Neutrophil to Lymphocyte Ratio (NLR) as a Prognostic Factor of Disease Severity in Novel Corona Virus-Infected Critical Patients in Dedicated Covid Hospital Government Bundelkhand Medical College Sagar MP: A Retrospective Cross-Sectional Study

Abstract

Background: Since December 2019, NCIP, or novel coronavirus infected pneumonia, has
spread to 195 countries and territories.The condition of some COVID19 patients rapidly
deteriorates. Identifying the prognostic predictors of mortality could help determine the
severity of the disease and make the best treatment decisions. Researchers have developed a
simple way to measure the body's inflammatory response by using the neutrophil to
lymphocyte ratio (NLR) in patients in intensive care.
Aims and objectives:To explore whether NLR as a prognostic factor for assessing disease
severity and fatal outcome in patients with severe coronavirus disease 2019 (COVID‐19).
Materials and Methods: Retrospectively, three hundred and fifty-nine RT PCR confirmed
patients with COVID‐19 were studied from May 2020 to September 2020. Complete blood
counts details were collected from the records of Central Pathology. The NLR was calculated
at the time of admission and analyzed for any association with the severity and prognosis of
the disease.
Results: A significant association between NLR and disease severity in critically ill COVID19 patients was obtained (p<0.05). Ninety-two patients who died had a median age of 68
years, significantly older than survivors 52 years (p=0.004), and male sex was more
predominant in non-survivors(P=0.004). The total leucocyte count was higher in nonsurvivors and males in 60-70 years. Patients having values >3.5 had an association with a
more severe form of the disease [NLR=24.0 (13.56‐48.82), P<0.001], longer duration of stay
in ICU [15 (10‐21), P<0.001], and greater mortality [78 (61.42%)].
Conclusions: This study establishes NLR as an independent prognostic marker to
differentiate severe versus non-severe disease in COVID-19 patients. Also, it can be used as a
valuable indicator of poor prognosis at the initial moment of hospitalization.