Original Article

Association between the Neutrophil-to-Lymphocyte Ratio and Inpatient Mortality in Hospitalized Older Veterans with COVID-19 Infection

Authors: Amy M. Gonnell, MD, Natasha M. Resendes, MD, Alma Diaz Quinones, MD, Andria Chada, MD, Christian Gomez, MD, Shivaan Oomrigar, MD, Jorge G. Ruiz, MD

Abstract

Posted in: Infectious Disease132

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References

1. Lithander FE, Neumann S, Tenison E, et al. COVID-19 in older people: a rapid clinical review. Age Ageing, 2020;49:501–515.
 
2. Becerra-Muñoz VM, Núñez-Gil IJ, Eid CM, et al. Clinical profile and predictors of in-hospital mortality among older patients hospitalised for COVID-19. Age Ageing 2021;50:326–334.
 
3. CDC COVID-19 Response Team. Severe outcomes among patients with coronavirus disease 2019 (COVID-19) - United States, February 12-March 16, 2020. https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm. Published March 27, 2020. Accessed December 17, 2022.
 
4. Epidemiology Working Group for NCIP Epidemic Response, Chinese Center for Disease Control and Prevention. [The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China [in Chinese]. Zhonghua Liu Xing Bing Xue Za Zhi 2020;41:145–151.
 
5. Dumitrascu F, Branje KE, Hladkowicz ES, et al. Association of frailty with outcomes in individuals with COVID-19: a living review and meta-analysis. J Am Geriatr Soc 2021;69:2419–2429.
 
6. Hu B, Huang S, Yin L, et al. The cytokine storm and COVID-19. J Med Virol 2021;93:250–256.
 
7. Wang Y, Pang SC, Yang Y, et al. A potential association between immunosenescence and high COVID-19 related mortality among elderly patients with cardiovascular diseases. Immun Ageing 2021;18:25.
 
8. Thomas B, Goodacre S, Lee E, et al. Prognostic accuracy of emergency department triage tools for adults with suspected COVID-19: the PRIEST observational cohort study. Emerg Med J 2021;38:587–593.
 
9. Zahorec R. “Neutrophil-to-lymphocyte ratio, past, present and future perspectives.” Bratisl Lek Listy 2021;122:474–488.
 
10. Blomaard LC, Speksnijder C, Lucke JA, et al. Geriatric screening, triage urgency, and 30-day mortality in older emergency department patients. J Am Geriatr Soc 2020;68:1755–1762.
 
11. Alkhatip AAAMM, Kamel MG, Hamza MK, et al. The diagnostic and prognostic role of neutrophil-to-lymphocyte ratio in COVID-19: a systematic review and meta-analysis. Expert Rev Mol Diagn 2021;21:505–514.
 
12. Ozdin M, Hakan K, Gulact U, et al. The diagnostic value of neutrophil to lymphocyte ratio in determining the severity of COVID-19. IMC J Med Sci 2021;16:1–7.
 
13. Li Y, Du X, Chen J, et al. Neutrophil-to-lymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. J Infect 2020;81:e6–e12.
 
14. Moradi EV, Teimouri A, Rezaee R, et al. Increased age, neutrophilto-lymphocyte ratio (NLR) and white blood cells count are associated with higher COVID-19 mortality. Am J Emerg Med 2021;40:11–14.
 
15. Lian J, Jin C, Hao S, et al. High neutrophil-to-lymphocyte ratio associated with progression to critical illness in older patients with COVID-19: a multicenter retrospective study. Aging (Albany NY) 2020;12:13849–13859.
 
16. Pillai J, Mistry PPK, Le Roux DA, et al. Laboratory parameters associated with prolonged hospital length of stay in COVID-19 patients in Johannesburg, South Africa. S Afr Med J 2022;112:201–208.
 
17. Liu G, Zhang S, Hu H, et al. The role of neutrophil-lymphocyte ratio and lymphocyte–monocyte ratio in the prognosis of type 2 diabetics with COVID-19. Scott Med J 2020;65:154–160.
 
18. Kashefizadeh A, Ohadi L, Golmohammadi M, et al. Clinical features, and short-term outcomes of COVID-19 in Tehran, Iran: an analysis of mortality and hospital stay. Acta Biomed 2020;91:e2020147.
 
