the prognostic accuracy of neutrophil-lymphocyte ratio in covid-19 patients

Introduction: covid-19 is a newly emerging pandemic viral disease. multiple management guidelines were introduced; nevertheless, their efficacy is still under debate. thus, the presences of prognostic factors are essential for predicting which patients will need more invasive treatments. objective: the study aims to investigate the prognostic accuracy of neutrophil-lymphocyte ratio in covid-19 infection. methods: this is a prospective study done in al-ain hospital in the united arab emirates. all the covid-19 patients presenting to the hospital were enrolled over 1 month from 20/3 to 20/4/2020. we gathered information about their age, sex, mode of transmission, and calculated their neutrophils/lymphocytes ratio (nlr) from the first complete blood picture on admission. we divided the patients into two groups: those whose age was 50 years and above and the those aged less than 50 years. we chose the best nlr cut-off value based on the youden index and receiver operating characteristic (roc) curve analysis and the target endpoint was presence or absence of intensive care unit (icu) admission. results: the study revealed that 48 patients (14%) needed icu admission, while 296 patients (86%) were admitted to a ward or quarantine facilities. when the patient's age was > 50, and nlr was ≥ 3.10, it showed a sensitivity of 95.24% and a specificity of 92.86% for predicting the need for icu admission. when nlr was ≥ 4.21, and the patient's age was < 50, the sensitivity and specificity were 70.3% and 93.7%, respectively. conclusions: nlr proved to be highly specific and sensitive in helping to identify patients who need more invasive care among people over 50 years of age with covid-19.