Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19
Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19
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DOI：
10.1016/j.jinf.2020.04.002
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发表时间：
2020-07-01
影响因子：
28.2
通讯作者：
Zhao, Yan
中科院分区：
文献类型：
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作者：
Liu, Yuwei;Du, Xuebei;Zhao, Yan
背景：多项研究已描述了新型冠状病毒（SARS - CoV - 2）感染性肺炎（COVID - 19）患者的临床特征，表明重症患者往往具有更高的中性粒细胞与淋巴细胞比值（NLR）。基线NLR是否可作为中国COVID - 19患者住院死亡的独立预测因子仍有待研究。
方法：对2020年1月1日至2月29日入住武汉大学中南医院的一组COVID - 19患者进行回顾性分析。收集包括NLR在内的实验室检查基线数据。建立单变量和多变量逻辑回归模型以评估基线NLR与住院全因死亡之间的独立关系。通过根据三分位数将NLR从连续变量转换为分类变量进行敏感性分析。还进行了交互作用和分层分析。
结果：最终分析纳入245例COVID - 19患者，住院死亡率为13.47%。多变量分析表明，NLR每增加一个单位，住院死亡风险增加8%（比值比[OR]=1.08；95%置信区间[95%CI]，1.01 - 1.14；P = 0.0147）。在校正潜在混杂因素后，与处于最低三分位数的患者相比，处于最高三分位数的患者NLR死亡风险高15.04倍（OR = 16.04；95%CI，1.14 - 224.95；P = 0.0395）。值得注意的是，在男性中，NLR每增加一个单位，完全校正后的死亡OR为1.10（OR = 1.10；95%CI，1.02 - 1.19；P = 0.016）。
结论：NLR是COVID - 19患者住院死亡的独立危险因素，尤其是男性。对NLR的评估可能有助于识别COVID - 19高危个体。（C）2020英国感染协会。由爱思唯尔有限公司出版。保留所有权利。
Background: Several studies have described the clinical characteristics of patients with novel coronavirus (SARS-CoV-2) infected pneumonia (COVID-19), indicating severe patients tended to have higher neutrophil to lymphocyte ratio (NLR). Whether baseline NLR could be an independent predictor of in-hospital death in Chinese COVID-19 patients remains to be investigated.Methods: A cohort of patients with COVID-19 admitted to the Zhongnan Hospital of Wuhan University from January 1 to February 29 was retrospectively analyzed. The baseline data of laboratory examinations, including NLR, were collected. Univariate and multivariate logistic regression models were developed to assess the independent relationship between the baseline NLR and in-hospital all-cause death. A sensitivity analysis was performed by converting NLR from a continuous variable to a categorical variable according to tertile. Interaction and stratified analyses were conducted as well.Results: 245 COVID-19 patients were included in the final analyses, and the in-hospital mortality was 13.47%. Multivariate analysis demonstrated that there was 8% higher risk of in-hospital mortality for each unit increase in NLR (Odds ratio [OR] =1.08; 95% confidence interval [95% CI], 1.01 to 1.14; P= 0.0147). Compared with patients in the lowest tertile, the NLR of patients in the highest tertile had a 15.04-fold higher risk of death (OR =16.04; 95% CI, 1.14 to 224.95; P= 0.0395) after adjustment for potential confounders. Notably, the fully adjusted OR for mortality was 1.10 in males for each unit increase of NLR (OR =1.10; 95% CI, 1.02 to 1.19; P=0.016).Conclusions: NLR is an independent risk factor of the in-hospital mortality for COVID-19 patients especially for male. Assessment of NLR may help identify high risk individuals with COVID-19. (C) 2020 The British Infection Association. Published by Elsevier Ltd. All rights reserved.