The Lymphocyte/Neutrophil Ratio as a Prognostic Index for Short Term Outcome in the ICU Admitted COVID-19 Adult Patients

In December 2019,the COVID-19 virus has been mainly breaking out in Wuhan in China as pneumonia affecting patients . Common clinical features During hospitalization started to appear including acute respiratory infection , inflammatory reaction , fever, pneumonia, cough, fatigue , anosmia .

The patient known suspected if he has a clinical picture of viral pneumonia, exposure history, and radiographic findings [CT] or [MRI] chest consistent with COVID-19 pneumonia. the gold standard and the Final diagnosis (PCR) positivity for the presence of coronavirus .

The immune response to respiratory infection causes neutrophils to collect inside the lung especially the alveoli. Neutrophils aggregation may lead to collateral tissue damage and cytotoxicity. According to Previous studies apoptosis of lymphocytes occurred due to the release of anti-inflammatory cytokines resulting in lymphopenia. high levels of circulating neutrophils have been demonstrated in COVID-19 patients(

A lot of literatures and studies have demonstrated the value of what is called neutrophil/ lymphocyte ratio (LNR) as a simple prognostic ratio correlated to morbidity and mortality. Up to our knowledge, there is no study utilized such ratio in COVID-19 ICU admitted patients, so that, this study has been built

Inclusion criteria

• Adult patients (aged ≥18 years)
• Patients who need non-invasive ventilation (NIV or CPAP) or invasive ventilation (intubation)

Exclusion criteria

• Previous diagnosis of severe liver or kidney failure.
• Patients with Human Immunodeficiency Virus (HIV) infection.
• Patients with previous hematological diseases (Leukemia) that condition alterations in blood counts.
• Consumption of treatments with any type of immunosuppressants prior to admission that conditions low lymphocytes.
• Patients with bone marrow depression.