ARTICLE
TITLE

Diagnostic value of neutrophil-to-lymphocyte, lymphocyte-to-monocyte and platelet-to-lymphocyte ratio among patients with COVID-19 pneumonia: A retrospective study

SUMMARY

Objectives: Our study was aimed to investigate the clinical characteristics of the patients with COVID-19 pneumonia and research new diagnostic methods for the disease.Methods: In this retrospective study, medical records of 46 novel coronavirus-infected pneumonia (NCIP) patients and 30 healthy individuals in the two multiple hospitals from January 2020 to March 2020 were studied. Clinical characteristics, chest computed tomographic (CT) scans, medicine treatment and laboratory information were collected and retrospectively analyzed. Neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) were evaluated.Results: The main symptoms of the patients with NCIP were fever (100%), cough (82.6%), anorexia (37%), expectoration (34.8%) and fatigue (21.7%), dyspnea (15.2%). Ground glass opacity (GGO) with patch shadow was the main observation of the CT imaging (43.4%), followed by GGO (21.7%), patch shadow (19.5%), GGO with consolidation (8.7%) and GGO with reticular pattern (2.1%). The median white blood cell (WBC) count, lymphocyte count, platelet, and lymphocyte-monocyte ratio (LMR) in NCIP group were all significantly lower than in control group (p<0.001, for all comparisons), while the median neutrophil-monocyte ratio (NLR) and platelets-monocyte ratio (PLR) were both significantly higher (p<0.001, for both comparisons). Median WBC count, lymphocyte count, and platelet count on discharge were significantly higher than on admission (p<0.05). Median PLR was significantly lower two weeks after discharge (p<0.001), while NLR remained the same. The area under the curve (AUC) value of WBC, lymphocyte and platelet counts, NLR, LMR and PLR were 0.766, 0.931, 0.655, 0.780, 0.847 and 0.845, respectively. Early stages of the disease were associated with quick changes in WBC, lymphocyte, and platelet levels. However, NLR did not recover even two weeks after the discharge.Conclusion: Changes in WBC, lymphocyte, and platelet counts, as well as NLR, LMR and PLR are strongly associated with COVID-19 pneumonia. Monitoring blood markers may assist in evaluating the progression of the diseasedoi: https://doi.org/10.12669/pjms.38.5.5798How to cite this:Long X, Zhang T, Duan S. Diagnostic value of neutrophil-to-lymphocyte, lymphocyte-to-monocyte and platelet-to-lymphocyte ratio among patients with COVID-19 pneumonia: A retrospective study. Pak J Med Sci. 2022;38(5):1118-1125.  doi: https://doi.org/10.12669/pjms.38.5.5798This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

 Articles related

Hongna Lv, Guangchao Zhu, Long’an Zhou    

Objective: To investigate the effect of endoscopic ultrasound real-time tissue elastography in differential diagnosis of benign and malignant digestive system tumors.Methods: Forty-two patients with solid tumors of digestive system who were admitted to o... see more


Wicaksono Probowoso Ishandono Dachlan    

As the prevalence of thyroid cancer increases, a diagnostic method that can identify malignancy that warrants further surgical treatment is needed. Fine needle aspiration biopsy (FNAB) and ultrasonography (USG) are preoperative test for diagnos... see more


Ariani Dewi Widodo, Ina Susianti Timan, Saptawati Bardosono, Minarma Siagian, Widdy Winarta, Dwi Prasetyo, Agus Firmansyah    

BACKGROUND Exocrine pancreatic insufficiency (EPI) is one of the most challenging cases to be diagnosed accurately in Indonesia because of the unavailability of the fecal elastase-1 (FE-1) test, which is the primary indirect diagnostic tool till date. St... see more


Marcel Prasetyo, Thariqah Salamah, Trifonia P. Siregar    

Background: Ultrasonography (USG) is regarded as the gold standard to differentiate normal plantar fascia and plantar fasciitis. Conventional radiography or plain X-ray is typically used to exclude differential diagnosis. Lately, conventional radiography... see more


Setya Wandita Setya Wandita    

Background: Dengue hemorrhagic fever (DHF) is still a problem in Indonesia. Early diagnosis is important in the management. The cytoplasm of activated lymphocytes in dengue infection contains ribonucleic acid (RNA). RNA can be specifically shown by pyron... see more