J Endocrinol Metab

Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc

Journal website https://www.jofem.org

Original Article

Volume 14, Number 2, April 2024, pages 71-77

The Diagnostic and Predictive Role of Neutrophil-Lymphocyte Ratio, Lymphocyte-Monocyte Ratio, Platelet-Lymphocyte Ratio and C-Reactive Protein in Diabetic and Nondiabetic COVID-19 Patients

**Table 1.** Demographic Features of Patients With COVID-19 Infection With Diabetes Mellitus (N = 123) and COVID-19 Infection Without Diabetes Mellitus (N = 124)
Characteristics	COVID-19 cases with type 2 diabetes (n = 123)	COVID-19 cases without type 2 diabetes (n = 124)	P value
*P < 0.05. COVID-19: coronavirus disease 2019; ICU: intensive care unit; LMWH: low-molecular-weight heparin.
Average age	61 years	50 years	< 0.0001*
Gender
Male	70 (56.9%)	97 (78.2%)	< 0.0001*
Female	53 (43.1%)	27 (21.8%)	< 0.0001*
Comorbidities	103 (83.7%)	45 (36.2%)	< 0.0001*
ICU admission	35 (28.5%)	30 (24.2%)	0.002*
Length of hospital stay (average days)	17 days	13 days	0.067
Mortality	14 (11.4%)	12 (9.7%)	< 0.0001*
LMWH given	113 (91.9%)	116 (93.5%)	0.045*

Table 1. Demographic Features of Patients With COVID-19 Infection With Diabetes Mellitus (N = 123) and COVID-19 Infection Without Diabetes Mellitus (N = 124)

Characteristics

COVID-19 cases with type 2 diabetes (n = 123)

COVID-19 cases without type 2 diabetes (n = 124)

P value

*P < 0.05. COVID-19: coronavirus disease 2019; ICU: intensive care unit; LMWH: low-molecular-weight heparin.

Average age

61 years

50 years

< 0.0001*

Gender

Male

70 (56.9%)

97 (78.2%)

< 0.0001*

Female

53 (43.1%)

27 (21.8%)

< 0.0001*

Comorbidities

103 (83.7%)

45 (36.2%)

< 0.0001*

ICU admission

35 (28.5%)

30 (24.2%)

0.002*

Length of hospital stay (average days)

17 days

13 days

0.067

Mortality

14 (11.4%)

12 (9.7%)

< 0.0001*

LMWH given

113 (91.9%)

116 (93.5%)

0.045*

**Table 2.** Lab Parameters of Patients With COVID-19 Infection With Diabetes Mellitus (N = 123) and COVID-19 Infection Without Diabetes Mellitus (N = 124)
Characteristics (reference range)	COVID-19 cases with type 2 diabetes (n = 123)	COVID-19 cases without type 2 diabetes (n = 124)	P value
*P < 0.05. COVID-19: coronavirus disease 2019; Hb: hemoglobin; WBC: white blood cell; NLR: neutrophil-lymphocyte ratio; LMR: lymphocyte-monocyte ratio; PLR: platelet-lymphocyte ratio.
Hb, g/dL (> 13 in males, > 12 in females)	13.02 (2.25)	13.76 (1.97)	0.079
WBC, × 10⁹ cells/L (4.5 - 11)	9.16 (8.51)	8.22 (5.04)	0.091
Neutrophils, × 10⁹ cells/L (2.0 - 8.0)	74.32 (13.02)	75.62 (15.79)	0.449
Lymphocytes, × 10⁹ cells/L (1.0 - 4.8)	17.65 (11.22)	18.77 (14.14)	0.097
Monocytes, × 10⁹ cells/L (0.30 - 0.90)	7.68 (13.93)	7.08 (7.72)	0.700
Eosinophils, × 10⁹ cells/L (- 0.5)	0.69 (1.92)	0.26 (0.550)	< 0.0001
Basophil count, × 10⁹ cells/L (0.02 - 0.05)	0.28 (0.274)	0.28 (0.243)	0.264
Platelets, × 10⁹ cells/L (150 - 400)	252.80 (96.64)	236.65 (98.17)	0.380
NLR (0.3 - 2.1)	7.36 (8.64)	6.40 (4.78)	0.052*
LMR (2.97 - 4.83)	3.76 (6.66)	3.41 (3.41)	0.258
PLR (36.63 - 172.68)	24.75 (30.82)	19.20 (15.55)	0.005*
D-dimer, mg/L (< 0.50)	3.24 (10.01)	2.96 (8.17)	0.571
C-reactive protein, mg/L (< 10)	117.35 (88.33)	108.19 (83.97)	0.207

Table 2. Lab Parameters of Patients With COVID-19 Infection With Diabetes Mellitus (N = 123) and COVID-19 Infection Without Diabetes Mellitus (N = 124)

Characteristics (reference range)

COVID-19 cases with type 2 diabetes (n = 123)

COVID-19 cases without type 2 diabetes (n = 124)

P value

*P < 0.05. COVID-19: coronavirus disease 2019; Hb: hemoglobin; WBC: white blood cell; NLR: neutrophil-lymphocyte ratio; LMR: lymphocyte-monocyte ratio; PLR: platelet-lymphocyte ratio.

