Neutrophil-to-Lymphocyte and Fibrinogen-to-Albumin Ratios are Important Indicators of Mortality in Patients with Coronavirus Disease 2019

Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a pandemic. Early diagnosis of complications and mortality caused by this disease will guide the treatment process in patients with COVID-19. Materials and methods: In total, 102 adult patients (≥18 years) who were followed up in the intensive care unit (ICU) between May and August 2020 because of COVID-19 were included in this study. Demographic data, comorbid diseases, and hematological parameters of the patients during admission to the ICU were examined. Hematological parameters such as leukocyte, neutrophil, lymphocyte, platelet counts, C-reactive protein (CRP), D-dimer, and lactate data were recorded. Neutrophil-to-lymphocyte ratio (NLR) and fibrinogen-to-albumin ratio (FAR) were calculated, and their effects on mortality were examined. Results: Of the patients, 71 (69.6%) were male and the mean age of all patients was 69.1 ± 14.3 (24–103) years. Comorbid diseases of the patients were as follows: hypertension, 40 (39.2%) patients; diabetes mellitus, 28 (27.4%); chronic obstructive pulmonary disease, 20 (19.6%); coronary artery disease, 14 (13.7%), heart failure, 4 (3.9%), and cerebrovascular disease, 3 (2.9%). Results showed that mortality was higher in patients with older age (median age = 72; range = 62–80 years), and bilateral infiltration was observed in lung computed tomography of all patients who died. Mortality was higher in patients with NLR > 9.16, FAR > 0.15, D-dimer > 2.01 mg/L, CRP > 11.6 mg/dL, lactate > 2.3 mmol/L. Conclusion: During the hospitalization of patients with COVID-19 to the ICU, neutrophilia, lymphopenia, hyperfibrinogenemia, high NLR, FAR, D-dimer, CRP, and lactate levels were found to be associated with mortality. Keywords: COVID-19; D-dimer; fibrinogen-to-albumin ratio; mortality factors; neutrophil-to-lymphocyte ratio