2019-20 coronavirus outbreak

Proportional hazards model

Multivariate analysis

Virology

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

Outbreak

Receiver operating characteristic

Coronavirus disease 2019 (COVID-19)

Immunology

Lymphocyte

Infectious disease (medical specialty)

Internal medicine

Neutrophil to lymphocyte ratio

Confidence interval

Area under the curve

Hazard ratio

Medicine

Gastroenterology

Disease

Logistic regression

International Immunopharmacology

To accumulate evidence that indicated 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. 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. The median age was 46.4 years old, and 37cases were females. A total of 27.8% 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%). Elevated age and NLR can be considered independent biomarkers for indicating poor clinical outcomes.

The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients