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

Publication ,  Journal Article
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 ...
Published in: Cell Metab
February 2, 2021

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.

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Published In

Cell Metab

DOI

EISSN

1932-7420

Publication Date

February 2, 2021

Volume

33

Issue

2

Start / End Page

258 / 269.e3

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Severity of Illness Index
  • SARS-CoV-2
  • Risk Factors
  • ROC Curve
  • Proportional Hazards Models
  • Neutrophils
  • Lymphocytes
  • Length of Stay
 

Citation

APA
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ICMJE
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Cai, J., Li, H., Zhang, C., Chen, Z., Liu, H., Lei, F., … Zhang, X.-J. (2021). The Neutrophil-to-Lymphocyte Ratio Determines Clinical Efficacy of Corticosteroid Therapy in Patients with COVID-19. Cell Metab, 33(2), 258-269.e3. https://doi.org/10.1016/j.cmet.2021.01.002
Cai, Jingjing, Haomiao Li, Changjiang Zhang, Ze Chen, Hui Liu, Fang Lei, Juan-Juan Qin, et al. “The Neutrophil-to-Lymphocyte Ratio Determines Clinical Efficacy of Corticosteroid Therapy in Patients with COVID-19.Cell Metab 33, no. 2 (February 2, 2021): 258-269.e3. https://doi.org/10.1016/j.cmet.2021.01.002.
Cai J, Li H, Zhang C, Chen Z, Liu H, Lei F, et al. The Neutrophil-to-Lymphocyte Ratio Determines Clinical Efficacy of Corticosteroid Therapy in Patients with COVID-19. Cell Metab. 2021 Feb 2;33(2):258-269.e3.
Cai, Jingjing, et al. “The Neutrophil-to-Lymphocyte Ratio Determines Clinical Efficacy of Corticosteroid Therapy in Patients with COVID-19.Cell Metab, vol. 33, no. 2, Feb. 2021, pp. 258-269.e3. Pubmed, doi:10.1016/j.cmet.2021.01.002.
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. The Neutrophil-to-Lymphocyte Ratio Determines Clinical Efficacy of Corticosteroid Therapy in Patients with COVID-19. Cell Metab. 2021 Feb 2;33(2):258-269.e3.
Journal cover image

Published In

Cell Metab

DOI

EISSN

1932-7420

Publication Date

February 2, 2021

Volume

33

Issue

2

Start / End Page

258 / 269.e3

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Severity of Illness Index
  • SARS-CoV-2
  • Risk Factors
  • ROC Curve
  • Proportional Hazards Models
  • Neutrophils
  • Lymphocytes
  • Length of Stay