2519. The prognostic significance of neutrophil-to-lymphocyte ratio in patients with Crimean-Congo Haemorrhagic Fever
Session: Poster Abstract Session: Virology Potpourri
Saturday, October 6, 2018
Room: S Poster Hall
Posters
  • KKKA-poster.jpg (849.8 kB)
  • Background: The neutrophil-to-lymphocyte ratio (NLR) has been shown to be associated with poor prognosis in both malign and benign disorders. However, the studies regarding NLR as a prognostic marker in Crimean-Congo haemorrhagic fever (CCHF) are limited. This study aimed to investigate the relationship between NLR and survival outcome in patients with CCHF.

    Methods: The demographic and laboratory characteristics of 723 adult patients having a positive IgM and/or a positive PCR result for CCHF in the blood sample between 2007 and 2017 were reviewed. The patients were divided into two groups according to survival and fatal outcome. The area under an ROC curve was calculated to evaluate the relationship between NLR and survival outcome. The statistical significance was set at p<0.05.

    Results: Plasma NLR, creatinine, AST, ALT, LDH and CK levels in fatal cases were significantly higher than those in survival ones (p<0.001 for all parameters), while platelet count was significantly lower (p<0.001). All population were re-evaluated according to NLR. Plasma ALT, AST, LDH, CK, and creatinine levels when NLR was ≤ 2 were significantly lower than those when NLR was > 2 (p=0.006, p= 0.017, p<0.001, p<0.001, and p<0.001, respectively) (Table 1). The area under an ROC curve for NLR was 72% (p<0.001).

    Table1: Demographic and laboratory characteristics in the patients with Crimean-Congo haemorrhagic fever

    Characteristics

    Survival patients

    (n=693)

    Fatal

    patients

    (n=30)

    p-value

    NLR ≤ 2

    (n=384)

    NLR > 2

    (n=339)

    p-value

    Age (%)

    49.1 (17.5)

    64.6 (14.3)

    0.001

    48.6 (17.0)

    51 (18.3)

    0.080

    Gender (% Female)

    46.6

    40

    0.477

    51.3

    40.7

    0.004

    Platelet count, (×103 platelets/mm3)

    49.8 (35.4)

    17.8 (7.5)

    0.001

    49.9 (33.7)

    46.7 (36.9)

    0.032

    ALT (U/l)

    230.2 (429.4)

    1386 (1295.6)

    0.001

    225.3(320.5)

    338.1(715.5)

    0.006

    AST (U/l)

    387.7 (529.1)

    3327.1(3478.8)

    0.001

    406.7(801.2)

    626.4(1262.3)

    0.017

    LDH (U/l)

    857.3(1049.9)

    5385.1(5404.3)

    0.001

    813.4(972.3)

    1307.6(2303.4)

    0.001

    CK (U/l)

    850.0(1173.3)

    3171.5(5353.2)

    0.001

    743.5(1023.3)

    1176.2(2109.3)

    0.001

    Creatinine (mg/dl)

    0.9 (0.5)

    2.7 (2.5)

    0.001

    0.9 (0.6)

    1,1 (0.9)

    0.001

    NLR

    2.9 (3.5)

    4.5 (3.3)

    0.001

    Dead (%)

    1.6

    7.1

    0.001

    Conclusion:

    NLR for clinicians may be an additional test as useful as platelet count and plasma creatinine, AST, ALT, LDH and CK levels. Our study shows that NLR might be used as a prognostic marker to predict the severity of the disease in CCHF.

    Kemalettin Ozden, Professor1, Ayse Albayrak, Associate professor2, Zulal Ozkurt, Professor2, Fuat Erdem, Professor3 and Mehmet Parlak, Professor2, (1)Department of Infectious Diseases and Clinical Microbiology, Ataturk University Faculty of Medicine, Erzurum, Turkey, (2)Department of Infectious Diseases and Clinical Microbiology, Erzurum, Turkey, (3)Department of Haematology, Ataturk University Faculty of Medicine, Erzurum, Turkey

    Disclosures:

    K. Ozden, None

    A. Albayrak, None

    Z. Ozkurt, None

    F. Erdem, None

    M. Parlak, None

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