Neutrophil to lymphocyte ratio (NLR) in COVID-19: A cheap prognostic marker in a resource constraint setting

Objectives: To identify association of neutrophil to lymphocyte ratio with disease severity and mortality. Methods: Total 720 Corona Virus RT-PCR positive patients were included in this cross-sectional study. Patients were admitted to KRL Hospital Islamabad from April 2020 to August 2020. Neutrophil to lymphocyte ratio (NLR) was recorded on admission and then serially. NLR cut-off was 3.0. WHO categories for disease severity (asymptomatic, mild, moderate and severe) were used. Demographic profile, symptoms and comorbidities were recorded. Results: The mean age of patients was 40 +/- 12.4 years with 96% being males. Majority patients (76.5%) were asymptomatic. Amongst symptoms, fever was the most common symptom. Diabetes mellitus was most common recorded co-morbidity. The mean NLR 2.5 +/- 2.78. Significant association was found between NLR and disease severity as well as mortality. Difference in mean NLR amongst disease severity categories was also significant. Conclusion: Results are compatible with worldwide studies and NLR is a cheap and easily available marker of disease severity and mortality.

Automated summary

In this study, 720 COVID-19 patients were analyzed to determine the association of neutrophil to lymphocyte ratio (NLR) with disease severity and mortality. The results showed a significant relationship between NLR and disease severity as well as mortality, suggesting NLR as a potential marker for assessing COVID-19 severity and predicting outcomes.