Corticosteroid therapy is now recommended as a treatment in patients with severe COVID-19. But one key question is how to objectively identify severely ill patients who may benefit from such therapy. Here, we assigned 12,862 COVID-19 cases from 21 hospitals in Hubei Province equally to a training and a validation cohort. We found that a neutrophil-to-lymphocyte ratio (NLR) > 6.11 at admission discriminated a higher risk for mortality. Importantly, however, corticosteroid treatment in such individuals was associated with a lower risk of 60-day all-cause mortality. Conversely, in individuals with an NLR <= 6.11 or with type 2 diabetes, corticosteroid treatment was not associated with reduced mortality, but rather increased risks of hyperglycemia and infections. These results show that in the studied cohort corticosteroid treatment is associated with beneficial outcomes in a subset of COVID-19 patients who are non-diabetic and with severe symptoms as defined by NLR.
基金：
National Key Research & Development Program of China, China [2016YFF0101504, 2016YFF0101505, 2020YFC2004700, 2020YFC2004702, 2020YFC0845500]; Special Foundation for Emergency Research on Prevention and Control of COVID19 of Guangdong Province, China [2020B1111330003]; National Science Foundation of China, China [81630011, 81970364, 81970070, 81970011, 81770053, 81870171, 81700356, 81570412]; Hubei Science and Technology Support Project, China [2019BFC582, 2018BEC473]; Medical Flight Plan of Wuhan University, China [TFJH2018006]
第一作者单位：[1]Wuhan Univ, Renmin Hosp, Dept Cardiol, Wuhan, Peoples R China[4]Cent South Univ, Xiangya Hosp 3, Dept Cardiol, Changsha 410000, Peoples R China
通讯作者：
通讯机构：[1]Wuhan Univ, Renmin Hosp, Dept Cardiol, Wuhan, Peoples R China[2]Wuhan Univ, Sch Basic Med Sci, Wuhan, Peoples R China[3]Wuhan Univ, Inst Model Anim, Wuhan, Peoples R China[6]Wuhan Univ, Zhongnan Hosp, Med Sci Res Ctr, Wuhan, Peoples R China[14]Wuhan Univ, Wuhan Hosp 3, Dept Gastroenterol, Wuhan, Peoples R China[15]Wuhan Univ, Tongren Hosp, Wuhan, Peoples R China[22]Univ Calif Los Angeles, David Geffen Sch Med, Cardiovasc Res Labs, Dept Anesthesiol, Los Angeles, CA 90095 USA[23]Univ Calif Los Angeles, David Geffen Sch Med, Cardiovasc Res Labs, Dept Physiol & Med, Los Angeles, CA 90095 USA
推荐引用方式(GB/T 7714)：
Cai Jingjing,Li Haomiao,Zhang Changjiang,et al.The Neutrophil-to-Lymphocyte Ratio Determines Clinical Efficacy of Corticosteroid Therapy in Patients with COVID-19[J].CELL METABOLISM.2021,33(2):258-+.doi:10.1016/j.cmet.2021.01.002.
APA：
Cai, Jingjing,Li, Haomiao,Zhang, Changjiang,Chen, Ze,Liu, Hui...&Li, Hongliang.(2021).The Neutrophil-to-Lymphocyte Ratio Determines Clinical Efficacy of Corticosteroid Therapy in Patients with COVID-19.CELL METABOLISM,33,(2)
MLA：
Cai, Jingjing,et al."The Neutrophil-to-Lymphocyte Ratio Determines Clinical Efficacy of Corticosteroid Therapy in Patients with COVID-19".CELL METABOLISM 33..2(2021):258-+
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