Table 1_Association between the glucose-to-lymphocyte ratio and prognosis in COVID-19 patients.docx

All patients were followed up until the unified cutoff date of February 18, 2023, with all-cause mortality set as the primary endpoint. Two separate grouping methods were used: GLR stratification for evaluating its independent predictive ability, and severity grouping (mild-to-moderate vs severe) as clinical reference. The two groups only partially overlapped, so high GLR is not equivalent to severe illness.

Patients were stratified into high GLR and low GLR groups. Overall survival (OS) was estimated via the Kaplan-Meier method and compared using the log-rank test.</p>Results<p>Our findings revealed that GLR levels were significantly higher in severe patients than in mild-to-moderate patients. Meanwhile, beta2-microglobulin (β2-MG), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and interleukin-10 (IL-10) were significantly elevated in the high GLR group, whereas apolipoprotein A1 (ApoA1), CD3 absolute value, CD4 absolute value, and CD8 absolute value were significantly lower.

Furthermore, patients with high GLR levels exhibited significantly shorter OS (P < 0.0001). An elevated GLR level (> 14.42) was found to be an independent, adverse prognostic factor for OS in Omicron patients, according to multivariate Cox proportional hazards regression analysis (P = 0.003).</p>Conclusions<p>Our data confirmed that GLR levels at initial diagnosis were significantly correlated with disease severity and prognosis in patients with COVID-19.

As an easily calculated metabolic-immune indicator, GLR acts as a promising complementary candidate biomarker for mortality risk stratification in Omicron COVID-19 patients; further independent external validation is required before its routine clinical application.</p>