Neutrophil-to-lymphocyte ratio and D-dimer are biomarkers of death risk in severe COVID-19: A retrospective observational study

Author(s)

Cunha Terra, Patricia Oliveira ; Donadel, Camila Derminio ; Oliveira, Luciana Correa ; Menegueti, Mayra Goncalves ; Auxiliadora-Martins, Maria ; Calado, Rodrigo Tocantins ; De Santis, Gil Cunha

• Document type: Journal article
• Source: HEALTH SCIENCE REPORTS; v. 5, n. 2, p. 6-pg., 2022-03-01.

Abstract

Background and Aims Over 4 million deaths from coronavirus disease (COVID)-19 have been reported in the world. Several biomarkers have been identified that predict disease severity, but there is still a need to identify biomarkers for death risk in severe COVID-19. We aim to define amongst the biomarkers already identified those which are mostly associated with increased death rate in patients with severe COVID-19. Methods In this retrospective study conducted in three public hospitals linked to the Medical School of Ribeirao Preto, Brazil, patients with severe COVID-19 were evaluated regarding biomarkers (neutrophil-to-lymphocyte ratio-NLR, D-dimer, fibrinogen) of death risk, obtained before administration of corticosteroids. Results Thirty-nine (32.8%) of the 119 patients included (104 [87.4%] on mechanical ventilation) died during hospitalization. Non-survivor group had higher median (range) NLR (12.63 [2.6-115] vs 7.43 [0.43-31.8]; P = .001), D-dimer (2.17 [0.27-20.00] vs 1.57 [0.28-20.00]; P = .03), but lower fibrinogen (631 [353-1078] vs 705 [407-1200]; P = .02). The group with NLR >= 10 and D-dimer >= 2 mu g/mL had a higher death risk than the group with NLR < 10 and D-dimer < 2 mu g/mL (OR: 5.39; CI 95%: 1.5-19.42; P = .01). Conclusion High NLR and D-dimer, especially when combined, are predictors of death risk for patients with severe COVID-19 and should be incorporated into their evaluation. (AU)

• FAPESP's process: 20/05367-3 - Convalescent donor plasma to treat patients with severe SARS-CoV-2 infection (COVID-19)
• Grantee: Rodrigo do Tocantins Calado de Saloma Rodrigues
• Support Opportunities: Regular Research Grants