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VOLUME 25 , ISSUE 10 ( October, 2021 ) > List of Articles

Original Article

Neutrophil-to-lymphocyte and Platelet-to-lymphocyte Ratios in those with Pulmonary Embolism in the Course of Coronavirus Disease 2019

Canan Akkus, Hakan Yilmaz, Rahime Duran, Suleyman Diker, Semih Celik, Cevdet Duran

Keywords : COVID-19, Hematological changes, Neutrophil-to-lymphocyte ratio, Platelet-to-lymphocyte ratio, Pulmonary embolism

Citation Information : Akkus C, Yilmaz H, Duran R, Diker S, Celik S, Duran C. Neutrophil-to-lymphocyte and Platelet-to-lymphocyte Ratios in those with Pulmonary Embolism in the Course of Coronavirus Disease 2019. Indian J Crit Care Med 2021; 25 (10):1131-1134.

DOI: 10.5005/jp-journals-10071-23998

License: CC BY-NC 4.0

Published Online: 30-09-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: To investigate the levels of neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocyte (PLR) ratios in those having a pulmonary embolism (PE) in the course of coronavirus disease 2019 (COVID-19). Methods: The records of those having COVID-19 were retrospectively obtained from the hospital automation system. NLR and PLR were measured with the help of patients’ blood cell counts. Results: Of 1,452 COVID-19 patients, 17 (1.2%) were diagnosed with PE. Compared with the controls, while leukocyte (p = 0.001), neutrophil (p <0.001), and neutrophil (p = 0.001) percentages, and NLR (p <0.001) and PLR (p = 0.006) had higher values, lymphocyte count (p = 0.004) and lymphocyte percentage (p <0.001) showed lower values in the patients with PE. Compared to the survivors, the non-survivors were found to have increased leukocyte (p <0.001), neutrophil (p <0.001), and neutrophil percentages (p <0.001), NLR (p <0.001) and PLR (p <0.001), and decreased lymphocyte (p <0.001) counts and percentage (p <0.001), hemoglobin (p = 0.005), hematocrit (p = 0.012), and platelet counts (p <0.001). While NLR and PLR cutoffs were found as 4.338 and 187.83 in predicting PE, the cutoff values of NLR and PLR were, respectively, 4.301 and 172.5 in predicting mortality. The logistic regression analysis also revealed that all hematological parameters had no effects on the development of PE. Conclusion: Although NLR and PLR had higher scores in PE patients, no relationship was determined between the levels of NLR and PLR and PE development. Further prospective studies including larger populations are required to enlighten the increased NLR and PLR in PE patients having COVID-19.


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  1. Al-Ani F, Chehade S, Lazo-Langner A. Thrombosis risk associated with COVID-19 infection. A scoping review. Thromb Res 2020;192:152–160. DOI: 10.1016/j.thromres.2020.05.039.
  2. Bompard F, Monnier H, Saab I, Tordjman M, Abdoul H, Fournier L, et al. Pulmonary embolism in patients with COVID-19 pneumonia. Eur Respir J 2020;56. DOI: 10.1183/13993003.01365-2020.
  3. Liao SC, Shao SC, Chen YT, Chen YC, Hung MJ. Incidence and mortality of pulmonary embolism in COVID-19: a systematic review and meta-analysis. Crit Care 2020;24(1):464. DOI: 10.1186/s13054-020-03175-z.
  4. Kong M, Zhang H, Cao X, Mao X, Lu Z. Higher level of neutrophil-to-lymphocyte is associated with severe COVID-19. Epidemiol Infect 2020;148:e139. DOI: 10.1017/S0950268820001557.
  5. Yan X, Li F, Wang X, Yan J, Zhu F, Tang S, et al. Neutrophil to lymphocyte ratio as prognostic and predictive factor in patients with coronavirus disease 2019: a retrospective cross-sectional study. J Med Virol 2020;92(11):2573–2581. DOI: 10.1002/jmv.26061.
  6. Chan AS, Rout A. Use of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in COVID-19. J Clin Med Res 2020;12(7):448–453. DOI: 10.14740/jocmr4240.
  7. Telo S, Kuluozturk M, Deveci F, Kirkil G. The relationship between platelet-to-lymphocyte ratio and pulmonary embolism severity in acute pulmonary embolism. Int Angiol 2019;38(1):4–9. DOI: 10.23736/S0392-9590.18.04028-2.
  8. Wang Q, Ma J, Jiang Z, Ming L. Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in acute pulmonary embolism: a systematic review and meta-analysis. Int Angiol 2018;37(1):4–11. DOI: 10.23736/S0392-9590.17.03848-2.
  9. Ma Y, Mao Y, He X, Sun Y, Huang S, Qiu J. The values of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in predicting 30 day mortality in patients with acute pulmonary embolism. BMC Cardiovasc Disord 2016;16:123. DOI: 10.1186/s12872-016-0304-5.
  10. Karatas MB, Ipek G, Onuk T, Güngör B, Durmuş G, Çanga Y, et al. Assessment of prognostic value of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in patients with pulmonary embolism. Acta Cardiol Sin 2016;32(3):313–320. DOI: 10.6515/acs20151013a.
  11. Soylu K, Gedikli O, Eksi A, Avcıoğlu Y, Soylu Aİ, Yüksel S, et al. Neutrophil-to-lymphocyte ratio for the assessment of hospital mortality in patients with acute pulmonary embolism. Arch Med Sci 2016;12(1):95–100. DOI: 10.5114/aoms.2016.57585.
  12. Kayrak M, Erdogan HI, Solak Y, Akilli H, Gül EE, Yildirim O, et al. Prognostic value of neutrophil to lymphocyte ratio in patients with acute pulmonary embolism: a restrospective study. Heart Lung Circ 2014;23(1):56–62. DOI: 10.1016/j.hlc.2013.06.004.
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