Neutrophil-to-lymphocyte ratio is elevated in acute hantavirus infection and correlates with markers of disease severity

Abstract 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-mediated effects. The neutrophil-to-lymphocyte ratio (NLR) is a mark...

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Main Authors: Nußhag, Christian (Author) , Gruber, Gefion (Author) , Zeier, Martin (Author) , Krautkrämer, Ellen (Author)
Format: Article (Journal)
Language:English
Published: 20 June 2024
In: Journal of medical virology
Year: 2024, Volume: 96, Issue: 6, Pages: 1-7
ISSN:1096-9071
DOI:10.1002/jmv.29759
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1002/jmv.29759
Verlag, kostenfrei, Volltext: https://onlinelibrary.wiley.com/doi/10.1002/jmv.29759
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Author Notes:Christian Nusshag, Gefion Gruber, Martin Zeier, Ellen Krautkrämer
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Summary:Abstract 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-mediated effects. The neutrophil-to-lymphocyte 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 (NLRadm: median 3.82, range 1.75?7.59), which increased during acute HFRS. Maximum NLR levels (NLRmax: median 4.19, range 1.75?13.16) were 2.38-fold 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-reactive 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 NLRmax, but not with NLRadm. 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.
Item Description:Gesehen am 04.12.2024
Physical Description:Online Resource
ISSN:1096-9071
DOI:10.1002/jmv.29759