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U-Shaped Association Between Baseline Neutrophil Count (bNC) And COVID-19-Related Mortality: A Retrospective Cohort Study in Chinese Patient Diagnosed with COVID-19 Infection
21 Pages Posted: 14 Apr 2020
More...Abstract
Background: Several descriptive studies have reported that higher neutrophil count (NC) may be correlated with poor prognosis in patients with confirmed COVID19 infection. However, the findings from these studies are limited by methodology and data analysis.
Methods: This study is a cohort study. We non-selectively and consecutively collected a total of 663 participants in a Chinese hospital from January 7, 2020 to February 28, 2020. Standardized and two-piecewise Cox regression model were employed to evaluated the association between baseline neutrophil count (bNC), NC change rate (NCR), and death.
Findings: bNC had a U-shaped association with death in patients with COVID19-related death. In the range of 0.1-1.64 (HR = 0.35, 95% CI = 0.16 to 0.79) and 4-32×10 9 /L of bNC (HR = 2.21, 95% CI = 1.02 to 4.79), the trends on bNC with mortality were opposite. By recursive algorithm, the bNC at which the risk of the death was lower was range of 1.64 to 4.0 ×10 9 /L. In addition, we find NCRs (NCR1 and NCR2) is not associated with covid19-related deaths.
Interpretation: Compared with NCR, bNC has the potential to be used for early risk stratification in patients with COVID19 infection. The relationship between bNC and mortality was U-shaped. The safe range of bNC was 1.64 to 4.0 ×10 9 /L. Identifying the correlation may be helpful for early risk stratification and medical decision making.
Funding Statement: This study was supported by the National Natural Science Foundation of China (Grants: 81671386 and 81974222).
Declaration of Interests: The authors declare no competing interests.
Ethics Approval Statement: The local ethics committee of the First People’s Hospital of JiangXia District approved this study. Informed consent of involving participants was not required because of the retrospective design of the study and the analysis used anonymous data.
Keywords: COVID-19; in-hospital mortality; Neutrophil
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