Correlation between erythrocyte sedimentation rate and neutrophil/lymphocyte ratio in patients with subacute chikungunya
Keywords:
Chikungunya, erythrocyte sedimentation rate, neutrophil-to-lymphocyte ratio, biomarkers, inflammationAbstract
Introduction: The subacute phase of chikungunya lasts between 11 and 90 days is characterized by persistent arthralgias mediated by systemic inflammation. Erythrocyte sedimentation rate and neutrophil-to-lymphocyte ratio are accessible biomarkers, but their correlation in this phase is unknown.
Objective: To determine the correlation between erythrocyte sedimentation rate and neutrophil-to-lymphocyte ratio in patients with subacute chikungunya.
Methods: Analytical cross-sectional study in 175 patients (81.1 % female, mean age 58.4 ± 12.1 years) with confirmed subacute chikungunya. Spearman's correlation coefficient was calculated between the erythrocyte sedimentation rate calculated by the Westergren method and the neutrophil/lymphocyte index according to the absolute neutrophil/lymphocyte ratio. Stratified analysis by sex and skin color was performed, along with linear regression with logarithmic transformation.
Results: Mean Erythrocyte sedimentation rate was 32.8 ± 19.4 mm/h and mean NLR was 1.92 ± 0.68. A weak-to-moderate positive correlation was found (rho = 0.382; 95 % CI: 0.251-0.499; p < 0.001). Correlation was consistent in females (rho=0.367) and males (rho=0.428), as well as in white (rho=0.371) and mixed-race (rho=0.402) skin color groups. The regression model showed that erythrocyte sedimentation rate explains 14.5 % of neutrophil-to-lymphocyte ratio variability (R²=0.145).
Conclusions: In subacute chikungunya, erythrocyte sedimentation rate and neutrophil-to-lymphocyte ratio show a weak-to-moderate positive correlation, indicating they are complementary rather than interchangeable markers. Their combined use provides a more complete assessment of the systemic inflammatory state.
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Copyright (c) 2026 María Elena Corrales Vázquez, Yaneth Cristóbal Moraguez, Annabell Castro Turuseta, Dinorah Marisabel Prada Hernández, Jorge Alexis Gómez Morejón4, Silvia Maria Pozo Abreu, José Pedro Martínez Larrarte
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