Analysis of Coronavirus Disease 2019 Chest High-resolution Computed Tomography Manifestations between Groups with Different Neutrophil- to-Lymphocyte Ratios

Objective: This study aimed to investigate the correlation between the neutrophil-to-lymphocyte ratio (NLR) and chest high-resolution computed tomography (HRCT) findings of coronavirus disease 2019 (COVID-19). Materials and Methods: NLR and chest HRCT findings of 132 patients diagnosed with COVID-19 in the department of infectious diseases of Beijing Shijitan Hospital Capital Medical University from December 1, 2022 to February 1, 2023 were retrospectively analyzed. The patients were divided into two groups with NLR cut-off value of 3.0, and their HRCT characteristics and imaging manifestation patterns were analyzed. For the measurement data of normal distribution, the t-test of continuous variables was used between the groups. The data of non-normal distribution are expressed as median and quartile and compared using Mann-Whitney U test. The counting data are expressed as frequency, and the chi-squared or Fisher's exact test was used for comparison between the groups. P<0.05 indicates that the difference is statistically significant. Results: The number of lesions ≤5 and the proportion of lesions ≤10% were higher in the low NLR group than that in the high NLR group. The number of lesions >10 and the proportion of lesions >50% were higher in the high NLR group than that in the low NLR group. The high NLR group was prone to mixed density shadow, crazy-paving pattern, mosaic sign, anti-halo sign, subpleural black belt, arcade-like sign than that in the low NLR group. The high NLR group was most likely to have nonspecific interstitial pneumonia-like, organizing pneumonia-like, and diffuse alveolar damage-like patterns than that in the low NLR group. Conclusion: Different NLRs have different manifestations of COVID-19 chest HRCT. The high NLR group is more prone to mixed density shadow, crazy-paving pattern, mosaic sign, anti-halo sign, subpleural black belt, and arcade-like sign, as well as most likely to have radiologic patterns of nonspecific interstitial pneumonia, organizing pneumonia, diffuse alveolar damage.