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Sex- and gender-specific differences in the inflammatory response to COVID-19: the role of the neutrophil-to-lymphocyte ratio
, 2, 3, 4, 56, 78, 9, 1011, 12, 13
Affiliations- Department of Clinical Research and Development, LUX MED Group, Warsaw, Poland
- Department of Public Health, International European University, Kyiv, Ukraine
- Department of Emergency Medicine, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Türkiye
- Department of Emergency Medicine, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Türkiye
- Department of Psychology, Faculty of Science and Letters, Ağrı İbrahim Çeçen University, Türkiye
- Graduate Studies and Research, Lebanese American University, Beirut, Lebanon
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine Houston, Houston, TX, USA
- Department of Clinical Research and Development, LUXMED Group, Warsaw, Poland
- Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
- Clalit Health Services, Akko, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics (LIAM), York University, Toronto, Canada
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Abstract
INTRODUCTION: The neutrophil-to-lymphocyte ratio (NLR) is a simple blood test marker used to predict the severity of COVID-19. The study aimed to describe the correlation between neutrophil–to–lymphocyte ratio sex- and gender-specific differences in the inflammatory response to COVID-19. MATERIAL AND METHODS: This retrospective observational study was conducted with patients diagnosed with COVID-19 in the emergency department of a tertiary hospital between January 1, 2022, and May 31, 2022. The receiver operating characteristic (ROC) area under the curve (AUC) analysis was conducted to verify NLR predictive capacity. RESULTS: The study population consisted of 47% women and 53% men with a mean age of 72.42 years. Women were significantly older than men on average. At admission, 73% of patients were classified as nonsevere, while 27% were severe. Overall, 63% of patients survived the infection. CONCLUSIONS: There were slight but not statistically significant differences in neutrophil counts between men and women. However, there were significant differences in lymphocyte counts and the NLR, with women having higher lymphocyte counts and men having higher NLR. The study found very weak correlations between age and neutrophil counts, lymphocyte counts, and NLR, suggesting no strong relationship between age and these variables. Patients with severe disease had higher neutrophil counts and NLR but lower lymphocyte counts compared to nonsevere patients. Survivors had lower neutrophil counts and NLR but higher lymphocyte counts compared to those who did not survive. NLR was a significant predictor of both admission status and survivor status, with ROC AUC values indicating its predictive capacity. These findings highlight the potential importance of NLR as a biomarker in predicting disease severity and survival in patients.
Abstract
INTRODUCTION: The neutrophil-to-lymphocyte ratio (NLR) is a simple blood test marker used to predict the severity of COVID-19. The study aimed to describe the correlation between neutrophil–to–lymphocyte ratio sex- and gender-specific differences in the inflammatory response to COVID-19. MATERIAL AND METHODS: This retrospective observational study was conducted with patients diagnosed with COVID-19 in the emergency department of a tertiary hospital between January 1, 2022, and May 31, 2022. The receiver operating characteristic (ROC) area under the curve (AUC) analysis was conducted to verify NLR predictive capacity. RESULTS: The study population consisted of 47% women and 53% men with a mean age of 72.42 years. Women were significantly older than men on average. At admission, 73% of patients were classified as nonsevere, while 27% were severe. Overall, 63% of patients survived the infection. CONCLUSIONS: There were slight but not statistically significant differences in neutrophil counts between men and women. However, there were significant differences in lymphocyte counts and the NLR, with women having higher lymphocyte counts and men having higher NLR. The study found very weak correlations between age and neutrophil counts, lymphocyte counts, and NLR, suggesting no strong relationship between age and these variables. Patients with severe disease had higher neutrophil counts and NLR but lower lymphocyte counts compared to nonsevere patients. Survivors had lower neutrophil counts and NLR but higher lymphocyte counts compared to those who did not survive. NLR was a significant predictor of both admission status and survivor status, with ROC AUC values indicating its predictive capacity. These findings highlight the potential importance of NLR as a biomarker in predicting disease severity and survival in patients.
Keywords
biomarkers; inflammation; immune system; COVID-19; sex- and gender-specific differences
About this articleTitle
Sex- and gender-specific differences in the inflammatory response to COVID-19: the role of the neutrophil-to-lymphocyte ratio
Journal
Disaster and Emergency Medicine Journal
Issue
Article type
Research paper
Pages
234-242
Published online
2023-12-12
Page views
368
Article views/downloads
144
DOI
Bibliographic record
Disaster Emerg Med J 2023;8(4):234-242.
Keywords
biomarkers
inflammation
immune system
COVID-19
sex- and gender-specific differences
Authors
Kacper Dziedzic
Michal Pruc
Mazlum Kilic
Rohat Ah
Murat Yildirim
Lukasz Szarpak
Kamil Safiejko
Rola Khamisy-Farah
Francesco Chirico
Nicola Luigi Bragazzi
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