الفهرس 
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Abstract
O
ne of the emerging-rapidly spreading- leading causes of pneumonia worldwide is a novel Corona virus, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019.
End-Stage Renal Disease (ESRD) patients are at high risk for coronavirus Disease 2019 (COVID-19) associated morbidity and mortality.
Infection is the second leading cause of hospitalization and death of ESRD patients, and pneumonia consists 20% of infection. Nevertheless, patients on dialysis also have higher mortality rate and higher medical burden than non-dialysis individuals.
Given the immunocompromised nature of ESRD and their high comorbidity burden, patients with ESRD are among the most vulnerable populations to COVID-19 -especially given the impractical nature of social distancing rules for patients who need in-centre hemodialysis.
Traditional SARS-CoV-2 detection procedures, like those used for other types of viral infectious pneumonia, rely on genetic molecular assays (reverse-transcription polymerase chain reaction [rRT-PCR]), immunoassay, and computed tomography (CT).
While the majority of cases are asymptomatic or moderate, a considerable percentage of people develop severe disease, which is frequently accompanied by a hyper inflammatory state known as a cytokine storm.
Many deaths could be avoided if hypercytokinemia could be predicted quickly and accurately using precise biological markers. Thus, the use of these markers would allow for closer clinical monitoring and aggressive supportive treatment to avoid a poor prognosis.
The screening panel for hyper-inflammation includes a variety of inflammatory markers like elevated levels of D-Dimers, hyperferritinemia and serum IL-6 that are frequently in shortage in many laboratories unlike the routine complete blood count (CBC) test.
NLR quickly calculated from a routine CBC test is considered one of the inflammatory markers in COVID-19 disease.
This study was conducted to determine the significance of Neutrophil-to-Lymphocyte Ratio (NLR) as an inflammatory marker of COVID-19 in ESRD patients.
Our data revealed that a higher level of NLR in COVID-19 group with a cut off value of 5.26 and was the most specific (95.24%) and sensitive (76.19%) predictor of COVID-19 among other hematological parameters.
Also, NLR has a significant positive correlation with the mortality of the COVID-group.
Compared to the lymphocyte and neutrophil counts, NLR alone was positively correlated with the CRP in the COVID-group.
According to our data, NLR is a sensitive and specific predictor for COVID-19 disease and its mortality in ESRD patients.
Our data stated that the use of anticoagulation and antiviral significantly improve the outcome of the COVID-19 patients on maintenance hemodialysis.
Our study showed that COVID-19 ESRD patients had a significantly higher D dimer, LDH, CRP and hyperferritinemia than the non- COVID-19 ESRD patients.
The COVID-group in our study had significant hypoalbuminemia, anemia and reduced urea reduction rate (URR).