{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T18:22:05Z","timestamp":1787422925347,"version":"build-2736575974"},"reference-count":35,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"unspecified","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"the National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["no. 81370119"],"award-info":[{"award-number":["no. 81370119"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"the China International Medical Foundation","award":["Z-2014-08-2209"],"award-info":[{"award-number":["Z-2014-08-2209"]}]},{"name":"the Zhenjiang Science and Technology Innovation Fund","award":["SH2023082"],"award-info":[{"award-number":["SH2023082"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,6,28]]},"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The novel COVID-19 was rapidly spreading and was highly contagious. COVID-19 caused over 6\u2009million deaths worldwide, with high mortality rates, particularly in severe cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to investigate whether serum albumin-neutrophil count to lymphocyte count ratio (NLR) score (ANS) could be used as a prognostic indicator of COVID-19 severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A retrospective study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Based on the WHO diagnostic criteria, patients were classified as either non-severe (n=270) or severe (n=100).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>NLR, serum albumin level and ANS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main results<\/jats:title>\n                    <jats:p>The NLR of patients with severe disease was significantly higher than that of those with non-severe disease. Serum albumin levels were significantly lower in patients with severe disease than in those with non-severe disease. The cut-off values representing the maximum potential effectiveness of serum albumin and NLR were 33.5\u2009g\/L and 8.25, respectively, according to the Youden index. In patients with severe COVID-19, we observed that the serum albumin level, NLR and ANS were independent prognostic indicators of severe COVID-19 using logistic analysis. The relative risk of severe COVID-19 was 7.65 (95% CI 3.72 to 15.75, p&lt;0.05) in the ANS 2 group compared with that in ANS 0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ANS could be used as a prognostic indicator of COVID-19 severity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-081627","type":"journal-article","created":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T14:16:17Z","timestamp":1721225777000},"page":"e081627","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Biomarker of severity in hospitalised patients with COVID-19: a retrospective study"],"prefix":"10.1136","volume":"14","author":[{"given":"Fen-Hong","family":"Qian","sequence":"first","affiliation":[{"name":"Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, 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