Do Neutrophil–Lymphocyte Ratio and Platelet–Lymphocyte Ratio Need to Be Stratified for Age and Comorbidities in COVID-19 Disease? A Subgroup Analysis of Two Distinct Cohorts over Disease Course

Nadya Kagansky, Yochai Levy, Anas Awar, Estela Derazne, Alexander Shilovsky, Dana Kagansky, Victor Chepelev, Evelina Mazurez, Ilia Stambler, Osnat Levtzion-Korach

Research output: Contribution to journalArticlepeer-review

Abstract

Several studies described neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) as markers of COVID-19 severity. In a recently published study, age and frailty affected NLR and PLR more than disease severity. The study compared two distinct cohorts. The first comprised older frailer patients positive for SARS-CoV-2, with mild or asymptomatic disease, admitted to designated COVID-19 departments in a large geriatric medical center (GMC). The second cohort comprised COVID-19 patients admitted to a large general hospital (GH) for symptomatic disease. This was a follow-up study comparing a subgroup of patients who had NLR and PLR values measured a week after admission. Only 100 of 177 patients in the original GMC cohort had a second NLR test compared to almost all (287 of 289) patients in the general hospital (GH) cohort. The subgroup baseline characteristics did not change significantly from that of the original cohort. Disease symptoms were more prevalent in the GH cohort. In the GMC group, the median second NLR rose from 3.9 to 4.6, while in the GH cohort, the NLR value dropped from 3.5 to 2.8, enhancing the NLR differences between the groups. Smaller changes were observed in the second PLR. These results strengthen the prior results that age and frailty seem to have a stronger impact on NLR and PLR than disease severity.

Original languageEnglish
Article number605
JournalJournal of Clinical Medicine
Volume13
Issue number2
DOIs
StatePublished - 21 Jan 2024
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2024 by the authors.

Keywords

  • COVID-19
  • frailty
  • geriatric
  • neutrophil-to-lymphocyte ratio
  • nursing homes
  • old age
  • platelet-to-lymphocyte ratio

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