ArticleInfectious diseases and therapy2024
Prognostic Significance of NLR and PLR in COVID-19: A Multi-Cohort Validation Study.
Article in Infectious diseases and therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Hematological and biochemical markers for predicting severity in COVID-19 patients.BMC infectious diseases · 2026Observational
- Hematological Parameter-Derived Inflammatory Scores in Non-Pancreatic Hyperlipasemia (NPHL)-The Prognosis Lies in the Blood.Biomedicines · 2025Article
- Significant Reduction of Chenodeoxycholic Acid and Glycochenodeoxycholic Acid in the Elderly with Severe COVID-19.Biomolecules · 2025Article
- 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
- Early Immunological and Inflammation Proteomic Changes in Elderly COVID-19 Patients Predict Severe Disease Progression.Biomedicines · 2025Article
- Predictive value of inflammatory indexes in in-hospital mortality for patients with acute aortic dissection.BMC cardiovascular disorders · 2025Article
- Efficacy of monocyte distribution width in predicting critical illness in patients with COVID-19 pneumonia: a retrospective cohort study.BMC infectious diseases · 2025Article
- Evaluating lymphocyte change rate and lactate as predictors of prognosis in critical COVID-19 patients in the intensive care unit.Frontiers in cellular and infection microbiology · 2025Article
- Inflammatory indexes and anemia in chronic kidney disease: correlation and survival analysis of the National Health and Nutrition Examination Survey 2005-2018.Renal failure · 2024Article
- Letter to the Editor Regarding "Prognostic Significance of NLR and PLR in COVID-19: A Multi-Cohort Validation Study".Infectious diseases and therapy · 2024Article
- Response to the Letter to the Editor Regarding "Prognostic Significance of NLR and PLR in COVID-19: A Multi-Cohort Validation Study".Infectious diseases and therapy · 2024Article
- Neutrophil-to-lymphocyte ratio as a predictor of all-cause and cardiovascular mortality in coronary heart disease and hypertensive patients: a retrospective cohort study.Frontiers in endocrinology · 2024Article
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16 authors.
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Abstract
introductionRecent studies have highlighted the prognostic value of easily accessible inflammatory markers, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) for predicting severe outcomes in patients affected by Coronavirus disease 2019 (COVID-19). Our study validates NLR and PLR cut-off values from a prior cohort at IRCCS Policlinico San Matteo (OSM) of Pavia, Italy, across two new cohorts from different hospitals. This aims to enhance the generalizability of these prognostic indicators.
methodsIn this retrospective cohort study, conducted at Milan's Ospedale Luigi Sacco (OLS) and IRCCS Ospedale Maggiore Policlinico (OMP) hospitals, we assess the predictive capacity of NLR and PLR for three main outcomes-non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP) usage, invasive ventilation (IV), and death-in patients with COVID-19 at admission. For each outcome, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were computed separately for male and female cohorts. Distinct NLR and PLR cut-off values were used for men (7.00, 7.29, 7.00 for NLR; 239.22, 248.00, 250.39 for PLR) and women (6.36, 7.00, 6.28 for NLR; 233.00, 246.45, 241.54 for PLR), retrieved from the first cohort at OSM.
resultsA total of 3599 patients were included in our study, 1842 from OLS and 1757 from OMP. OLS and OMP sensitivity values for both NLR and PLR (NLR: 24-67%, PLR: 40-64%) were inferior to specificity values (NLR: 64-76%, PLR: 55-72%). Additionally, PPVs generally remained lower (< 63%), while NPVs consistently surpassed 68% for PLR and 72% for NLR. Finally, both PLR and NLR exhibited consistently higher NPVs for more severe outcomes (> 82%) compared to NPVs for CPAP/NIV.
conclusionsConsistent findings across diverse patient populations validate the reliability and applicability of NLR and PLR cut-off values. High NPVs emphasize their role in identifying individuals less likely to experience severe outcomes. These markers not only aid in risk stratification but also guide resource allocation in emergencies or limited-resource situations.
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