{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T16:23:51Z","timestamp":1781886231432,"version":"3.54.5"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"the Mexican National Research Council","award":["313494"],"award-info":[{"award-number":["313494"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Monocytes are pivotal during inflammation. Sepsis added to COVID-19 increases mortality and inflammation. However, the role of monocytes in this condition is unclear. Our aim was to determine monocyte frequencies and HLA-DR expression related to size distribution in patients with severe COVID-19 with or without sepsis. Twenty-nine patients with COVID-19, 9 patients with COVID-19 + sepsis, and 11 non-COVID nonseptic volunteers were recruited. Patients with COVID-19 + sepsis had increased monocyte count (P = 0.004) and monocyte-to-lymphocyte ratio (MLR, P = 0.01) prior to bacterial sepsis development. The monocyte-to-lymphocyte ratio had an area under the curve of 77.8%, suggesting its potential utility in predicting bacterial sepsis up to 21 d before positive culture. In these patients, smaller intermediate and nonclassical monocytes expressed higher levels of HLA-DR (P &amp;lt; 0.05). Diminished HLA-DR expression in bigger monocytes was associated with an increase in severity and inflammatory markers (r2 values equal to or higher than \u00b10.4, P &amp;lt; 0.05). Our results suggest that the monocyte-to-lymphocyte ratio could be a potential early marker for bacterial sepsis development in patients with severe COVID-19.<\/jats:p>","DOI":"10.1093\/jleuko\/qiaf064","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T07:54:28Z","timestamp":1751356468000},"source":"Crossref","is-referenced-by-count":3,"title":["Early increased monocyte-to-lymphocyte ratio as a potential biomarker of bacterial sepsis in patients with severe COVID-19"],"prefix":"10.1093","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2585-7361","authenticated-orcid":false,"given":"Edna","family":"Basilio-G\u00e1lvez","sequence":"first","affiliation":[{"name":"Medical Research Unit in Immunochemistry, UMAE Specialty Hospital of the National Medical Center \u201cSiglo XXI,\u201d Mexican Institute of Social Security , CDMX , , CP 06720","place":["Mexico"]},{"name":"National School of Biological Sciences, National Polytechnic Institute 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