Jul 23, 2019

Yan Zhang,1 Pengfei Zou,2 Hainv Gao,2 Meifang Yang,1 Ping Yi,1 Jianhe Gan,3 Yinzhong Shen,4 Weihong Wang,5 Wenhong Zhang,6 Jun Li,7 Peng Liu,8 Lanjuan Li1 1The State Key Laboratory for Diagnosis and Treatment of Infectious Disease, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China; 2Department of Infectious Disease, Shulan Hospital, Hangzhou, Zhejiang Province, People’s Republic of China; 3Department of Infectious Disease, The First Affiliated Hospital, Medical College of Soochow University, Suzhou, Jiangsu Province, People’s Republic of China; 4Department of Infectious Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of China; 5Department of Infectious Disease, Central Hospital of Huzhou, Zhejiang, People’s Republic of China; 6Department of Infectious Disease, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China; 7Department of Infectious Disease, Jiangsu Province People’s Hospital, Jiangsu, People’s Republic of China; 8Department of Infectious Disease, Ningbo No.2 Hospital, Ningbo, Zhejiang Province, People’s Republic of China Background: Avian AIV-H7N9 influenza progresses rapidly and has a high fatality rate. However, it lacks an early effective biomarker to predict disease severity and fatal outcomes successfully. Our study aimed to explore whether the neutrophil-to-lymphocyte ratio (NLR) taken within 24 h after admission can predict disease severity and fatality in AIV-H7N9-infected patients. Methods: We retrospectively studied 237 AIV-H7N9-infected patients from multiple centers from 2013 to 2015. We used univariate analysis and multivariate analysis to compare clinical variables between the survival and fatal groups to evaluate the prognostic value. Results: The NLR taken within 24 h after admission in the fatal group was significantly higher than that in the survival group (P<0.01). Our study found that NLR was independently associated with fatality. The area under the curve (AUC) of the NLR was 0.70, and moreover, when the NLR =19.94, the specificity was 100%, and the sensitivity was 28.4%. The fatality in the NLR ≥19.94 group was significantly increased relative to the patients with an NLR <19.94 (P<0.05). Conclusion: The NLR is potentially a predictive prognostic biomarker in patients infected with the AIV-H7N9 influenza virus. Keywords: NLR (neutrophil-to-lymphocyte ratio), influenza A, AIV-H7N9, biomarker   This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License . By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms .