Prognostic Value of C-Reactive Protein to Lymphocyte Ratio (CLR) in Emergency Department Patients with SARS-CoV-2 Infection

• Published in: Journal of personalized medicine 2021-12, Vol.11 (12), p.1274
• Main Authors: Tonduangu, Ndenga, Le Borgne, Pierrick, Lefebvre, François, Alame, Karine, Bérard, Lise, Gottwalles, Yannick, Cipolat, Lauriane, Gennai, Stéphane, Bilbault, Pascal, Lavoignet, Charles-Eric, Abensur Vuillaume, Laure
• Format: Article
• Language: English
• Subjects: Adaptive immunology; Biomarkers; C-reactive protein; Coronaviruses; COVID-19; Emergency medical care; Emerging diseases; Human health and pathology; Immunology; Infectious diseases; Inflammation; Life Sciences; Lymphocytes; Mortality; Multivariate analysis; Patients; Precision medicine; Severe acute respiratory syndrome coronavirus 2
• ISSN: 2075-4426; 2075-4426
• DOI: 10.3390/jpm11121274

(1) Introduction: According to recent studies, the ratio of C-reactive-protein to lymphocyte is more sensitive and specific than other biomarkers associated to systemic inflammatory processes. This study aimed to determine the prognostic value of CLR on COVID-19 severity and mortality at emergency department (ED) admission. (2) Methods: Between 1 March and 30 April 2020, we carried out a multicenter and retrospective study in six major hospitals of northeast France. The cohort was composed of patients hospitalized for a confirmed diagnosis of moderate to severe COVID-19. (3) Results: A total of 1,035 patients were included in this study. Factors associated with infection severity were the CLR (OR: 1.001, CI 95%: (1.000-1.002), = 0.012), and the lymphocyte level (OR: 1.951, CI 95%: (1.024-3.717), = 0.042). In multivariate analysis, the only biochemical factor significantly associated with mortality was lymphocyte rate (OR: 2.308, CI 95%: (1.286-4.141), = 0.005). The best threshold of CLR to predict the severity of infection was 78.3 (sensitivity 79%; specificity 47%), and to predict mortality, was 159.5 (sensitivity 48%; specificity 70%). (4) Conclusion: The CLR at admission to the ED could be a helpful prognostic biomarker in the early screening and prediction of the severity and mortality associated with SARS-CoV-2 infection.