Objective To investigate the clinical value of lymphocyte to monocyte ratio(LMR)and C-reactive protein to prealbumin ratio(CRP/PA)in predicting severe influenza A virus infection in infants.Methods Infants hospitalized in the Department of Pediatrics of Tai'an Women and Children Health Care Hospital with influenza A virus infection from January 2019 to December 2022,including a severe group(192 cases),a mild group(187 cases),and healthy controls(393 cases)were selected.Their blood routine,CRP and PA levels were detected and neutrophil to lymphocyte ratio(NLR),LMR,platelet to lymphocyte ratio(PLR),systemic immunoinflammatory index(SII),CRP/PA were calculated.Receiver operating characteristic(ROC)curve and Logistic regression were used to analyze the diagnostic and predictive value of LMR and CRP/PA for severe influenza A virus infection.Results Compared with control group and mild group,NLM,PLR,SII and CRP/PA in severe disease group were significantly increased,while LMR was significantly decreased(1.09,88.07,310.75,0.05 and 3.90,respectively,P＜0.05).Compared with the control group,the mild group exhibited a significant increase in CRP/PA and a significant decrease in LMR(0.04 and 6.31,respectively,P＜0.05).ROC curve showed that when diagnosing severe infections,CRP/PA had the highest specificity at 96.1％,and the sensitivity and area under ROC curve(AUC)of the combined detection of LMR and CRP/PA were superior to individual detections(88.5％and 0.941,respectively).Combined detection of LMR and CRP/PA for distinguishing between mild and severe infections showed higher sensitivity,specificity,and AUC compared to individual detections(76.4％,60.2％,and 0.707,respectively).After adjusting for age,sex,and NLM,PLR,and SII,the increased CRP/PA and decreased LMR were independently associated with influenza A virus infection and can distinguish between mild and severe cases.Conclusion The increase of CRP/PA and the decrease of LMR in infants infected with influenza A virus can also help to distinguish mild and severe cases,and can be used as an indicator to predict the severity of infection.The combined analysis of LMR,CRP/PA is of great value in the differential diagnosis of mild and severe infections.
lymphocyte to monocyte ratioC-reactive protein to prealbumin ratioinfluenza A virussevere infectioninfant
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