The Neutrophil-to-Lymphocyte Ratio Determines Clinical Efficacy of Corticosteroid Therapy in Patients with COVID-19.

Journal Article (Journal Article)

Corticosteroid therapy is now recommended as a treatment in patients with severe COVID-19. But one key question is how to objectively identify severely ill patients who may benefit from such therapy. Here, we assigned 12,862 COVID-19 cases from 21 hospitals in Hubei Province equally to a training and a validation cohort. We found that a neutrophil-to-lymphocyte ratio (NLR) > 6.11 at admission discriminated a higher risk for mortality. Importantly, however, corticosteroid treatment in such individuals was associated with a lower risk of 60-day all-cause mortality. Conversely, in individuals with an NLR ≤ 6.11 or with type 2 diabetes, corticosteroid treatment was not associated with reduced mortality, but rather increased risks of hyperglycemia and infections. These results show that in the studied cohort corticosteroid treatment is associated with beneficial outcomes in a subset of COVID-19 patients who are non-diabetic and with severe symptoms as defined by NLR.

Full Text

Duke Authors

Cited Authors

  • Cai, J; Li, H; Zhang, C; Chen, Z; Liu, H; Lei, F; Qin, J-J; Liu, Y-M; Zhou, F; Song, X; Zhou, J; Zhao, Y-C; Wu, B; He, M; Yang, H; Zhu, L; Zhang, P; Ji, Y-X; Zhao, G-N; Lu, Z; Liu, L; Mao, W; Liao, X; Lu, H; Wang, D; Xia, X; Huang, X; Wei, X; Xia, J; Zhang, B-H; Yuan, Y; She, Z-G; Xu, Q; Ma, X; Wang, Y; Yang, J; Zhang, X; Zhang, X-J; Li, H

Published Date

  • February 2, 2021

Published In

Volume / Issue

  • 33 / 2

Start / End Page

  • 258 - 269.e3

PubMed ID

  • 33421384

Pubmed Central ID

  • PMC7832609

Electronic International Standard Serial Number (EISSN)

  • 1932-7420

Digital Object Identifier (DOI)

  • 10.1016/j.cmet.2021.01.002


  • eng

Conference Location

  • United States