A60-29 Neutrophil to Lymphocyte Ratio and Asthma Severity in Children With Asthma Presenting in a Nigerian Teaching Hospital

Rationale

The chronic airway inflammation of asthma is attributed to mast cell activation with resultant release of leukotrienes, histamines and other inflammatory products mediated by activated helper T-lymphocytes (Th2). Neutrophil to lymphocyte ratio (NLR) is an inflammatory marker which is easy to obtain, affordable and has been shown to aid in the risk stratification of patients with various diseases. We thus set out to ascertain the relationship between NLR and asthma severity in children with asthma, presenting at a tertiary hospital in Nigeria.

Methods

A total of 148 subjects aged six to seventeen years were consecutively recruited. Information regarding socio demographic variables, clinical profile of the patients including symptoms of asthma and medications used were obtained using an interviewer administered questionnaire. Asthma control and asthma severity were determined using standard methods NLR was calculated for all subjects and controls, following a complete blood count assay. Analysis was done using IBM Statistical Product and Service Solutions (IBM SPSS) software version 25. The specificity and sensitivity patterns, as well as the positive predictive value of NLR as a biomarker of asthma severity were evaluated. The level of significance at 95% confidence interval was p < 0.05.

Results

The mean age of children with Asthma(subjects) was 12.04 ± 3.48, while that of controls was 11.68 ± 3.78. The male to female ratio was 1.6:1. According to severity classification based on lowest level of control, 66.2% (49) of the asthmatics had mild asthma, 31.1% (23) had moderate and 2.7% (2) had severe asthma. The difference between NLR of children with asthma and control was not statistically significant. There was however, a statistically significant relationship between NLR and asthma severity, with patients that had severe asthma having very high NLR (p < 0.05). Based on the Area Under the Curve (AUC) and the Youden index of NLR, 0.77 and 0.54 respectively, the diagnostic accuracy of NLR as a biomarker able to predict asthma severity is good

Conclusion

High NLR is a reliable biomarker of asthma severity as NLR was significantly higher in those with severe compared to mild or moderate asthma. Although NLR may not be a useful diagnostic biomarker of childhood asthma since there is no significant difference in the NLR of children with asthma compared to non-asthmatic controls, elevated levels may be a reliable biomarker of asthma exacerbation in children.

This abstract is funded by: None