Prognostic Significance of NLR and PLR in COVID-19: A Multi-Cohort Validation Study

• DOI: 10.1007/s40121-024-00967-6
• Publication Date: 2024-04-21T13:01:10Z
• Authors: Marta Colaneri; Camilla Genovese; Federico Fassio; Marta Canuti; Andrea Giacomelli; Anna Lisa Ridolfo; Erika Asperges; Giuseppe Albi; Raffaele Bruno; Spinello Antinori; Antonio Muscatello; Bianca Mariani; Ciro Canetta; Francesco Blasi; Alessandra Bandera; Andrea Gori
• Keywords: Gold standard (test)

Recent studies have highlighted the prognostic value of easily accessible inflammatory markers, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte (PLR) for predicting severe outcomes in patients affected by Coronavirus disease 2019 (COVID-19). Our study validates NLR PLR cut-off values from a prior cohort at IRCCS Policlinico San Matteo (OSM) Pavia, Italy, across two new cohorts different hospitals. This aims to enhance generalizability these indicators. In this retrospective study, conducted Milan's Ospedale Luigi Sacco (OLS) Maggiore (OMP) hospitals, we assess predictive capacity three main outcomes—non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP) usage, invasive (IV), death—in with COVID-19 admission. For each outcome, sensitivity, specificity, (PPV), negative (NPV) were computed separately male female cohorts. Distinct used men (7.00, 7.29, 7.00 NLR; 239.22, 248.00, 250.39 PLR) women (6.36, 7.00, 6.28 233.00, 246.45, 241.54 PLR), retrieved first OSM. A total 3599 included our 1842 OLS 1757 OMP. OMP sensitivity both (NLR: 24–67%, PLR: 40–64%) inferior specificity 64–76%, 55–72%). Additionally, PPVs generally remained lower (< 63%), while NPVs consistently surpassed 68% 72% NLR. Finally, exhibited higher more (> 82%) compared CPAP/NIV. Consistent findings diverse patient populations validate reliability applicability values. High emphasize their role identifying individuals less likely experience outcomes. These markers not only aid risk stratification but also guide resource allocation emergencies limited-resource situations.