Liu, A;
Hammond, R;
Chan, K;
Chukwuenweniwe, C;
Johnson, R;
Khair, D;
Duck, E;
Olubodun, O;
Barwick, K;
Banya, W;
et al.
Liu, A; Hammond, R; Chan, K; Chukwuenweniwe, C; Johnson, R; Khair, D; Duck, E; Olubodun, O; Barwick, K; Banya, W; Stirrup, J; Donnelly, PD; Kaski, JC; Coates, ARM
(2023)
Characterisation of Ferritin-Lymphocyte Ratio in COVID-19.
Biomedicines, 11 (10).
p. 2819.
ISSN 2227-9059
https://doi.org/10.3390/biomedicines11102819
SGUL Authors: Coates, Anthony Robert Milnes
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Abstract
Introduction: The ferritin-lymphocyte ratio (FLR) is a novel inflammatory biomarker for the assessment of acute COVID-19 patients. However, the prognostic value of FLR for predicting adverse clinical outcomes in COVID-19 remains unclear, which hinders its clinical translation. Methods: We characterised the prognostic value of FLR in COVID-19 patients, as compared to established inflammatory markers. Results: In 217 study patients (69 years [IQR: 55-82]; 60% males), FLR was weakly correlated with CRP (R = 0.108, p = 0.115) and white cell count (R = -0.144; p = 0.034). On ROC analysis, an FLR cut-off of 286 achieved a sensitivity of 86% and a specificity of 30% for predicting inpatient mortality (AUC 0.60, 95% CI: 0.53-0.67). The negative predictive values of FLR for ruling out mortality, non-invasive ventilation requirement and critical illness (intubation and/or ICU admission) were 86%, 85% and 93%, respectively. FLR performed similarly to CRP (AUC 0.60 vs. 0.64; p = 0.375) for predicting mortality, but worse than CRP for predicting non-fatal outcomes (all p < 0.05). On Kaplan-Meier analysis, COVID-19 patients with FLR values > 286 had worse inpatient survival than patients with FLR ≤ 286, p = 0.041. Conclusions: FLR has prognostic value in COVID-19 patients, and appears unrelated to other inflammatory markers such as CRP and WCC. FLR exhibits high sensitivity and negative predictive values for adverse clinical outcomes in COVID-19, and may be a good "rule-out" test. Further work is needed to improve the sensitivity of FLR and validate its role in prospective studies for guiding clinical management.
Item Type: | Article |
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Additional Information: | Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
Keywords: | C-reactive protein, coronavirus disease 19, ferritin–lymphocyte ratio, inflammatory biomarkers, risk stratification, white cell count |
SGUL Research Institute / Research Centre: | Academic Structure > Infection and Immunity Research Institute (INII) |
Journal or Publication Title: | Biomedicines |
ISSN: | 2227-9059 |
Language: | eng |
Publisher License: | Creative Commons: Attribution 4.0 |
PubMed ID: | 37893192 |
Go to PubMed abstract | |
URI: | https://openaccess.sgul.ac.uk/id/eprint/115841 |
Publisher's version: | https://doi.org/10.3390/biomedicines11102819 |
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