The Neutrophil-to-Monocyte Ratio and Lymphocyte-to-Neutrophil Ratio at Admission Predict In-Hospital Mortality in Mexican Patients with Severe SARS-CoV-2 Infection (Covid-19)

• Published in: Microorganisms (Basel) Vol. 8; no. 10; p. 1560
• Main Authors: Rizo-Téllez, Salma A, Méndez-García, Lucia A, Flores-Rebollo, Cruz, Alba-Flores, Fernando, Alcántara-Suárez, Raúl, Manjarrez-Reyna, Aarón N, Baltazar-López, Neyla, Hernández-Guzmán, Verónica A, León-Pedroza, José I, Zapata-Arenas, Rogelio, González-Chávez, Antonio, Hernández-Ruíz, Joselín, Carrillo-Ruíz, José D, Serrano-Loyola, Raúl, Guerrero-Avendaño, Guadalupe M L, Escobedo, Galileo
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 10.10.2020; MDPI
• Subjects: Cardiovascular disease; Cardiovascular diseases; Coronary artery disease; Coronaviruses; COVID-19; Diabetes mellitus (non-insulin dependent); Heart diseases; Hospitals; Hypertension; in-hospital death risk; Intensive care units; Leukocytes (neutrophilic); lymphocyte; Lymphocytes; monocyte; Monocytes; Mortality; mortality predictor; NMR; Nuclear magnetic resonance; Patients; Risk analysis; Risk factors; SARS-Cov-2; Sensitivity; Severe acute respiratory syndrome coronavirus 2; Survival; Viral diseases; United States > US; Mexico; SARS-Cov-2; mortality predictor; Covid-19; in-hospital death risk; monocyte; intensive care unit; neutrophil; lymphocyte
• ISSN: 2076-2607; 2076-2607
• DOI: 10.3390/microorganisms8101560

There is a deep need for mortality predictors that allow clinicians to quickly triage patients with severe coronavirus disease 2019 (Covid-19) into intensive care units at the time of hospital admission. Thus, we examined the efficacy of the lymphocyte-to-neutrophil ratio (LNR) and neutrophil-to-monocyte ratio (NMR) as predictors of in-hospital death at admission in patients with severe Covid-19. A total of 54 Mexican adult patients with Covid-19 that met hospitalization criteria were retrospectively enrolled, followed-up daily until hospital discharge or death, and then assigned to survival or non-survival groups. Clinical, demographic, and laboratory parameters were recorded at admission. A total of 20 patients with severe Covid-19 died, and 75% of them were men older than 62.90 ± 14.18 years on average. Type 2 diabetes, hypertension, and coronary heart disease were more prevalent in non-survivors. As compared to survivors, LNR was significantly fourfold decreased while NMR was twofold increased. LNR ≤ 0.088 predicted in-hospital mortality with a sensitivity of 85.00% and a specificity of 74.19%. NMR ≥ 17.75 was a better independent risk factor for mortality with a sensitivity of 89.47% and a specificity of 80.00%. This study demonstrates for the first time that NMR and LNR are accurate predictors of in-hospital mortality at admission in patients with severe Covid-19.