Infection and Drug Resistance (Mar 2024)

Evaluation of the Prognostic Role of Neutrophil-Lymphocyte Ratio, C-Reactive Protein-Albumin Ratio, and Platelet-Lymphocyte Ratio in Patients with the Co-Presentation of Coronary Artery Disease and COVID-19

  • Xu X,
  • Zhu X,
  • Wang H,
  • Liu X,
  • Yang C,
  • Liu L,
  • Chen T,
  • Cai L,
  • Zhu H

Journal volume & issue
Vol. Volume 17
pp. 885 – 897

Abstract

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Xiaoqun Xu,1,* Xinyu Zhu,2,* Hanxin Wang,3 Xiao Liu,3 Chao Yang,3 Libin Liu,1 Tielong Chen,4 Long Cai,1 Houyong Zhu4 1Centre of Laboratory Medicine, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, People’s Republic of China; 2Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China; 3The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China; 4Department of Cardiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Houyong Zhu, Department of Cardiology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, No. 453 Stadium Road, Hangzhou, 310007, People’s Republic of China, Email [email protected] Long Cai, Department of Clinical Laboratory, Hangzhou Red Cross Hospital, NO. 208 East Huancheng Road, Hangzhou, 310003, People’s Republic of China, Email [email protected]: The purpose of this study was to investigate the role of neutrophil-lymphocyte ratio (NLR), C-reactive protein-albumin ratio (CAR), and platelet-lymphocyte ratio (PLR) in the prognosis of patients with coronary artery disease (CAD) complicated with coronavirus disease 2019 (COVID-19).Methods: This study included 265 patients. A receiver operating characteristic (ROC) curve analysis was performed to preliminarily evaluate the predictive ability of NLR, CAR, and PLR for all-cause death. The primary outcome was all-cause death during hospitalization, while the secondary outcomes were cardiovascular death and respiratory failure death. The Cox proportional hazard model with adjusted covariates was used to analyze the cumulative risk of outcomes. We also conducted subgroup analyses based on the acute and chronic characteristics of CAD. Propensity score matching (PSM) was used to further evaluate the robustness of the primary outcome.Results: The ROC curve analysis results showed that the area under curve (AUC) values were 0.686 (95% CI 0.592– 0.781, P< 0.001) for NLR, 0.749 (95% CI 0.667– 0.832, P< 0.001) for CAR, and 0.571 (95% CI 0.455– 0.687, P=0.232) for PLR. The Cox proportional hazard model showed that trends in NLR and PLR did not affect the risk of all-cause death (P=0.096 and P=0.544 for trend, respectively), but a higher CAR level corresponded to a higher risk of all-cause death (P< 0.001 for trend). Similarly, The trends of NLR and PLR did not affect the risk of cardiovascular death and respiratory failure death, while a higher CAR level corresponded to a higher risk of cardiovascular death and respiratory failure death. The results of subgroup analyses and PSM were consistent with the total cohort.Conclusion: In patients with CAD complicated with COVID-19, a higher CAR level corresponded to a higher risk of all-cause death, cardiovascular death, and respiratory failure death, while trends in NLR and PLR did not.Keywords: coronary artery disease, coronavirus disease 2019, neutrophil-lymphocyte ratio, C-reactive protein-albumin ratio, platelet-lymphocyte ratio

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