Chronic obstructive pulmonary disease (COPD) stands as one of the leading causes of mortality worldwide. Acute exacerbations of COPD (AECOPD) lead to rapid respiratory function decline and worsened disease status. Despite recent studies, the ability of the neutrophil-to-lymphocyte ratio (NLR) to predict outcomes in patients with COPD remains controversial. It remains controversial whether NLR can predict clinical outcomes in hospitalized patients with AECOPD. Therefore, this study was conducted to investigate the predictive value of NLR for severity, adverse outcomes in hospitalized patients with AECOPD, and predicting treatment response in patients with AECOPD

Chronic obstructive pulmonary disease (COPD) stands as one of the leading causes of mortality worldwide, posing an increasing economic burden. Acute exacerbations of COPD (AECOPD) are defined as acute deterioration of respiratory symptoms requiring additional treatment, leading to rapid respiratory function decline, diminished quality of life, and worsened disease status. Neutrophils are the most common type of white blood cells (WBC) and participate in multiple inflammatory and immune processes through phagocytosis and cytokine release. Lymphocytes play a crucial role as coordinators of the inflammatory and immune processes in various physiological mechanisms. The neutrophil-to-lymphocyte ratio (NLR) is calculated by dividing the number of neutrophils by the number of lymphocytes in the peripheral blood test, reflecting an increase in neutrophils and a secondary decrease in lymphocyte count during the inflammatory response. The NLR is considered a biological marker reflecting the inflammatory condition and is increasingly recognized in various disorders such as pneumonia, malignant, coronary artery disease, or hematological disorders.

Inclusion Criteria:

• Patients aged 18 and above, Patients who will be admitted at the Chest department, Ain-Shams University Hospitals, diagnosed with AECOPD based on the Global Initiative for Chronic Obstructive Lung Disease 2024 criteria

Exclusion Criteria:

• Patients who refused treatment.
• COPD patients with Malignancy, hematological disorders

Patients aged 18 and above Patients who will be admitted at Chest department, Ain-Shams University Hospitals diagnosed with AECOPD based on the global initiative for chronic obstructive lung disease 2024 criteria