The Neutrophil to Lymphocyte Ratio and In-Hospital All-Cause Mortality in Patients with COVID-19

Objective: In December 2019, pneumonia associated with severe acute respiratory syndrome coronavirus 2 emerged in China, and has been spread worldwide eventuating the coronavirus disease 2019 (COVID-19) pandemic As of June 27, 2020, 195,883 people have been diagnosed with COVID-19 in Turkey, among them 5082 are dead Moreover, 9,999,606 people were infected worldwide The neutrophil-to-lymphocyte ratio (NLR) has been reported as an inflammatory biomarker This study aimed to evaluate the relationship between NLR on admission and in-hospital all-cause mortality in adult patients with COVID-19 Methods: This retrospective cohort study included a total of 455 COVID-19 patients from Turkey The diagnosis of COVID-19 was made according to the World Health Organization's interim guidance and confirmed by RNA detection of SARS-CoV-2 The NLR was calculated for each patient Results: The NLR on admission was found to be significantly higher in nonsurvivor COVID-19 patients than survivors (12 3 [0 8-137 3] vs 3 2 [0 6-79 0], p<0 001) Forward stepwise logistic regression analysis was carried out to determine the independent predictors of in-hospital all-cause mortality of patients with COVID-19 The analysis demonstrated that age [odds ratio (OR)=1 203, 95% confidence interval (CI): 1 027-1 408, p=0 022], NLR (OR=1 261, 95% CI: 1 054-1 509, p=0 011), lactate dehydrogenase level (OR=1 013, 95% CI: 1 004-1 022, p=0 005), glomerular filtration rate (OR=0 920, 95% CI: 0 853-0 992, p=0 030), alanine transaminase level (OR=1 107, 95% CI: 1 011-1 212, p=0 028), and aspartate transaminase level on admission (OR=0 939, 95% CI: 0 8880 993, p=0 027) were independent predictors of in-hospital all-cause mortality of patients with COVID-19 In the receiver operating characteristic curve analysis, the sensitivity and specificity of the NLR for predicting in-hospital all-cause mortality were found to be 92% and 53%, respectively, at the cut-off value of 3 Conclusion: The NLR on admission predicts in-hospital all-cause mortality of patients with COVID-19