Neutrophil:lymphocyte ratio predicts short-term outcome of COVID-19 in haemodialysis patients

Background: Information regarding coronavirus disease 2019 (COVID-19) in haemodialysis (HD) patients is limited and early studies suggest a poor outcome We aimed to identify clinical and biological markers associated with severe forms of COVID-19 in HD patients Methods: We conducted a prospective, observational and multicentric study Sixty-two consecutive adult HD patients with confirmed COVID-19 from four dialysis facilities in Paris, France, from 19 March to 19 May 2020 were included Blood tests were performed before diagnosis and at Days 7 and 14 after diagnosis Severe forms of COVID-19 were defined as requiring oxygen therapy, admission in an intensive care unit or death Cox regression models were used to compute adjusted hazard ratios (aHRs) Kaplan-Meier curves and log-rank tests were used for survival analysis Results: Twenty-eight patients (45%) displayed severe forms of COVID-19 Compared with non-severe forms, these patients had more fever (93% versus 56%, P 3 7 was the major marker associated with severe forms, with an aHR of 4 28 (95% confidence interval 1 52-12 0;P = 0 006) After a median follow-up time of 48 days (range 27-61), six patients with severe forms died (10%) Conclusions: HD patients are at increased risk of severe forms of COVID-19 An elevated N:L ratio at Day 7 was highly associated with the severe forms Assessing the N:L ratio could inform clinicians for early treatment decisions