tetano
Editor, Senior Moderator
Physiol Rep
. 2026 Feb;14(3):e70682.
doi: 10.14814/phy2.70682.
The neutrophil-to-lymphocyte ratio as a marker of immunosenescence and COVID-19 outcomes in the elderly: A narrative review
Maha Gasmi[SUP] 1 [/SUP], Kimia Torabinasab[SUP] 2 [/SUP], Ruth Williams-Hooker[SUP] 3 [/SUP], Santo Marsigliante[SUP] 4 [/SUP], Antonella Muscella[SUP] 4 [/SUP]
Affiliations
Older adults are highly vulnerable to severe COVID-19. Unlike our previous work on broad immunosenescence, this review focuses on peripheral hematological markers as practical indicators of risk. To examine lymphopenia, neutrophilia, and the neutrophil-to-lymphocyte ratio (NLR) as clinically accessible markers of immune aging and COVID-19 severity in older adults. Literature search of PubMed, Scopus, and Web of Science (up to 2025) for studies on aging, immunosenescence, lymphopenia, neutrophilia, NLR, and COVID-19. These markers consistently correlate with worse COVID-19 outcomes; NLR is a simple, reliable indicator of immune dysregulation, systemic inflammation, and mortality risk. Lymphopenia, neutrophilia, and elevated NLR are low-cost, readily measurable markers associated with COVID-19 severity, highlighting their prognostic value and complementing prior immunosenescence research.
Keywords: COVID‐19; immunosenescence; lymphopenia; neutrophil dysfunction; neutrophilia; neutrophil‐to‐lymphocyte ratio (NLR).
. 2026 Feb;14(3):e70682.
doi: 10.14814/phy2.70682.
The neutrophil-to-lymphocyte ratio as a marker of immunosenescence and COVID-19 outcomes in the elderly: A narrative review
Maha Gasmi[SUP] 1 [/SUP], Kimia Torabinasab[SUP] 2 [/SUP], Ruth Williams-Hooker[SUP] 3 [/SUP], Santo Marsigliante[SUP] 4 [/SUP], Antonella Muscella[SUP] 4 [/SUP]
Affiliations
- PMID: 41673927
- DOI: 10.14814/phy2.70682
Older adults are highly vulnerable to severe COVID-19. Unlike our previous work on broad immunosenescence, this review focuses on peripheral hematological markers as practical indicators of risk. To examine lymphopenia, neutrophilia, and the neutrophil-to-lymphocyte ratio (NLR) as clinically accessible markers of immune aging and COVID-19 severity in older adults. Literature search of PubMed, Scopus, and Web of Science (up to 2025) for studies on aging, immunosenescence, lymphopenia, neutrophilia, NLR, and COVID-19. These markers consistently correlate with worse COVID-19 outcomes; NLR is a simple, reliable indicator of immune dysregulation, systemic inflammation, and mortality risk. Lymphopenia, neutrophilia, and elevated NLR are low-cost, readily measurable markers associated with COVID-19 severity, highlighting their prognostic value and complementing prior immunosenescence research.
Keywords: COVID‐19; immunosenescence; lymphopenia; neutrophil dysfunction; neutrophilia; neutrophil‐to‐lymphocyte ratio (NLR).