Association of neutrophil-lymphocyte ratio with clinical outcome of COVID-19 patients: A prospective study

Abstract

Aim: This study aims to find the association of neutrophil-lymphocyte ratio (N-L ratio) of COVID-19 patients admitted in an Indian setting with clinical profile and disease outcomes. Background: The COVID-19 pandemic hit in early 2020 with the presentation of varied severity of acute respiratory illness. This study tries to use N-L ratio as a predictor of adverse outcome. Methodology: The prospective single-center study considered adults patients of both the gender, diagnosed with COVID-19 infection by reverse transcription-polymerase chain reaction technique. Necessary demographic and clinical data were collected, and selected subjects were followed up until discharge or death. Individuals were classified as those who survived and those who succumbed to death. t-test was used for comparing continuous variables and Chi-square test for categorical data for comparing different parameters between the groups. Results: The study included 1977 patients with a male:female ratio of 1:0.62. Fever, dyspnea, and cough were noted as the major symptoms prevalent among patients who succumbed to death when compared to those who survived (P < 0.00001). Statistically significant variables noted between the groups were age, total leukocytes count (TLC), neutrophil, lymphocytes, all the comorbidity variables, and the asymptomatic status. Variables identified as significant predictors of disease outcomes were TLC, neutrophils, lymphocytes, and N-L ratio. Most of the subjects belonging to the mortality group required oxygen and other intensive care unit facilities when compared to the survival group (P < 0.00001). Conclusion: TLC, neutrophils, lymphocytes, and N-L ratio are noted as significant predictors of COVID-19 outcome. The mean days of viral clearance noted in COVID subjects is around 8.98 ± 3.54 days.

Keywords

• covid-19
• india
• infection
• neutrophil-lymphocyte ratio