Archives of Public Health

Vol. 13 No. 2 (2021): Archives of Public Health
Clinical Science

C-reactive protein and Neutrophil-Lymphocyte Ratio as predictors of clinical severity of COVID-19

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  • Stefan Pandilov,
  • Suzana Klenkoski,
  • Elena Jovanovska Janeva,
  • Gazmend Mehmeti,
  • Dragan Mijakoski,
  • Sasho Stoleski,
  • Hristian Duma,
  • Dejan Dokic
Stefan Pandilov
University Clinic for Eye Diseases; Ss Cyril and Methodius University in Skopje Faculty of Medicine, Republic of North Macedonia
Suzana Klenkoski
University Clinic for Eye Diseases; Ss Cyril and Methodius University in Skopje Faculty of Medicine, Republic of North Macedonia
Elena Jovanovska Janeva
University Clinic of Pulmonology and Allergy; Ss Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Gazmend Mehmeti
University Clinic for Eye Diseases; Ss Cyril and Methodius University in Skopje Faculty of Medicine, Republic of North Macedonia
Dragan Mijakoski
Institute of Occupational Health, WHO CC, GA2LEN CC, Skopje; Ss Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Sasho Stoleski
Institute of Occupational Health, WHO CC, GA2LEN CC, Skopje; Ss Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Hristian Duma
University Clinic for Eye Diseases; Ss Cyril and Methodius University in Skopje Faculty of Medicine, Republic of North Macedonia
Dejan Dokic
University Clinic of Pulmonology and Allergy; Ss Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
DOI: https://doi.org/10.3889/aph.2021.6006

Published 2021-11-20

Keywords

  • COVID-19,
  • CRP,
  • NLR,
  • neutrophils,
  • lymphocytes,
  • clinical severity
    • ...More
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How to Cite

1.
Pandilov S, Klenkoski S, Jovanovska Janeva E, Mehmeti G, Mijakoski D, Stoleski S, Duma H, Dokic D. C-reactive protein and Neutrophil-Lymphocyte Ratio as predictors of clinical severity of COVID-19. Arch Pub Health [Internet]. 2021 Nov. 20 [cited 2023 Dec. 9];13(2):130-43. Available from: https://www.id-press.eu/aph/article/view/6006

Copyright (c) 2021 Stefan Pandilov, Suzana Klenkoski, Elena Jovanovska Janeva, Gazmend Mehmeti, Dragan Mijakoski, Sasho Stoleski, Hristian Duma, Dejan Dokic

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

COVID-19 is an infectious disease that can manifest quite differently. In this study we examined the relationship between the value of serum CRP(C-reactive protein) andneutrophil-lymphocyte ratio (NLR) as predictor factors for the development of a severe clinical manifestation in COVID19 patients. Materials and methods: We followed 95 COVID-19 positive patients who were hospitalized at the University Clinic for Eye Diseases - COVID Center. We analyzed the initial laboratory parameters of white blood cells and CRP on admission of the patients and the results of laboratory analyses performed before they left the Clinic, or the last parameters before the lethal outcome in those patients who died. Several models of logistic regression were tested to analyze the predictive value of these markers of inflammation for lethal outcome in patients hospitalized for COVID-19. Results: Bivariate analysis demonstrated that the length of hospital stay was significantly shorter in patients with lethal outcome (p=0.001). The NLR was significantly higher in patients with lethal outcome at both times (p=0.005; and p=0.017). Leukocyte’s count (p=0.046, and p<0.001) and CRP (p=0.013,and p=0.005) were also significantly higher in patients with lethal outcome at both times. The increase on the NLR scale both at hospitalization and at discharge (or the last analysis before death) leads to increase in the odds of lethal outcome (T1:40.4% increased odds; T2:36% increased odds). Conclusion: CRP and NLR are laboratory parameters that can predict the severity of the clinical manifestation in patients with COVID-19.

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