Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) as Prognostic Markers of COVID-19 Disease Irrespective of Immunosuppression Status: A Case-Control Retrospective Single-Center Study
Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been studied as predictors for severe COVID-19 outcomes. The aim of the present study is to identify prognostic cut-off values of NLR and PLR for intubation and death in hospitalized COVID-19 patients, with or without i...
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2025-06-01
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| author | Amalia Papanikolopoulou Vasiliki Rapti Polyxeni Alexiou Charalampos M. Charalampous Maria Effrosyni Livanou Vissaria Sakka Konstantinos N. Syrigos Garyfallia Poulakou |
| author_facet | Amalia Papanikolopoulou Vasiliki Rapti Polyxeni Alexiou Charalampos M. Charalampous Maria Effrosyni Livanou Vissaria Sakka Konstantinos N. Syrigos Garyfallia Poulakou |
| author_sort | Amalia Papanikolopoulou |
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| description | Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been studied as predictors for severe COVID-19 outcomes. The aim of the present study is to identify prognostic cut-off values of NLR and PLR for intubation and death in hospitalized COVID-19 patients, with or without immunosuppression. From June 2021 to December 2022, we retrospectively analyzed 393 consecutively admitted COVID-19 patients, who were divided in two cohorts according to immunosuppression status (hematological malignancy and/or autoimmune condition vs. non-immunocompromised), using a propensity score-matching in 1:2 ratio. Higher NLR and PLR values were observed on days 1 and 4 for severe COVID-19, irrespective of immunosuppression status. NLR on day 1 >5.06 and day 4 >6.40 (<i>p</i> < 0.001), as well as PLR on day 1 >262.2 and day 4 >217.3 (<i>p</i> = 0.003), were associated with a greater probability for intubation. Similarly, a higher probability for death was found in the subset of patients with NLR on day 1 >4.82 (<i>p</i> < 0.001) and day 4 >6.41 (<i>p</i> < 0.001) and PLR on day 1 >229 (<i>p</i> = 0.009) and day 4 >205.4 (<i>p</i> = 0.003). Both PLR and NLR exhibited consistently higher negative predictive values (NPVs) (>93%) compared to positive predictive values (PPVs) for intubation and death. NLR and PLR displayed strong prognostic potential in hospitalized COVID-19 patients regarding intubation and death, irrespective of immunosuppression status, thus the surveillance of these biomarkers may help clinicians identify high-risk COVID-19 patients at an early stage. |
| format | Article |
| id | doaj-art-53d45e9b7b414f9f8d0156112ec7983d |
| institution | Kabale University |
| issn | 2076-0817 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
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| series | Pathogens |
| spelling | doaj-art-53d45e9b7b414f9f8d0156112ec7983d2025-08-20T03:29:51ZengMDPI AGPathogens2076-08172025-06-0114655010.3390/pathogens14060550Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) as Prognostic Markers of COVID-19 Disease Irrespective of Immunosuppression Status: A Case-Control Retrospective Single-Center StudyAmalia Papanikolopoulou0Vasiliki Rapti1Polyxeni Alexiou2Charalampos M. Charalampous3Maria Effrosyni Livanou4Vissaria Sakka5Konstantinos N. Syrigos6Garyfallia Poulakou7Third Department of Internal Medicine and Laboratory, School of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, 11527 Athens, GreeceThird Department of Internal Medicine and Laboratory, School of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, 11527 Athens, GreeceThird Department of Internal Medicine and Laboratory, School of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, 11527 Athens, GreeceThird Department of Internal Medicine and Laboratory, School of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, 11527 Athens, GreeceThird Department of Internal Medicine and Laboratory, School of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, 11527 Athens, GreeceThird Department of Internal Medicine and Laboratory, School of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, 11527 Athens, GreeceThird Department of Internal Medicine and Laboratory, School of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, 11527 Athens, GreeceThird Department of Internal Medicine and Laboratory, School of Medicine, Sotiria General Hospital, National and Kapodistrian University of Athens, 11527 Athens, GreeceNeutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been studied as predictors for severe COVID-19 outcomes. The aim of the present study is to identify prognostic cut-off values of NLR and PLR for intubation and death in hospitalized COVID-19 patients, with or without immunosuppression. From June 2021 to December 2022, we retrospectively analyzed 393 consecutively admitted COVID-19 patients, who were divided in two cohorts according to immunosuppression status (hematological malignancy and/or autoimmune condition vs. non-immunocompromised), using a propensity score-matching in 1:2 ratio. Higher NLR and PLR values were observed on days 1 and 4 for severe COVID-19, irrespective of immunosuppression status. NLR on day 1 >5.06 and day 4 >6.40 (<i>p</i> < 0.001), as well as PLR on day 1 >262.2 and day 4 >217.3 (<i>p</i> = 0.003), were associated with a greater probability for intubation. Similarly, a higher probability for death was found in the subset of patients with NLR on day 1 >4.82 (<i>p</i> < 0.001) and day 4 >6.41 (<i>p</i> < 0.001) and PLR on day 1 >229 (<i>p</i> = 0.009) and day 4 >205.4 (<i>p</i> = 0.003). Both PLR and NLR exhibited consistently higher negative predictive values (NPVs) (>93%) compared to positive predictive values (PPVs) for intubation and death. NLR and PLR displayed strong prognostic potential in hospitalized COVID-19 patients regarding intubation and death, irrespective of immunosuppression status, thus the surveillance of these biomarkers may help clinicians identify high-risk COVID-19 patients at an early stage.https://www.mdpi.com/2076-0817/14/6/550SARS-CoV-2COVID-19neutrophil-to-lymphocyte ratio (NLR)platelet-to-lymphocyte ratio (PLR)prognostic markerintubation |
| spellingShingle | Amalia Papanikolopoulou Vasiliki Rapti Polyxeni Alexiou Charalampos M. Charalampous Maria Effrosyni Livanou Vissaria Sakka Konstantinos N. Syrigos Garyfallia Poulakou Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) as Prognostic Markers of COVID-19 Disease Irrespective of Immunosuppression Status: A Case-Control Retrospective Single-Center Study Pathogens SARS-CoV-2 COVID-19 neutrophil-to-lymphocyte ratio (NLR) platelet-to-lymphocyte ratio (PLR) prognostic marker intubation |
| title | Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) as Prognostic Markers of COVID-19 Disease Irrespective of Immunosuppression Status: A Case-Control Retrospective Single-Center Study |
| title_full | Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) as Prognostic Markers of COVID-19 Disease Irrespective of Immunosuppression Status: A Case-Control Retrospective Single-Center Study |
| title_fullStr | Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) as Prognostic Markers of COVID-19 Disease Irrespective of Immunosuppression Status: A Case-Control Retrospective Single-Center Study |
| title_full_unstemmed | Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) as Prognostic Markers of COVID-19 Disease Irrespective of Immunosuppression Status: A Case-Control Retrospective Single-Center Study |
| title_short | Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) as Prognostic Markers of COVID-19 Disease Irrespective of Immunosuppression Status: A Case-Control Retrospective Single-Center Study |
| title_sort | neutrophil to lymphocyte ratio nlr and platelet to lymphocyte ratio plr as prognostic markers of covid 19 disease irrespective of immunosuppression status a case control retrospective single center study |
| topic | SARS-CoV-2 COVID-19 neutrophil-to-lymphocyte ratio (NLR) platelet-to-lymphocyte ratio (PLR) prognostic marker intubation |
| url | https://www.mdpi.com/2076-0817/14/6/550 |
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