Journal of Marine Medical Society

ORIGINAL ARTICLE
Year
: 2021  |  Volume : 23  |  Issue : 2  |  Page : 159--166

Prognostic significance of absolute lymphocyte count, absolute neutrophil count, and neutrophil-to-lymphocyte ratio in COVID-19


KV Padmaprakash1, Kuldeep Kumar Ashta2, Nishant Raman3, Vasu Vardhan4, Sandeep Thareja5, J Muthukrishnan1, KS Rajmohan6, Sudhir Dubey6, Dheeraj Nauhwaar1, Abhinav Kumar2, P Basavaraj2 
1 Department of Gastroenterology, Base Hospital, New Delhi, India
2 Department of Internal Medicine, Base Hospital, New Delhi, India
3 Medical Officer, Base Hospital, New Delhi, India
4 Commandant, Base Hospital Delhi Cantt, New Delhi, India
5 Brig IC and Cdr Tps, Base Hospital Delhi Cantt, New Delhi, India
6 Department of Pathology, Base Hospital, New Delhi, India

Correspondence Address:
Nishant Raman
Medical Officer, Base Hospital, Delhi Cantonment, New Delhi
India

Introduction: Effective triage of COVID-19 patients, especially in resource-limited settings, requires cost-effective and readily available markers. The present study looks at the prognostic role of three such laboratory parameters, absolute lymphocyte count (ALC), absolute neutrophil count (ANC), and neutrophil-to-lymphocyte ratio (NLR). Methodology: A retrospective cohort study was done including 328 COVID-19 reverse transcriptase–polymerase chain reaction-confirmed hospitalized patients aged 18 and above in a tertiary center in northern India. Baseline demographic, clinical, and laboratory parameters were collected on the day of admission. Statistical analysis included descriptive statistics, sensitivity–specificity analysis for optimum cutoffs, multiple logistic regression, and Cox proportional hazards regression. Results: The median age of the patients was 45 with 266 (81.1%) males and 62 (18.9%) females. A total of 109 (33.2%) patients were affected with moderate to severe disease. Forty-nine (14.9%) patients had fatal outcomes. Median ALC was lower in patients with moderate to severe disease compared to mild disease (895 vs. 1554.2) and in nonsurvivors compared to survivors (732.0 vs. 1423.9). Median ANC (5182.8 vs. 3057.6) and NLR (5.38 vs. 2.03) were significantly raised in patients with moderate to severe disease as against mild disease and in nonsurvivors(ANC 7040.25 vs. 3448.5, NLR 10.05 vs. 2.35). ALC <1273, ANC >3907, and NLR >2.74 showed considerable sensitivity and specificity for disease severity at admission. ALC and ANC were significantly associated with the odds of moderate to severe disease at admission in the multivariable logistic regression analysis. ALC <1183, ANC >4612, and NLR >3.76 had good sensitivity and specificity as predictors of mortality and emerged as independent risk factors for mortality in the multivariable Cox proportional hazards regression. Conclusion: ALC, ANC, and NLR are relatively cost-effective and readily available routine investigations obtained as a part of complete blood count. These indices show good prognostic significance. Their utility in clinical algorithms can better guide management of patients.


How to cite this article:
Padmaprakash K V, Ashta KK, Raman N, Vardhan V, Thareja S, Muthukrishnan J, Rajmohan K S, Dubey S, Nauhwaar D, Kumar A, Basavaraj P. Prognostic significance of absolute lymphocyte count, absolute neutrophil count, and neutrophil-to-lymphocyte ratio in COVID-19.J Mar Med Soc 2021;23:159-166


How to cite this URL:
Padmaprakash K V, Ashta KK, Raman N, Vardhan V, Thareja S, Muthukrishnan J, Rajmohan K S, Dubey S, Nauhwaar D, Kumar A, Basavaraj P. Prognostic significance of absolute lymphocyte count, absolute neutrophil count, and neutrophil-to-lymphocyte ratio in COVID-19. J Mar Med Soc [serial online] 2021 [cited 2022 Jan 25 ];23:159-166
Available from: https://www.marinemedicalsociety.in/article.asp?issn=0975-3605;year=2021;volume=23;issue=2;spage=159;epage=166;aulast=Padmaprakash;type=0