Clinical impact of monocyte distribution width and neutrophil-to-lymphocyte ratio for distinguishing COVID-19 and influenza from other upper respiratory tract infections: A pilot study

PLoS One. 2020 Nov 2;15(11):e0241262. doi: 10.1371/journal.pone.0241262. eCollection 2020.

Abstract

The coronavirus disease 2019 (COVID-19) has become a pandemic. Rapidly distinguishing COVID-19 from other respiratory infections is a challenge for first-line health care providers. This retrospective study was conducted at the Taipei Medical University Hospital, Taiwan. Patients who visited the outdoor epidemic prevention screening station for respiratory infection from February 19 to April 30, 2020, were evaluated for blood biomarkers to distinguish COVID-19 from other respiratory infections. Monocyte distribution width (MDW) ≥ 20 (odds ratio [OR]: 8.39, p = 0.0110, area under curve [AUC]: 0.703) and neutrophil-to-lymphocyte ratio (NLR) < 3.2 (OR: 4.23, p = 0.0494, AUC: 0.673) could independently distinguish COVID-19 from common upper respiratory tract infections (URIs). Combining MDW ≥ 20 and NLR < 3.2 was more efficient in identifying COVID-19 (AUC: 0.840). Moreover, MDW ≥ 20 and NLR > 5 effectively identified influenza infection (AUC: 0.7055). Thus, MDW and NLR can distinguish COVID-19 from influenza and URIs.

MeSH terms

  • Area Under Curve
  • Biomarkers / metabolism
  • COVID-19
  • Coronavirus Infections / immunology
  • Coronavirus Infections / pathology*
  • Female
  • Humans
  • Influenza, Human / immunology
  • Influenza, Human / pathology*
  • Lymphocytes / cytology*
  • Lymphocytes / metabolism
  • Male
  • Monocytes / cytology*
  • Monocytes / metabolism
  • Neutrophils / cytology*
  • Neutrophils / metabolism
  • Odds Ratio
  • Pandemics
  • Pilot Projects
  • Pneumonia, Viral / immunology
  • Pneumonia, Viral / pathology*
  • ROC Curve
  • Respiratory Tract Infections / immunology
  • Respiratory Tract Infections / pathology

Substances

  • Biomarkers

Grants and funding

The author(s) received no specific funding for this work.