@article{Adil_Baig_Amir_Chatha_Habib_Majid_2020, title={NEUTROPHIL TO LYMPHOCYTE RATIO VS PLATELETS TO LYMPHOCYTE RATIO: BIOMARKERS TO PREDICT SEVERITY OF DISEASE AND THEIR COMPARISON IN PATIENTS OF COVID-19}, volume={70}, url={https://pafmj.org/PAFMJ/article/view/5010}, DOI={10.51253/pafmj.v70i6.5010}, abstractNote={<p class="NormalWeb" align="justify"><span class="Strong" dir="LTR"><strong>Objective:</strong></span><span dir="LTR"> To determine and compare Neutrophil to Lymphocyte Ratio (NLR) and Platelet to Lymphocyte Ratio (PLR) in predicting severity of disease in patients with COVID-19.</span></p> <p class="NormalWeb" align="justify"><span class="Strong" dir="LTR"><strong>Study design:</strong></span><span dir="LTR"> Descriptive comparative study.</span></p> <p class="NormalWeb" align="justify"><span class="Strong" dir="LTR"><strong>Place and Duration of study:  </strong></span><span dir="LTR">Department of Medicine, CMH Thal from April to July, 2020</span></p> <p class="NormalWeb" align="justify"><span class="Strong" dir="LTR"><strong>Patients & Methods: </strong></span><span dir="LTR">61 patients of COVID-19 confirmed through polymerase chain reaction were recruited and divided into severe and non severe disease. Complete blood counts were done. Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio were calculated and analyzed.</span></p> <p class="NormalWeb" align="justify"><span class="Strong" dir="LTR"><strong>Results: </strong></span><span dir="LTR">14 patients (23%) of severe disease had mean age of 49.93±19.42 and 47 patients (77%) with non-severe disease had mean age of 33.32±9.16. The mean Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte ratio in patients who had severe disease was 7.20±4.20 and 204.25±148.42 (p=0.001 and p=0.026) respectively. The diagnostic performance of both Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio produced statistically significant area under the curve (AUC), (p <0.001). The adjusted and unadjusted area under curve for Neutrophil to Lymphocyte Ratio was 0.92 (95% CI: 0.85–1.00) and 0.923 (95% CI: 0.839-1.000) and for Platelet to Lymphocyte Ratio it was 0.883 (95% CI: 0.781–0.985) and 0.825(95% CI:  0.707-0.943) respectively.</span></p> <p class="NormalWeb" align="justify"><span class="Strong" dir="LTR"><strong> Conclusion: </strong></span><span dir="LTR">Elevated Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio are independent biomarkers which predict severity of disease in COVID-19 patients with Neutrophil to Lymphocyte Ratio being better predictor in terms of diagnostic accuracy. </span></p> <p class="NormalWeb" align="justify"><span class="Strong" dir="LTR"><strong>Keywords:</strong></span><span dir="LTR"> Corona virus disease 2019 (COVID</span><span dir="LTR">‐</span><span dir="LTR">19), Neutrophil to Lymphocyte ratio, Platelet to Lymphocyte ratio</span></p>}, number={6}, journal={Pakistan Armed Forces Medical Journal}, author={Adil, Muhammad and Baig, Zahid Farooq and Amir, Muhammad and Chatha, Sohail Saqib and Habib, Aamir and Majid, Muhammad}, year={2020}, month={Dec.}, pages={1609–15} }