Comparison of Lymphocyte-CRP ratio to conventional inflammatory markers for predicting clinical outcomes in COVID-19

Alexander Qichen Liu, Robert Hammond, Kenneth Chan, Chukwugozie Chukwuenweniwe, Rebecca Johnson, Duaa Khair, Eleanor Duck, Oluwaseun Olubodun, Kristian Barwick, Winston Banya, James Stirrup, Peter Duncan Donnelly, Juan Carlos Kaski, Anthony R Coates*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Background: In COVID-19 patients, lymphocyte–CRP ratio (LCR) is a promising biomarker for predicting adverse clinical outcomes. How well LCR performs compared to conventional inflammatory markers for prognosticating COVID-19 patients remains unclear, which hinders the clinical translation of this novel biomarker.


Methods: In a cohort of COVID-19 inpatients, we characterised the clinical applicability of LCR by comparing its prognostic value against conventional inflammatory markers for predicting inpatient mortality and a composite of mortality, invasive/non-invasive ventilation and intensive care unit admissions.


Results: Of the 413 COVID-19 patients, 100 (24%) patients suffered inpatient mortality. On Receiver Operating Characteristics analysis, LCR performed similarly to CRP for predicting mortality (AUC 0.74 vs. 0.71, p = 0.049) and the composite endpoint (AUC 0.76 vs. 0.76, p = 0.812). LCR outperformed lymphocyte counts (AUC 0.74 vs. 0.66, p = 0.002), platelet counts (AUC 0.74 vs. 0.61, p = 0.003) and white cell counts (AUC 0.74 vs. 0.54, p < 0.001) for predicting mortality. On Kaplan–Meier analysis, patients with a low LCR (below a 58 cut-off) had worse inpatient survival than patients with other LCR values (p < 0.001).


Conclusion: LCR appears comparable to CRP, but outperformed other inflammatory markers, for prognosticating COVID-19 patients. Further studies are required to improve the diagnostic value of LCR to facilitate clinical translation.
Original languageEnglish
Article number909
Number of pages11
JournalJournal of Personalized Medicine
Volume13
Issue number6
DOIs
Publication statusPublished - 29 May 2023

Keywords

  • Lymphocyte–CRP ratio
  • Coronavirus disease 19
  • C-reactive protein
  • Risk stratification
  • Prognostic risk
  • COVID-19

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