{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:41:25Z","timestamp":1790106085095,"version":"4.0.1"},"reference-count":39,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T00:00:00Z","timestamp":1695168000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Acute bronchiolitis is the most common cause of hospitalization in young children. Data on monocyte\u2010to\u2010lymphocyte\u2010ratio (MLR) and neutrophil\u2010to\u2010lymphocyte\u2010ratio (NLR) as biomarkers are limited. We aim to evaluate these ratios in children hospitalized with respiratory syncytial virus (RSV) bronchiolitis and their value as biomarkers for severe clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>A single\u2010center retrospective cohort study of children aged &lt;2 years hospitalized due to RSV bronchiolitis, between January 2018 and March 2022, with a complete blood count upon admission. We divided the cohort into quartiles based on MLR and NLR values. We examined associations between quartiles and four clinical severity outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 2038 children (median age: 4.4 months, IQR: 1.9\u22129.8) were included in the study. The median MLR and NLR values for quartiles 1\u22124 were 0.14, 0.22, 0.30, 0.47, and 0.37, 0.70, 1.16, 2.29, respectively. Children with higher MLR had higher hospitalization rates to the pediatric intensive care unit (PICU) (Q1 2.4%, Q4 9.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), extended hospital stays (Q1 19.4%, Q4 32%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), and lower minimal oxygen saturation (Q1 90%, Q4 87%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Cut\u2010off values of 0.34 for MLR and 0.67 for NLR optimally identified PICU admissions. In a model accounting for age and sex, the fourth MLR quartile had an RR of 3.4 (95% CI: 1.76\u22127.22) and successfully predicted PICU admissions (area under the curve\u2009=\u20090.73; 95% CI: 0.681\u22120.789).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MLR and NLR are potential biomarkers for identifying children with RSV bronchiolitis at a higher risk for severe outcomes, specifically PICU admission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.26687","type":"journal-article","created":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T07:40:53Z","timestamp":1695195653000},"page":"3530-3541","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Monocyte and neutrophil to lymphocyte ratios in hospitalized children with RSV bronchiolitis"],"prefix":"10.1002","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6926-8505","authenticated-orcid":false,"given":"Nitzan","family":"Burrack","sequence":"first","affiliation":[{"name":"Clinical Research Center Soroka University Medical Center Beer Sheva Israel"},{"name":"Faculty of Health Sciences Ben\u2010Gurion University of the Negev Beer\u2010Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0546-9548","authenticated-orcid":false,"given":"Assaf","family":"Adar","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences Ben\u2010Gurion University of the Negev Beer\u2010Sheva Israel"},{"name":"Department of Pediatrics Soroka University Medical Center Beer\u2010Sheva 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Center Beer Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6064-6909","authenticated-orcid":false,"given":"Itai","family":"Hazan","sequence":"additional","affiliation":[{"name":"Clinical Research Center Soroka University Medical Center Beer Sheva Israel"},{"name":"Faculty of Health Sciences Ben\u2010Gurion University of the Negev Beer\u2010Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6646-9061","authenticated-orcid":false,"given":"Amir","family":"Horev","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences Ben\u2010Gurion University of the Negev Beer\u2010Sheva Israel"},{"name":"Pediatric Dermatology Service Soroka University Medical Center Beer Sheva 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