• Jiangli Cheng, Aijia Ma, Jing Yang, Meiling Dong, Xuelian Liao, and Yan Kang.
• Department of Critical Care Medicine, West China Hospital of Sichuan University, No. 37, Guoxue Alley, 610041, Chengdu, Sichuan Province, China.
• Wien. Klin. Wochenschr. 2021 Sep 1; 133 (17-18): 882-891.

PurposeThe aim of this study was to determine whether the neutrophil to lymphocyte ratio (NLR) can predict severe Coronavirus disease 2019 (COVID-19).Patients And MethodsA multicenter case-control study was conducted to investigate whether the NLR can help predict the severity of COVID-19. Patients confirmed to have COVID-19 between 16 January 2020 and 15 March 2020 were enrolled. Furthermore, meta-analyses were conducted based on both previous studies and our case-control study.ResultsIn the case-control study, 213 patients (severe: 81) were included. The results suggested that the NLR was an independent risk factor (odds ratio [OR], 1.155, 95% confidence interval [95% CI]: 1.043-1.279, P = 0.006) and a great predictor (the area under the ROC curve was 0.728, 95% CI: 0.656-0.800) for severe COVID-19. In total, 18 datasets from 16 studies combined with our case-control study (severe: 1211; non-severe: 5838) were included in the meta-analyses and the results showed that the NLR of the severe COVID-19 group was significantly higher than that of the non-severe group (SMD = 1.10, 95% CI: 0.90-1.31, P < 0.001). Based on the 2 × 2 data from 6 studies, the SROC of NLR for predicting severe COVID-19 was 0.802, with a sensitivity of 0.67 (95% CI: 0.61-0.72) and a specificity of 0.75 (95% CI: 0.73-0.78).ConclusionBased on a multicenter case-control study and a meta-analysis, we found that the initial NLR was a great predictor of severe COVID-19.© 2021. The Author(s).

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