Expert Rev Mol Diagn . The Diagnostic and Prognostic Role of Neutrophil-to-Lymphocyte Ratio in COVID-19: A Systematic Review and Meta-Analysis

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Expert Rev Mol Diagn


. 2021 Apr 10.
doi: 10.1080/14737159.2021.1915773. Online ahead of print.
The Diagnostic and Prognostic Role of Neutrophil-to-Lymphocyte Ratio in COVID-19: A Systematic Review and Meta-Analysis


Ahmed Abdelaal Ahmed Mahmoud M Alkhatip ^{1 2} , Mohamed Gomaa Kamel ³ , Mohamed Khaled Hamza ⁴ , Ehab Mohamed Farag ² , Hany Mahmoud Yassin ⁵ , Mohamed Elayashy ⁴ , Amr Ahmed Naguib ⁴ , Mohamed Wagih ⁴ , Fatma Abd-Elshahed Abd-Elhay ³ , Haytham Zien Algameel ⁶ , Mohammed A Yousef ⁷ , Andrew Purcell ⁸ , Mohamed Helmy ⁴



Affiliations

• PMID: 33840351
• DOI: 10.1080/14737159.2021.1915773

Abstract

Background: The world urgently requires surrogate markers to diagnose COVID-19 and predict its progression. The severity is not easily predicted via currently used biomarkers. Critical COVID-19 patients need to be screened for hyperinflammation to improve mortality but expensive cytokine measurement is not routinely conducted in most laboratories. The neutrophil-to-lymphocyte ratio (NLR) is a novel biomarker in patients with various diseases. We evaluated the diagnostic and prognostic accuracy of the NLR in COVID-19 patients.
Methods: We searched for relevant articles in seven databases. The quantitative analysis was conducted if at least two studies were evaluating the NLR role in COVID-19.
Results: We included 8,120 individuals, including 7,482 COVID-19 patients, from 32 articles. Patients with COVID-19 had significantly higher levels of NLR compared to negative individuals. Advanced COVID-19 stages had significantly higher levels of NLR than earlier stages.
Conclusions: We found significantly higher levels of NLR in advanced stages compared to earlier stages of COVID-19 with good accuracy to diagnose and predict the disease outcome, especially mortality prediction. A close evaluation of critical SARS-CoV-2 patients and efficient early management are essential measures to decrease mortality. NLR could help in assessing the resource allocation in severe COVID-19 patients even in restricted settings.

Keywords: Neutrophil-to-Lymphocyte Ratio ? COVID-19 ? Coronavirus ? Diagnosis ? Prognosis ? Systematic Review ? Meta-analysis.