International Journal of General Medicine (Jul 2021)

Predictive Value of Neutrophil/Lymphocyte Ratio (NLR) on Cardiovascular Events in Patients with COVID-19

  • Zhan L,
  • Liu Y,
  • Cheng Y,
  • Guo W,
  • Yang J

Journal volume & issue
Vol. Volume 14
pp. 3899 – 3907

Abstract

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Lili Zhan,1,* Yang Liu,2,* Yanxiang Cheng,1 Weichun Guo,2 Jing Yang3 1Department of Gynecology, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of China; 2Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan 430060, People’s Republic of China; 3Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jing Yang; Weichun Guo No. 99 ZhangZhiDong Street Wuchang District, Wuhan, 430060, Hubei, People’s Republic of ChinaTel +8627-88041911; +8627-88041911 Email [email protected]; [email protected]: The research on the association between coronavirus disease 2019 (COVID-19) and cardiovascular disease (CVD) is still insufficient.Aim: This study aimed to investigate the association between neutrophil/lymphocyte ratio (NLR) and risk of cardiovascular events in patients with COVID-19.Methods: Our study included 159 patients with COVID-19 who were measured for NLR value within the first 24 hours of admission. They were followed up for 6 months after discharge and then the relationship between levels of NLR and risk of cardiovascular events was assessed.Results: In all included patients with COVID-19, NLR values in patients with cardiovascular events [16.28 (4.95– 45.18)] were significantly higher than patients without cardiovascular events [4.75 (2.60– 7.47)]. A multivariate logistic regression model revealed that elevated NLR value [increased per SD, 2.41 (1.43– 4.29), P< 0.001; increased 1 of NLR, 2.05 (1.33– 4.01), P=0.010] was significantly and independently associated with increased risk of CVD history on admission after adjustment of related confounding factors. Then, Cox regression analysis revealed that elevated NLR value had a significant association with increased risk of cardiovascular events [increased per SD, 2.36 (1.42– 4.36), P< 0.001; Increased 1 of NLR, 2.00 (1.30– 3.97), P=0.014] after adjustments of these same confounding factors. Furthermore, the ROC curve suggested that NLR value (AUC=0.803, 95% CI=0.731– 0.875, P< 0.001, sensitivity 81.2%, and specificity 82.6%) has a good predictive value for cardiovascular events during follow-up.Conclusion: High NLR value was clinically associated with elevated risk of cardiovascular events in patients with COVID-19, which might be a potential biomarker for predicting cardiovascular events in the current COVID-19 pandemic.Keywords: cardiovascular events, COVID-19, neutrophil/lymphocyte ratio, predictive value, biomarker

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