NLR: A Cost-effective Nomogram to Guide Therapeutic Interventions in COVID-19

ABSTRACT

COVID-19 exhibits a non-yet elucidated heterogeneity dominated by mild form of the illness. Nevertheless, mortality is frequent among patients with a delayed innate immune response that suddenly exacerbates during the second week after admission leading to a lethal over inflammation. Therefore, this rapid and unpredictable deterioration requires timely prediction of COVID-19 refractoriness and critical illness. The two biomarkers readily available in routine laboratories, blood lymphocytes and neutrophil counts, are expected to provide an accurate clinical tool to incline reasonable medication and care because lymphopenia marks immune exhaustion while neutrophilia demonstrates the immunological exuberation. Meanwhile, combining the two parameters as a Neutrophil-to-lymphocyte ratio (NLR) helps to constitute a powerful predictive and prognostic nomogram. This scoring tool allows clinicians to stratify COVID-19 severities on admission and guide early interventions to accelerate recovery and shorten the course of disease in order to alleviate the shortage of medical resources and reduce mortality.

KEYWORDS:

• SARS-CoV-2
• Covid-19
• refractory patients
• nomogram
• neutrophil-to-lymphocyte ratio
• risk stratification

Acknowledgments

I am very thankful to Prof. Bachir Kerboua and my student Maroua Benzouada for their constructive comments on improving the language, grammar, and readability of this paper.

Disclosure statement

The author declares that he has no conflict of interest.

Additional information

Funding

This work was supported by the General Directorate of Research and Technology Development, Ministry of Higher Education and Scientific Research of Algeria.