{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T22:56:16Z","timestamp":1793055376927,"version":"4.5.0"},"reference-count":49,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T00:00:00Z","timestamp":1718841600000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Pathogenic Eurasian hantaviruses cause hemorrhagic fever with renal syndrome (HFRS), which is characterized by acute kidney injury. The clinical course shows a broad range of severity and is influenced by direct and immune\u2010mediated effects. The neutrophil\u2010to\u2010lymphocyte ratio (NLR) is a marker of systemic inflammation and predicts severity and outcome in various diseases. Therefore, we examined the role of NLR in HFRS caused by hantavirus Puumala (PUUV) and its association with disease severity and kidney injury. We detected elevated NLR levels on admission (NLR\n                    <jats:sub>adm<\/jats:sub>\n                    : median 3.82, range 1.75\u22127.59), which increased during acute HFRS. Maximum NLR levels (NLR\n                    <jats:sub>max<\/jats:sub>\n                    : median 4.19, range 1.75\u221213.16) were 2.38\u2010fold higher compared to the reference NLR level of 1.76 in the general population. NLR levels on admission correlate with markers of severity (length of hospital stay, serum creatinine) but not with other markers of severity (leukocytes, platelets, C\u2010reactive protein, lactate dehydrogenase, serum albumin, proteinuria). Interestingly, levels of nephrin, which is a specific marker of podocyte damage in kidney injury, are highest on admission and correlate with NLR\n                    <jats:sub>max<\/jats:sub>\n                    , but not with NLR\n                    <jats:sub>adm<\/jats:sub>\n                    . Together, we observed a correlation between systemic inflammation and the severity of HFRS, but our results also revealed that podocyte damage precedes these inflammatory processes.\n                  <\/jats:p>","DOI":"10.1002\/jmv.29759","type":"journal-article","created":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T04:18:37Z","timestamp":1718857117000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Neutrophil\u2010to\u2010lymphocyte ratio is elevated in acute hantavirus infection and correlates with markers of disease severity"],"prefix":"10.1002","volume":"96","author":[{"given":"Christian","family":"Nusshag","sequence":"first","affiliation":[{"name":"Department of Nephrology University of Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gefion","family":"Gruber","sequence":"additional","affiliation":[{"name":"Department of Nephrology University of Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Zeier","sequence":"additional","affiliation":[{"name":"Department of Nephrology University of Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Krautkr\u00e4mer","sequence":"additional","affiliation":[{"name":"Department of Nephrology University of Heidelberg  Heidelberg 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