PMID- 35948607
OWN - NLM
STAT- MEDLINE
DCOM- 20220812
LR  - 20221020
IS  - 2045-2322 (Electronic)
IS  - 2045-2322 (Linking)
VI  - 12
IP  - 1
DP  - 2022 Aug 10
TI  - Predictive value of neutrophil-to-lymphocyte ratio for the fatality of COVID-19 
      patients complicated with cardiovascular diseases and/or risk factors.
PG  - 13606
LID - 10.1038/s41598-022-17567-4 [doi]
LID - 13606
AB  - Previous studies have reported that a high neutrophil-to-lymphocyte ratio (NLR) 
      is associated with disease severity and poor prognosis in COVID-19 patients. We 
      aimed to investigate the clinical implications of NLR in patients with COVID-19 
      complicated with cardiovascular diseases and/or its risk factors (CVDRF). In 
      total, 601 patients with known NLR values were selected from the CLAVIS-COVID 
      registry for analysis. Patients were categorized into quartiles (Q1, Q2, Q3, and 
      Q4) according to baseline NLR values, and demographic and clinical parameters 
      were compared between the groups. Survival analysis was conducted using the 
      Kaplan-Meier method. The diagnostic performance of the baseline and follow-up NLR 
      values was tested using receiver operating characteristic (ROC) curve analysis. 
      Finally, two-dimensional mapping of patient characteristics was conducted using 
      t-stochastic neighborhood embedding (t-SNE). In-hospital mortality significantly 
      increased with an increase in the baseline NLR quartile (Q1 6.3%, Q2 11.0%, Q3 
      20.5%; and Q4, 26.6%; p < 0.001). The cumulative mortality increased as the 
      quartile of the baseline NLR increased. The paired log-rank test revealed 
      significant differences in survival for Q1 vs. Q3 (p = 0.017), Q1 vs. Q4 
      (p < 0.001), Q2 vs. Q3 (p = 0.034), and Q2 vs. Q4 (p < 0.001). However, baseline 
      NLR was not identified as an independent prognostic factor using a multivariate 
      Cox proportional hazards regression model. The area under the curve for 
      predicting in-hospital death based on baseline NLR was only 0.682, whereas that 
      of follow-up NLR was 0.893. The two-dimensional patient map with t-SNE showed a 
      cluster characterized by high mortality with high NLR at follow-up, but these did 
      not necessarily overlap with the population with high NLR at baseline. NLR may 
      have prognostic implications in hospitalized COVID-19 patients with CVDRF, but 
      its significance depends on the timing of data collection.
CI  - (c) 2022. The Author(s).
FAU - Higaki, Akinori
AU  - Higaki A
AD  - Department of Cardiology, Ehime Prefectural Central Hospital, Matsuyama, Japan. 
      keroplant83@gmail.com.
FAU - Okayama, Hideki
AU  - Okayama H
AD  - Department of Cardiology, Ehime Prefectural Central Hospital, Matsuyama, Japan.
FAU - Homma, Yoshito
AU  - Homma Y
AD  - Department of Infectious Diseases, Ehime Prefectural Central Hospital, Matsuyama, 
      Japan.
FAU - Sano, Takahide
AU  - Sano T
AD  - Department of Cardiovascular Medicine, Toho University Graduate School of 
      Medicine, Tokyo, Japan.
FAU - Kitai, Takeshi
AU  - Kitai T
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular 
      Center, Osaka, Japan.
AD  - Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, 
      Japan.
FAU - Yonetsu, Taishi
AU  - Yonetsu T
AD  - Department of Interventional Cardiology, Tokyo Medical and Dental University, 
      Tokyo, Japan.
FAU - Torii, Sho
AU  - Torii S
AD  - Department of Cardiology, Tokai University School of Medicine, Isehara, Japan.
FAU - Kohsaka, Shun
AU  - Kohsaka S
AD  - Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
FAU - Kuroda, Shunsuke
AU  - Kuroda S
AD  - Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
FAU - Node, Koichi
AU  - Node K
AD  - Department of Cardiovascular Medicine, Saga University, Saga, Japan.
FAU - Matsue, Yuya
AU  - Matsue Y
AD  - Department of Cardiovascular Biology and Medicine, Juntendo University Graduate 
      School of Medicine, Tokyo, Japan.
AD  - Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of 
      Medicine, Tokyo, Japan.
FAU - Matsumoto, Shingo
AU  - Matsumoto S
AD  - Division of Cardiovascular Medicine, Department of Internal Medicine, Toho 
      University Faculty of Medicine, Tokyo, Japan.
LA  - eng
PT  - Journal Article
DEP - 20220810
PL  - England
TA  - Sci Rep
JT  - Scientific reports
JID - 101563288
SB  - IM
MH  - *COVID-19/complications
MH  - *Cardiovascular Diseases
MH  - Hospital Mortality
MH  - Humans
MH  - Lymphocytes
MH  - Neutrophils
MH  - Prognosis
MH  - ROC Curve
MH  - Retrospective Studies
MH  - Risk Factors
PMC - PMC9364304
COIS- The authors declare no competing interests.
EDAT- 2022/08/11 06:00
MHDA- 2022/08/13 06:00
PMCR- 2022/08/10
CRDT- 2022/08/10 23:20
PHST- 2021/06/12 00:00 [received]
PHST- 2022/07/27 00:00 [accepted]
PHST- 2022/08/10 23:20 [entrez]
PHST- 2022/08/11 06:00 [pubmed]
PHST- 2022/08/13 06:00 [medline]
PHST- 2022/08/10 00:00 [pmc-release]
AID - 10.1038/s41598-022-17567-4 [pii]
AID - 17567 [pii]
AID - 10.1038/s41598-022-17567-4 [doi]
PST - epublish
SO  - Sci Rep. 2022 Aug 10;12(1):13606. doi: 10.1038/s41598-022-17567-4.