在过去三年中，由严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 引起的 2019 年冠状病毒病 (COVID-19) 产生了全球影响。 COVID-19 导致头颈鳞状细胞癌 (HNSCC) 的诊断和治疗延迟。癌症和 COVID-19 都会引发全身炎症反应，从而导致细胞因子风暴，从而创造支持肿瘤生长的有利肿瘤微环境。多项研究表明，中性粒细胞与淋巴细胞比率 (NLR) 的增加与 COVID-19 疾病严重程度之间存在正相关。研究还表明，高 NLR 与癌症患者的不良生存结果相关。我们的目的是调查 NLR 的增加是否与在术前受到 COVID-19 等感染影响的 HNSCC 患者的肿瘤快速进展有关。这是对计划接受手术的 HNSCC 患者的回顾性分析。接受过手术，并在 2021 年 4 月至 2021 年 5 月期间的术前期间感染了 COVID-19。该研究分析了 COVID 前后的 NLR 与 HNSCC 疾病进展的关系。 统计分析以四分位距表示并用百分比编号。使用社会科学统计包（Windows 版 IBM SPSS Statistics，IBM Corp.，版本 26.0，纽约州阿蒙克）进行分析。我们评估了 200 个可手术病例，其中 38/200 (20%) 的 HNSCC 患者是 COVID-19。 19 积极。在这些 COVID-19 阳性患者中，27/38 (71%) 的患者接受了手术。大约 11/38 (28.9%) 的患者无法手术。并且，14/27（53.8%）的手术患者也改变了治疗计划。从联合门诊治疗计划到手术日期的平均持续时间为25.18天。 感染了 COVID-19 并因疾病进展而改变治疗计划的患者的平均 NLR 值为 3.84（新冠肺炎前）和 11.11（新冠肺炎后），中位数分别为 3.04 和 10.50。这些差异显示统计显着性 p 值为 0.000。相比之下，治疗计划没有改变的患者的平均 NLR 值为 4.51（新冠肺炎前）和 9.70（新冠肺炎后），中位数分别为 3.47 和 3.42，结果 p 值为 0.082，不显着。这是一项独一无二的研究，评估了 NLR 升高在 COVID-19 病毒感染患者中的作用及其与疾病临床进展的关系。研究结果表明，HNSCC 患者 NLR 升高以及并发 SARS-CoV2 感染可能会加速疾病进展，增加肿瘤负荷和淋巴结转移。版权所有 © 2024，Sarkar 等人。

Over the last three years, the coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had a global impact. COVID-19 has led to diagnostic and treatment delays in head and neck squamous cell cancers (HNSCCs). Both cancer and COVID-19 trigger systemic inflammatory responses that can result in cytokine storms, creating a favorable tumor microenvironment that supports tumor growth. Various studies have shown a positive association between increasing neutrophil-to-lymphocyte ratio (NLR) and disease severity in COVID-19. Studies have also shown that high NLR is associated with poor survival outcomes in cancer patients. Our aim is to investigate whether an increased NLR is linked to rapid tumor progression in patients with HNSCC who have also been affected by infections like COVID-19 in the pre-operative period.This was a retrospective analysis of patients of HNSCC who were scheduled for surgery and had contracted COVID-19 in their pre-operative period between April 2021 and May 2021. The study analyzed pre- and post-COVID NLR in relation to disease progression in HNSCC. Statistical analysis was presented as an interquartile range and numbered with the percentage. Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 26.0, Armonk, NY) was utilized for the analysis.We evaluated 200 operable cases of which 38/200 (20%) patients with HNSCC were COVID-19 positive. Out of those COVID-19-positive patients, 27/38 (71%) patients got operated. Around, 11/38 (28.9%) patients were inoperable. And, 14/27 (53.8%) operated patients also had a change in treatment plan. The mean duration from the joint clinic treatment plan to the date of surgery was 25.18 days. Patients who had contracted COVID-19 and had a change in their treatment plan due to disease progression exhibited mean NLR values of 3.84 (pre-COVID) and 11.11 (post-COVID), with respective medians of 3.04 and 10.50. These differences showed a statistically significant p-value of 0.000. In contrast, patients who had no change in treatment plan displayed mean NLR values of 4.51 (pre-COVID) and 9.70 (post-COVID), with respective medians of 3.47 and 3.42, resulting in with a non-significant p-value of 0.082.This is a one-of-its-kind study that has evaluated the role of elevated NLR in patients with a COVID-19 virus infection and its relationship with the clinical progression of the disease. The findings suggest that elevated NLR in patients with HNSCC, along with concurrent SARS-CoV2 infection, may contribute to accelerated disease progression with an increase in tumor burden and nodal metastasis.Copyright © 2024, Sarkar et al.