Neutrophil-to-Lymphocyte Ratios Are Closely Associated With the Severity and Course of Non-mild COVID-19
Sen Qun, Yulan Wang, Jun Chen, Xiang Huang, Hui Guo, Zhaohui Lu, Jinquan Wang, Changcheng Zheng, Yan Ma, Yuyou Zhu, Daqing Xia, Yinzhong Wang, Hongliang He, Yong Wang, Mingming Fei, Yihong Yin, Mao Zheng, Yehong Xu, Wei Ge, Fuyong Hu, Jian Zhou
Abstract
<sec><title>Background</title> Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is spreading worldwide. Measuring the prevention and control of the disease has become a matter requiring urgent focus. </sec><sec><title>Objective</title> Based on coronavirus disease 2019 (COVID-19) clinical data from Wuhan, we conducted an in-depth analysis to clarify some of the pathological mechanisms of the disease and identify simple measures to predict its severity early on. </sec><sec><title>Methods</title> A total of 230 patients with non-mild COVID-19 were recruited, and information on their clinical characteristics, inflammatory cytokines, and T lymphocyte subsets was collected. Risk factors for severity were analyzed by binary logistic regression, and the associations of neutrophil-to-lymphocyte ratios (N/LRs) with illness severity, disease course, CT grading, inflammatory cytokines, and T lymphocyte subsets were evaluated. </sec><sec><title>Results</title> Our results showed that the N/LRs were closely related to interleukin (IL)-6 and IL-10 (<italic>P</italic> < 0.001, <italic>P</italic> = 0.024) and to CD3<sup>+</sup> and CD8<sup>+</sup> T lymphocytes (<italic>P</italic> < 0.001, <italic>P</italic> = 0.046). In particular, the N/LRs were positively correlated with the severity and course of the disease (<italic>P</italic> = 0.021, <italic>P</italic> < 0.001). Compared to the values at the first test after admission, IL-6 and IL-10 were significantly decreased and increased, respectively, as of the last test before discharge (<italic>P</italic> = 0.006, <italic>P</italic> < 0.001). More importantly, through binary logistic regression, we found that male sex, underlying diseases (such as cardiovascular disease), pulse, and N/LRs were all closely related to the severity of the disease (<italic>P</italic> = 0.004, <italic>P</italic> = 0.012, <italic>P</italic> = 0.013, <italic>P</italic> = 0.028). </sec><sec><title>Conclusions</title> As a quick and convenient marker of inflammation, N/LRs may predict the disease course and severity level of non-mild COVID-19; male sex, cardiovascular disease, and pulse are also risk factors for the severity of non-mild COVID-19. </sec>