European Journal of Cardiovascular Medicine

Background: Inflammation plays an important role in development and progression of the COVID 19 disease. Among all inflammatory markers, IL6 is a good predictor for symptomatic cases. But it is time-consuming, less cost-effective that cannot be done in low resource constraint setting.  So, we want to search another equally effective inflammatory biomarker that can be done in low resource setting. NLR and d-NLR are inflammatory parameters, we estimate association of NLR and d-NLR with disease severity and mortality. Methods: 150 COVID-19 patients aging between 18 and 45 years and 150 age and sex matched apparently healthy people were included. Then case group participants are subdivided into three sub-groups according to disease severity. Thereafter, all of the patients and healthy persons were subjected to the estimation of serum IL-6 and find out NLR and d-NLR. Results: It was found that the mean NLR d-NLR and IL6 were increased with disease severity. Then Pairwise multiple comparison in the post hoc ANOVA analysis with Bonferroni correction within the case group was performed and it became evident that IL6 concentration and NLR were significantly increased. It also found that IL6 and NLR were well correlated with disease severity. Then Pearson correlation was done and it was shown that IL6 with NLR and d-NLR are well correlated with disease severity. Then to determine the diagnostic value of the NLR for COVID 19 ROC curve and logistic regression analysis were performed and found that NLR of 5.89 and d-NLR 2.78 were demonstrated as the optimal cut-off value as a predictor of disease severity and 9.48 was disease mortality. Conclusion: NLR and d-NLR equally effective like IL6 for disease severity, prognosis and mortality from COVID-19.  They can be done in primary health care level as they are cheap, easily available.