ArticleInternational journal of general medicine2021
Validation of Neutrophil-to-Lymphocyte Ratio Cut-off Value Associated with High In-Hospital Mortality in COVID-19 Patients.
Article in International journal of general medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 37 citations in OpenAlex.
- Variation of the Neutrophil-to-Lymphocyte Ratio and Mean Platelet Volume in a Multicenter Study of Critically Ill Patients with COVID-19 Living at Different Altitudes.Medical sciences (Basel, Switzerland) · 2026Article
- Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) as Prognostic Markers of COVID-19 Disease Irrespective of Immunosuppression Status: A Case-Control Retrospective Single-Center Study.Pathogens (Basel, Switzerland) · 2025Article
- Left vs. Right Bundle Branch Block in COVID-19 Patients: Distinct Clinical Presentations and Prognostic Implications.Journal of clinical medicine · 2025Article
- The severity of pediatric COVID-19 during hospitalization is not associated with mortality within six months of discharge.BMC pediatrics · 2025Article
- Neutrophil-to-lymphocyte ratio as a prognostic indicator in COVID-19: Evidence from a northern tanzanian cohort.PloS one · 2025Article
- The Effects of Beta-Blockers on Leukocytes and the Leukocyte Subpopulation in Heart Failure Patients.Biomedicines · 2024Article
- [Neutrophil-lymphocyte ratio as predictor of mortality in patients with necrotizing fasciitis].Revista medica del Instituto Mexicano del Seguro Social · 2024Observational
- Early decrease in blood lymphocyte count is associated with poor prognosis in COVID-19 patients: a retrospective cohort study.BMC pulmonary medicine · 2023Article
- Article
- Dynamic NLR and PLR in Predicting COVID-19 Severity: A Retrospective Cohort Study.Infectious diseases and therapy · 2023Article
- Prognostic Value of Neutrophil-to-Lymphocyte Ratio and Vaccination for Negative Conversion Time of Nucleic Acid in Nonsevere COVID-19 Patients Infected by SARS-CoV-2 Omicron Variant.International journal of clinical practice · 2023Article
- CovAID: Identification of factors associated with severe COVID-19 in patients with inflammatory rheumatism or autoimmune diseases.Frontiers in medicine · 2023Article
- Factors Affecting Duration of Hospital Stay in Deceased COVID-19 Patients.International journal of general medicine · 2023Article
- Platelet-to-White Blood Cell Ratio as a Predictor of Mortality in Patients with Severe COVID-19 Pneumonia: A Retrospective Cohort Study.Infection and drug resistance · 2023Article
- Significance of hemogram-derived ratios for predicting in-hospital mortality in COVID-19: A multicenter study.Health science reports · 2022Article
- Mean Platelet Volume as a Predictor of COVID-19 Severity: A Prospective Cohort Study in the Highlands of Peru.Diseases (Basel, Switzerland) · 2022Article
- Factors Associated with 30-Day in-Hospital Mortality Among Patients Admitted with Severe Covid-19 in Mbarara Regional Referral Hospital.Infection and drug resistance · 2022Article
- Charlson comorbidity index, neutrophil-to-lymphocyte ratio and undertreatment with renin-angiotensin-aldosterone system inhibitors predict in-hospital mortality of hospitalized COVID-19 patients during the omicron dominant period.Frontiers in immunology · 2022Article
- Comparative analysis of neutrophil to lymphocyte ratio and derived neutrophil to lymphocyte ratio with respect to outcomes of in-hospital coronavirus disease 2019 patients: A retrospective study.Frontiers in medicine · 2022Article
- The Neutrophil-to-Lymphocyte Ratio and the Platelet-to-Lymphocyte Ratio as Predictors of Mortality in Older Adults Hospitalized with COVID-19 in Peru.Disease markers · 2022Article
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe neutrophil-to-lymphocyte ratio (NLR) could be a predictive factor of severe COVID-19. However, most relevant studies are retrospective, and the optimal NLR cut-off point has not been determined. The objective of our research was identification and validation of the best NLR cut-off value on admission that could predict high in-hospital mortality in COVID-19 patients.
methodsMedical files of all patients admitted for COVID-19 pneumonia in our dedicated COVID-units between March and April 2020 (derivation cohort) and between October and December 2020 (validation cohort) were reviewed.
resultsTwo hundred ninety-nine patients were included in the study (198 in the derivation and 101 in the validation cohort, respectively). Youden's J statistic in the derivation cohort determined the optimal cut-off value for the performance of NLR at admission to predict mortality in hospitalized patients with COVID-19. The NLR cut-off value of 5.94 had a sensitivity of 62% and specificity of 64%. In ROC curve analysis, the AUC was 0.665 [95% CI 0.530-0.801, p= 0.025]. In the validation cohort, the best predictive cut-off value of NLR was 6.4, which corresponded to a sensitivity of 63% and a specificity of 64% with AUC 0.766 [95% CI 0.651-0.881, p <0.001]. When the NLR cut-off value of 5.94 was applied in the validation cohort, there was no significant difference in death and survival in comparison with the derivation NLR cut-off. Net reclassification improvement (NRI) analysis showed no significant classification change in outcome between both NLR cut-off values (NRI:0.012, p=0.31).
conclusionIn prospective analysis, an NLR value of 5.94 predicted high in-hospital mortality upon admission in patients hospitalized for COVID-19 pneumonia.
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