-Córdova, Ali; Alarcón-Braga, Esteban A; Benites-Zapata, Vicente A; Ivan Salas-Tello, W
- Abstract
<bold>Background: </bold>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.<bold>Objective: </bold>To evaluate the prognostic value of the NLR in patients diagnosed with COVID-19.<bold>Methods: </bold>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.<bold>Results: </bold>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 (I2 = 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).<bold>Conclusions: </bold>Higher values of NLR were associated with severity and all-cause mortality in hospitalised COVID-19 patients.
- Publication
International Journal of Clinical Practice, 2021, Vol 75, Issue 11, p1
- ISSN
1368-5031
- Publication type
meta analysis
- DOI
10.1111/ijcp.14596