The Diagnostic and Predictive Role of Neutrophil-Lymphocyte Ratio, Lymphocyte-Monocyte Ratio, Platelet-Lymphocyte Ratio and C-Reactive Protein in Diabetic and Nondiabetic COVID-19 Patients

Abstract

Background: Coronavirus disease 2019 (COVID-19) infection is more severe in diabetic cases due to abnormality in hematological and inflammatory markers. This study was conducted to determine the values of neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR) and C-reactive protein in COVID-19 diabetic and COVID-19 nondiabetic patients, with a specific focus on associating these markers with disease severity and mortality.

Methods: A descriptive study was done by collecting hematological and inflammatory laboratory parameters of COVID-19 diabetic patients (n = 123) and COVID-19 nondiabetic patients (n = 124) retrospectively at King Fahad Medical City, Saudi Arabia.

Results: Compared with nondiabetics, patients with diabetes were older, and their mean values of white blood cells (9.16; 8.22), monocytes (7.68; 7.08), and eosinophils were high (0.69; 0.26), and lymphocytes were low (17.65; 18.77). The NLR, LMR, PLR, C-reactive protein and D-dimer were higher, with statistical significance for NLR (P = 0.05) and PLR (P = 0.005). Diabetic COVID-19 cases had longer hospital stay (17 days), higher intensive care admissions (28.5%), and a higher mortality rate (11.4%). The percentage of diabetic COVID-19 patients with comorbidities was higher. Multinomial logistic regression analysis was performed controlling for age and sex, and we obtained odds ratio for several factors. The association for NLR, LMR, PLR and D-dimer with mortality and severity was not statistically significant.

Conclusions: The results obtained from this research identified that NLR, LMR, PLR, C-reactive protein, and D-dimer were higher in COVID-19 diabetic patients than COVID-19 nondiabetic patients.

J Endocrinol Metab. 2024;14(2):71-77
doi: https://doi.org/10.14740/jem934