Neutrophil to lymphocyte ratio (NLR) in COVID-19: A cheap prognostic marker in a resource constraint setting

  • Kaleem Ullah Toori KRL Hospital
  • Muhammad Arsalan Qureshi KRL Hospital
  • Asma Chaudhry Southend University Hospital
  • Muhammad Farhan Safdar KRL Hospital
Keywords: COVID-19 RT-PCR, Neutrophil to lymphocyte ratio (NLR), Disease severity (asymptomatic, mild, moderate and severe), Mortality


Objectives: To identify association of neutrophil to lymphocyte ratio with disease severity and mortality.

Methods: Total 720 Corona Virus RT-PCR positive patients were included in this cross-sectional study. Patients were admitted to KRL Hospital Islamabad from April 2020 to August 2020. Neutrophil to lymphocyte ratio (NLR) was recorded on admission and then serially. NLR cut-off was 3.0. WHO categories for disease severity (asymptomatic, mild, moderate and severe) were used. Demographic profile, symptoms and co-morbidities were recorded.

Results: The mean age of patients was 40 ± 12.4 years with 96% being males. Majority patients (76.5%) were asymptomatic. Amongst symptoms, fever was the most common symptom. Diabetes mellitus was most common recorded co-morbidity. The mean NLR 2.5 ± 2.78. Significant association was found between NLR and disease severity as well as mortality. Difference in mean NLR amongst disease severity categories was also significant

Conclusion: Results are compatible with worldwide studies and NLR is a cheap and easily available marker of disease severity and mortality.


How to cite this:
Toori KU, Qureshi MA, Chaudhry A, Safdar MF. Neutrophil to lymphocyte ratio (NLR) in COVID-19: A cheap prognostic marker in a resource constraint setting. Pak J Med Sci. 2021;37(5):1435-1439. doi:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Author Biography

Kaleem Ullah Toori, KRL Hospital

Consultant Physician

How to Cite
Toori, K. U., Qureshi, M. A., Chaudhry, A., & Safdar, M. F. (2021). Neutrophil to lymphocyte ratio (NLR) in COVID-19: A cheap prognostic marker in a resource constraint setting. Pakistan Journal of Medical Sciences, 37(5).
Original Articles