19. Jeraiby MA, Hakamy MI, Albarqi MB, et al. Routine laboratory parameters predict serious outcome as well as length of hospital stay in COVID-19. Saudi Med J 2021;42:1165–1172.
 
20. Chelariu AC, Coman AE, Lionte C, et al. The value of early and follow-up elevated scores based on peripheral complete blood cell count for predicting adverse outcomes in COVID-19 patients. J Pers Med 2022;12:2037.
 
21. Haran C, Gimpel D, Clark H, et al. Preoperative neutrophil and lymphocyte ratio as a predictor of mortality and morbidity after cardiac surgery. Heart Lung Circ 2021;30:414–418.
 
22. Da Silva M, Cleghorn MC, Elnahas A, et al. Postoperative day one neutrophil-to-lymphocyte ratio as a predictor of 30-day outcomes in bariatric surgery patients. Surg Endosc 2017;31:2645–2650. .
 
23. Uthamalingam S, Patvardhan EA, Subramanian S, et al. Utility of the neutrophil to lymphocyte ratio in predicting long-term outcomes in acute decompensated heart failure. Am J Cardiol 2011;107:433–438.
 
24. Ergin ÖN, Bayram S, Anarat FB, et al. Prognostic factors affecting survival of patients with intertrochanteric femoral fractures over 90 years treated with proximal femoral nailing. Eur J Trauma Emerg Surg 2020;46: 663–669.
 
25. Seropian IM, Romeo FJ, Pizarro R, et al. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as predictors of survival after heart transplantation. ESC Heart Fail 2018;5:149–156.
 
26. Tan L, Wang Q, Zhang D, et al. Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Signal Transduct Target Ther 2020;5:61.
 
27. Sotoodeh Ghorbani S, Taherpour N, Bayat S, et al. Epidemiologic characteristics of cases with reinfection, recurrence, and hospital readmission due to COVID-19: a systematic review and meta-analysis. J Med Virol 2022;94:44–53.
 
28. Kimura LF, Sant’Anna MB, Andrade SA, et al. COVID-19 induces proatherogenic alterations in moderate to severe non-comorbid patients: a single-center observational study. Blood Cells Mol Dis 2021;92:102604.
 
29. Miller EA, Simpson E, Nadash P, et al. Thrust into the spotlight: COVID-19 focuses media attention on nursing homes. J Gerontol B Psychol Sci Soc Sci 2021;76:e213–e218.
 
30. Lai YF, Lim YW, Kuan WS, et al. Asian attitudes and perceptions toward hospital-at-home: a cross-sectional study. Front Public Health 2021;9:704465.
 
31. Kojima G. Frailty as a predictor of nursing home placement among community-dwelling older adults: a systematic review and meta-analysis. J Geriatr Phys Ther 2018;41:42–48.
 
32. Hao Q, Zhou L, Dong B, et al. The role of frailty in predicting mortality and readmission in older adults in acute care wards: a prospective study. Sci Rep 2019;9:1207.
 
33. Sherman RL, Judon KM, Koufacos NS, et al. Utilizing a health information exchange to facilitate COVID-19 VA primary care follow-up for veterans diagnosed in the community. JAMIA Open 2021;4:ooab020.
 
34. Nuti SV, Qin L, Rumsfeld JS, et al. Association of admission to Veterans Affairs hospitals vs non-Veterans Affairs hospitals with mortality and readmission rates among older men hospitalized with acute myocardial infarction, heart failure, or pneumonia. JAMA 2016;315:582–592.
 
35. Anhang Price R, Sloss EM, Cefalu M, et al. Comparing quality of care in Veterans Affairs and non-Veterans Affairs settings. J Gen Intern Med 2018;33:1631–1638.
 
36. Austin CA, Mohottige D, Sudore RL, et al. Tools to promote shared decision making in serious illness: a systematic review. JAMA Intern Med 2015;175: 1213–1221.
 
37. Ellis G, Langhorne P. Comprehensive geriatric assessment for older hospital patients. Br Med Bull 2005;71:45–59.
 
38. Hshieh TT, Yang T, Gartaganis SL, et al. Hospital Elder Life Program: systematic review and meta-analysis of effectiveness. Am J Geriatr Psychiatry 2018;26: 1015–1033.