Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Original Article

Volume 12, Number 7, July 2020, pages 415-422


Lymphocyte-to-C-Reactive Protein Ratio: A Novel Predictor of Adverse Outcomes in COVID-19

Figures

Figure 1.
Figure 1. Baseline characteristics of the included populations.
Figure 2.
Figure 2. Mean NLR and LCR values at day 1 and day 7 of hospitalization across different interventions and outcomes. NLR: neutrophil-to-lymphocyte ratio; LCR: lymphocyte-to-C-reactive protein ratio.
Figure 3.
Figure 3. Forest plots of unadjusted odds ratio of outcomes across NLR and LCR groups. NLR: neutrophil-to-lymphocyte ratio; LCR: lymphocyte-to-C-reactive protein ratio.

Tables

Table 1. Baseline Characteristics of the Included Population Across Comparison Groups for Which the Pooled Estimate Were Adjusted
 
NLR < 10NLR > 11SignificanceLCR < 10LCR > 11Significance
DM: diabetes mellitus; HTN: hypertension; CKD: chronic kidney disease; CAD: coronary artery disease; COPD: chronic obstructive pulmonary disease; HCQ: hydroxychloroquine; TM: tocilizumab; SD: steroid; AC: anticoagulation.
Age63.6 years61.6 yearsP = 0.7162.6 years63.7 yearsP = 0.65
Sex
  Men66 (80.50%)16 (19.50%)P = 0.16723 (27.70%)60 (72.30%)P = 0.04
  Women75 (88.20%)10 (11.80%)13 (14.90%)74 (85.10%)
DM
  No92 (85.20%)16 (14.80%)P = 0.71623 (21.10%)86 (78.90%)P = 0.974
  Yes49 (83.10%)10 (16.90%)13 (21.30%)48 (78.70%)
HTN
  No48 (80.00%)12 (20.00%)P = 0.23714 (23.30%)46 (76.70%)P = 0.611
  Yes93 (86.90%)14 (13.10%)22 (20.00%)88 (80.00%)
CAD
  No114 (82.60%)24 (17.40%)P = 0.1630 (21.60%)109 (78.40%)P = 0.784
  Yes27 (93.10%)2 (6.90%)6 (19.40%)25 (80.60%)
CKD
  No114 (83.80%)22 (16.20%)P = 0.6528 (20.30%)110 (79.70%)P = 0.557
  Yes27 (87.10%)4 (12.90%)8 (25.00%)24 (75.00%)
COPD
  No119 (83.20%)24 (16.80%)P = 0.2932 (21.90%)114 (78.10%)P = 0.56
  Yes22 (91.70%)2 (8.30%)4 (16.70%)20 (83.30%)
HCQ
  No27 (87.10%)4 (12.90%)P = 0.658 (27.60%)21 (72.40%)P = 0.354
  Yes114 (83.80%)22 (16.20%)28 (19.90%)113 (80.10%)
TM
  No117 (84.80%)21 (15.20%)P = 0.7828 (20.30%)110 (79.70%)P = 0.557
  Yes24 (82.80%)5 (17.20%)8 (25.00%)24 (75.00%)
SD
  No115 (83.30%)23 (16.70%)P = 0.3932 (22.90%)108 (77.10%)P = 0.247
  Yes26 (89.70%)3 (10.30%)4 (13.30%)26 (86.70%)
AC
  No115 (85.80%)19 (14.20%)P = 0.31825 (18.40%)111 (81.60%)P = 0.075
  Yes26 (78.80%)7 (21.20%)11 (32.40%)23 (67.60%)

 

Table 2. ORs of Outcomes in NLR Groups on Day 1 and Day 7 of Treatment
 
OutcomesDay 1Day 7
NNLR < 10NLR > 11Unadjusted odds (P value)aOR (P value)NNLR < 10NLR > 11Unadjusted odds (P value)aOR (P value)
aOR: adjusted odds ratio; OR: odds ratio; NLR: neutrophil-to-lymphocyte ratio.
Vent5746 (81%)11 (19%)OR 1.5 (0.6 - 3.5, P = 0.46)aOR 1.5 (0.6 - 3.7, P = 0.33)5536 (66%)19 (34%)OR 3.3 (1.4 - 7.7, P = 0.008)aOR 3.1 (1.2 - 8.4, P = 0.024)
No vent11095 (86%)15 (14%)8069 (86%)11 (14%)
Upgrade5342 (79%)11 (21%)OR 1.7 (0.7 - 4.1, P = 0.30)aOR 1.7 (0.7 - 4.1, P = 0.24)5034 (68%)16 (32%)OR 2.4 (1.0 - 5.4, P = 0.06)aOR 2.3 (0.9 - 6.1, P = 0.08)
No upgrade11499 (87%)15 (13%)8571 (84%)14 (16%)
Dialysis107 (70%)3 (30%)OR 2.5 (0.6 - 10.3, P = 0.39)aOR 2.5 (0.5 - 11.2, P = 0.25)86 (75%)2 (25%)OR 1.2 (0.2 - 6.1, P = 0.81)aOR 0.7 (0.1 - 5.7, P = 0.73)
No dialysis157134 (85%)23 (15%)12799 (78%)28 (22%)
Died1814 (78%)4 (22%)OR 1.6 (0.5 - 5.5, P = 0.63)aOR 1.9 (0.5 - 6.7, P = 0.30)1812 (67%)6 (33%)OR 11.0 (3.6 - 33.0, P < 0.0001)aOR 11.1 (3.11 - 39.1, P < 0.0001)
Alive149127 (85%)22 (15%)11799 (85%)18 (15%)

 

Table 3. ORs of Outcomes in LCR Groups on Day 1 and Day 7 of Treatment
 
OutcomesDay 1Day 7
NLCR < 100LCR > 101Unadjusted odds (P value)aOR (P value)NLCR < 100LCR > 101Unadjusted odds (P value)aOR (P value)
aOR: adjusted odds ratio; OR: odds ratio; LCR: lymphocyte-to-C-reactive protein ratio.
Vent6017 (28%)43 (72%)OR 2.5 (1.3 - 5.0, P = 0.01)aOR 2.5 (1.3 - 5.0, P = 0.009)5612 (21%)44 (78%)OR 1.8 (0.8 - 4.0, P = 0.21)aOR 1.06 (0.43 - 2.64, P = 0.89)
No vent11055 (50%)55 (50%)7625 (33%)51 (68%)
Upgrade5514 (26%)41 (75%)OR 2.9 (1.47 - 6.1, P = 0.004)aOR 3.1 (1.5 - 6.3, P = 0.003)5010 (20%)40 (80%)OR 2.0 (0.9 - 5.0, P = 0.16)aOR 1.16 (0.46 - 2.96, P = 0.74)
No upgrade11558 (50%)57 (50%)8227 (33%)55 (67%)
Dialysis103 (30%)7 (70%)OR 1.8 (0.4 - 7.1, P = 0.63)aOR 1.8 (0.4 - 8.0, P = 0.44)71 (14%)6 (86%)OR 2.4 (0.3 - 21.0, P = 0.70)aOR 3.7 (0.2 - 55.6, P = 0.34)
No dialysis16069 (43%)91 (57%)12536 (29%)89 (71%)
Died2010 (50%)10 (50%)OR 0.71 (0.3 - 1.8, P = 0.62)aOR 0.8 (0.3 - 2.0, P = 0.60)1912 (63%)7 (37%)OR 0.2 (0.06 - 0.47, P = 0.001)aOR 0.1 (0.01 - 0.30, P < 0.0001)
Alive15062 (41%)88 (58%)11325 (22%)88 (78%)