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Study on the Correlation of Elevated Neutrophil-To-Lymphocyte Ratio and Platelet-To-Lymphocyte Ratio With Covid-19 Mortality among Patients in a Hospital Isolation Ward in Baler, Aurora

Allany Gaile I. Lanot, Jazmin D. Cabagnot, Angela Wyneth T. De La Cruz, Danielle Therese S. Iringan, Reine Arielle M. Masangkay, Francesca Ann C. Mones, Alison Gail A. Salvador, Darla Kimberly M. Tolosa, Ian Paulo C. Gigante 0000-0003-2183-68541, 0000-0001-9502-09092 0000-0002-3743-27503, 0000-0003-1000-62734, 0000-002-0433-95175, 0000-0002-4882-22286, 0000-0002-5903-68207, 0000-0002-8237-31048, 0000-0002-4064-3209,,,,,,,,
University of Santo Tomas, Manila, Philippines



Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) are inflammatory biomarkers known to assess several disease types effectively. With the surge of Coronavirus disease (COVID-19) cases, many patients manifested various systemic inflammatory conditions suggesting a possible relationship between the predictive values of NLR and PLR to COVID-19 mortality. The study aims to assess a correlation between elevated biomarker values of NLR and PLR with COVID-19 mortality. A single-center, cross-sectional study of COVID-19 patients, admitted to a hospital isolation ward in Baler, Aurora, between May to October 2021 was conducted. Secondary data, namely demographic profiles, complete blood count results, and comorbidities upon admission, were collected. The effect of NLR and PLR on the risk of mortality, along with the impact of covariate variables that may affect the study’s outcome, was determined using a multiple binary logistic regression model and the computation of the odds ratio. 264 COVID-19 patients were included in the study–202 were recovered and 62 were deceased. Multiple binary logistic regression demonstrated a higher mortality risk in patients with elevated NLR (OR=2.607; 95% CI: 1.276 to 5.324; p=.009). Other risk factors such as age (OR=1.053; 95% CI: 1.029 to 1.077; p<.001) and diabetes mellitus (OR=3.537; 95% CI: 1.441 to 8.682; p=.006) are risk factors for COVID-19 mortality. Patients with elevated NLR values indicate poor clinical outcomes with a higher mortality risk compared to those with low NLR in COVID-19 patients. Moreover, age and diabetes must be considered in patient assessment upon admission due to their correlation to COVID-19 mortality.

Keywords: COVID-19 mortality, inflammatory biomarker, Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR).

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