Introduction The COVID-19 pandemic has highlighted the critical role of biological biomarkers in the prognostic assessment of hospitalized patients. D-dimers are among the most reliable prognostic biomarkers in COVID-19; however, their measurement may be difficult to access in resource-limited healthcare settings. Hematological ratios derived from the complete blood count—particularly the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR)—have been proposed as simple and cost-effective alternatives. Purpose To compare the prognostic value of hematological ratios (NLR, PLR, and LMR) with that of D-dimers for predicting COVID-19–related mortality in a resource-limited setting. Methods We conducted a retrospective cross-sectional study including patients hospitalized for COVID-19 at the Military Hospital of Camp Kokolo in Kinshasa (Democratic Republic of the Congo) between May 2020 and August 2021. A total of 480 hospitalized patients were included, among whom 76 deaths were recorded. Biological biomarkers measured at admission included D-dimers and the NLR, PLR, and LMR ratios. Discriminatory performance for mortality prediction was assessed using receiver operating characteristic (ROC) curve analysis, with calculation of the area under the curve (AUC) and 95% confidence intervals (CIs). Results D-dimers demonstrated excellent prognostic performance (AUC = 0.91; 95% CI 0.88, 0.94). In contrast, hematological ratios showed limited discriminatory ability: NLR (AUC = 0.58; 95% CI 0.43, 0.74), PLR (AUC = 0.39; 95% CI 0.20, 0.59), and LMR (AUC = 0.52; 95% CI 0.33, 0.72). Conclusion In this cohort, D-dimers were markedly superior to hematological ratios for predicting COVID-19–related mortality. Although readily accessible, NLR, PLR, and LMR demonstrated limited prognostic utility when used in isolation in resource-limited settings.
KASEKA et al. (Fri,) studied this question.