Hb, g/dL (> 13 in males, > 12 in females)

13.02 (2.25)

13.76 (1.97)

0.079

WBC, × 10⁹ cells/L (4.5 - 11)

9.16 (8.51)

8.22 (5.04)

0.091

Neutrophils, × 10⁹ cells/L (2.0 - 8.0)

74.32 (13.02)

75.62 (15.79)

0.449

Lymphocytes, × 10⁹ cells/L (1.0 - 4.8)

17.65 (11.22)

18.77 (14.14)

0.097

Monocytes, × 10⁹ cells/L (0.30 - 0.90)

7.68 (13.93)

7.08 (7.72)

0.700

Eosinophils, × 10⁹ cells/L (- 0.5)

0.69 (1.92)

0.26 (0.550)

< 0.0001

Basophil count, × 10⁹ cells/L (0.02 - 0.05)

0.28 (0.274)

0.28 (0.243)

0.264

Platelets, × 10⁹ cells/L (150 - 400)

252.80 (96.64)

236.65 (98.17)

0.380

NLR (0.3 - 2.1)

7.36 (8.64)

6.40 (4.78)

0.052*

LMR (2.97 - 4.83)

3.76 (6.66)

3.41 (3.41)

0.258

PLR (36.63 - 172.68)

24.75 (30.82)

19.20 (15.55)

0.005*

D-dimer, mg/L (< 0.50)

3.24 (10.01)

2.96 (8.17)

0.571

C-reactive protein, mg/L (< 10)

117.35 (88.33)

108.19 (83.97)

0.207

**Table 3.** Multinomial Regression Analysis Controlling for Age and Sex to Know the Impact of Lab Parameters on COVID-19 Mortality
Variable	P value	OR (95% confidence interval)
*P < 0.05. COVID-19: coronavirus disease 2019; OR: odds ratio; NLR: neutrophil-lymphocyte ratio; LMR: lymphocyte-monocyte ratio; PLR: platelet-lymphocyte ratio.
NLR	0.967	1.003 (0.889 - 1.130)
LMR	0.223	1.047 (0.972 - 1.128)
PLR	0.087	1.030 (0.996 - 1.065)
D-dimer	0.078	0.961 (0.920 - 1.004)
C-reactive protein	0.048*	0.996 (0.992 - 1.000)

Table 3. Multinomial Regression Analysis Controlling for Age and Sex to Know the Impact of Lab Parameters on COVID-19 Mortality

Variable

P value

OR (95% confidence interval)

*P < 0.05. COVID-19: coronavirus disease 2019; OR: odds ratio; NLR: neutrophil-lymphocyte ratio; LMR: lymphocyte-monocyte ratio; PLR: platelet-lymphocyte ratio.

NLR

0.967

1.003 (0.889 - 1.130)

LMR

0.223

1.047 (0.972 - 1.128)

PLR

0.087

1.030 (0.996 - 1.065)

D-dimer

0.078

0.961 (0.920 - 1.004)

C-reactive protein

0.048*

0.996 (0.992 - 1.000)

**Table 4.** Multinomial Regression Analysis Controlling for Age and Sex to Know the Impact of Lab Parameters on COVID-19 Severity
Variable	P value	OR (95% confidence interval)
COVID-19: coronavirus disease 2019; OR: odds ratio; NLR: neutrophil-lymphocyte ratio; LMR: lymphocyte-monocyte ratio; PLR: platelet-lymphocyte ratio.
NLR	0.557	0.973 (0.889 - 1.065)
LMR	0.827	0.994 (0.939 - 1.052)
PLR	0.310	1.013 (0.988 - 1.038)
D-dimer	0.248	1.018 (0.988 - 1.050)
C-reactive protein	0.163	0.997 (0.993 - 1.001)

Table 4. Multinomial Regression Analysis Controlling for Age and Sex to Know the Impact of Lab Parameters on COVID-19 Severity

Variable

P value

OR (95% confidence interval)

COVID-19: coronavirus disease 2019; OR: odds ratio; NLR: neutrophil-lymphocyte ratio; LMR: lymphocyte-monocyte ratio; PLR: platelet-lymphocyte ratio.

NLR

0.557

0.973 (0.889 - 1.065)

LMR

0.827

0.994 (0.939 - 1.052)

PLR

0.310

1.013 (0.988 - 1.038)

D-dimer

0.248

1.018 (0.988 - 1.050)

C-reactive protein

0.163

0.997 (0.993 - 1.001)