Neutrophil-to-Lymphocyte Ratio Predicts COVID-19 Mortality in the Yucatecan Maya Population: A Retrospective Cohort Study
Background: Severe and critical forms of COVID-19 have been associated with high mortality, particularly in vulnerable or underrepresented populations. The neutrophil-to-lymphocyte ratio (NLR) is an emerging inflammatory biomarker that may aid in early risk stratification. Objective: To evaluate the...
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MDPI AG
2025-06-01
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| Online Access: | https://www.mdpi.com/2673-8112/5/7/96 |
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| author | Adriel Ismael Alonso Batun Vania Janet Tello Romero Onel Abraham Pacheco Polanco Nina Mendez-Dominguez |
| author_facet | Adriel Ismael Alonso Batun Vania Janet Tello Romero Onel Abraham Pacheco Polanco Nina Mendez-Dominguez |
| author_sort | Adriel Ismael Alonso Batun |
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| description | Background: Severe and critical forms of COVID-19 have been associated with high mortality, particularly in vulnerable or underrepresented populations. The neutrophil-to-lymphocyte ratio (NLR) is an emerging inflammatory biomarker that may aid in early risk stratification. Objective: To evaluate the prognostic value of the NLR in hospitalized patients with severe or critical COVID-19 and assess its association with in-hospital mortality in the Yucatecan Maya population of southeastern Mexico. Methods: This retrospective cohort study included 172 adult patients admitted with severe or critical COVID-19 to a tertiary care center in Yucatán, Mexico. Clinical, demographic, and laboratory variables were analyzed. Univariate and multivariate logistic regression were used to identify predictors of in-hospital mortality. ROC analysis determined the optimal NLR threshold. Results: Among the 172 patients, 79 (45.9%) died during hospitalization. Non-survivors exhibited significantly higher NLR values compared to survivors (median 18.4 vs. 6.3; <i>p</i> < 0.001). In multivariate analysis, the NLR remained an independent predictor of mortality (OR 1.66; 95% CI: 1.26–2.17; <i>p</i> < 0.001). The ROC curve showed an AUC of 0. 0.83 for Intensive Care Unit and 903 for in hospital death. Conclusions: In this regional cohort of the Yucatecan Maya population, the NLR was a strong independent predictor of mortality in patients with severe or critical COVID-19. The identified cutoff of the NLR ≥ 9.76 may serve as a valuable, low-cost tool for early risk assessment in similar settings with limited resources. |
| format | Article |
| id | doaj-art-a6b9ba5ae2ed436cb5d35e0230c4faed |
| institution | Kabale University |
| issn | 2673-8112 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
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| series | COVID |
| spelling | doaj-art-a6b9ba5ae2ed436cb5d35e0230c4faed2025-08-20T03:36:19ZengMDPI AGCOVID2673-81122025-06-01579610.3390/covid5070096Neutrophil-to-Lymphocyte Ratio Predicts COVID-19 Mortality in the Yucatecan Maya Population: A Retrospective Cohort StudyAdriel Ismael Alonso Batun0Vania Janet Tello Romero1Onel Abraham Pacheco Polanco2Nina Mendez-Dominguez3Department of Internal Medicine, Hospital General Agustín O’Horan, Merida 97000, MexicoDepartment of Internal Medicine, Hospital General Agustín O’Horan, Merida 97000, MexicoPulmonology, Hospital General Agustin O’Horan, Merida 97000, MexicoIMSS-BIENESTAR, Hospital Regional de Alta Especialidad de la Peninsula de Yucatan, Merida 97130, MexicoBackground: Severe and critical forms of COVID-19 have been associated with high mortality, particularly in vulnerable or underrepresented populations. The neutrophil-to-lymphocyte ratio (NLR) is an emerging inflammatory biomarker that may aid in early risk stratification. Objective: To evaluate the prognostic value of the NLR in hospitalized patients with severe or critical COVID-19 and assess its association with in-hospital mortality in the Yucatecan Maya population of southeastern Mexico. Methods: This retrospective cohort study included 172 adult patients admitted with severe or critical COVID-19 to a tertiary care center in Yucatán, Mexico. Clinical, demographic, and laboratory variables were analyzed. Univariate and multivariate logistic regression were used to identify predictors of in-hospital mortality. ROC analysis determined the optimal NLR threshold. Results: Among the 172 patients, 79 (45.9%) died during hospitalization. Non-survivors exhibited significantly higher NLR values compared to survivors (median 18.4 vs. 6.3; <i>p</i> < 0.001). In multivariate analysis, the NLR remained an independent predictor of mortality (OR 1.66; 95% CI: 1.26–2.17; <i>p</i> < 0.001). The ROC curve showed an AUC of 0. 0.83 for Intensive Care Unit and 903 for in hospital death. Conclusions: In this regional cohort of the Yucatecan Maya population, the NLR was a strong independent predictor of mortality in patients with severe or critical COVID-19. The identified cutoff of the NLR ≥ 9.76 may serve as a valuable, low-cost tool for early risk assessment in similar settings with limited resources.https://www.mdpi.com/2673-8112/5/7/96neutrophil-to-lymphocyte ratioCOVID-19 mortalityYucatecan Maya population |
| spellingShingle | Adriel Ismael Alonso Batun Vania Janet Tello Romero Onel Abraham Pacheco Polanco Nina Mendez-Dominguez Neutrophil-to-Lymphocyte Ratio Predicts COVID-19 Mortality in the Yucatecan Maya Population: A Retrospective Cohort Study COVID neutrophil-to-lymphocyte ratio COVID-19 mortality Yucatecan Maya population |
| title | Neutrophil-to-Lymphocyte Ratio Predicts COVID-19 Mortality in the Yucatecan Maya Population: A Retrospective Cohort Study |
| title_full | Neutrophil-to-Lymphocyte Ratio Predicts COVID-19 Mortality in the Yucatecan Maya Population: A Retrospective Cohort Study |
| title_fullStr | Neutrophil-to-Lymphocyte Ratio Predicts COVID-19 Mortality in the Yucatecan Maya Population: A Retrospective Cohort Study |
| title_full_unstemmed | Neutrophil-to-Lymphocyte Ratio Predicts COVID-19 Mortality in the Yucatecan Maya Population: A Retrospective Cohort Study |
| title_short | Neutrophil-to-Lymphocyte Ratio Predicts COVID-19 Mortality in the Yucatecan Maya Population: A Retrospective Cohort Study |
| title_sort | neutrophil to lymphocyte ratio predicts covid 19 mortality in the yucatecan maya population a retrospective cohort study |
| topic | neutrophil-to-lymphocyte ratio COVID-19 mortality Yucatecan Maya population |
| url | https://www.mdpi.com/2673-8112/5/7/96 |
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