Moisa Emanuel, Corneci Dan, Negoita Silvius, Filimon Cristina Raluca, Serbu Andreea, Negutu Mihai Ionut, Grintescu Ioana Marina
Department of Anaesthesia and Intensive Care Medicine, Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Clinic of Anaesthesia and Intensive Care Medicine, Elias Emergency University Hospital, 011461 Bucharest, Romania.
Biomedicines. 2021 Nov 10;9(11):1656. doi: 10.3390/biomedicines9111656.
Hematological indices can predict disease severity, progression, and death in patients with coronavirus disease-19 (COVID-19).
To study the predictive value of the dynamic changes (first 48 h after ICU admission) of the following ratios: neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR), monocyte-to-lymphocyte (MLR), systemic inflammation index (SII), and derived neutrophil-to-lymphocyte (dNLR) for invasive mechanical ventilation (IMV) need and death in critically ill COVID-19 patients.
Observational, retrospective, and multicentric analysis on 272 patients with severe or critical COVID-19 from two tertiary centers. Hematological indices were adjusted for confounders through multivariate analysis using Cox regression.
Patients comprised 186 males and 86 females with no difference across groups ( > 0.05). ΔNLR > 2 had the best independent predictive value for IMV need (HR = 5.05 (95% CI, 3.06-8.33, < 0.0001)), followed by ΔSII > 340 (HR = 3.56, 95% CI 2.21-5.74, < 0.0001) and ΔdNLR > 1 (HR = 2.61, 95% CI 1.7-4.01, < 0.0001). Death was also best predicted by an NLR > 11 (HR = 2.25, 95% CI: 1.31-3.86, = 0.003) followed by dNLR > 6.93 (HR = 1.89, 95% CI: 1.2-2.98, = 0.005) and SII > 3700 (HR = 1.68, 95% CI: 1.13-2.49, = 0.01).
Dynamic changes of NLR, SII, and dNLR independently predict IMV need and death in critically ill COVID-19 patients.
血液学指标可预测冠状病毒病19（COVID-19）患者的疾病严重程度、进展及死亡情况。
研究以下比值（入住重症监护病房后最初48小时内）的动态变化：中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、单核细胞与淋巴细胞比值（MLR）、全身炎症指数（SII）以及衍生中性粒细胞与淋巴细胞比值（dNLR）对重症COVID-19患者有创机械通气（IMV）需求及死亡的预测价值。
对来自两个三级中心的272例重症或危重症COVID-19患者进行观察性、回顾性多中心分析。通过使用Cox回归的多变量分析对血液学指标的混杂因素进行校正。
患者包括186例男性和86例女性，各组间无差异（>0.05）。ΔNLR>2对IMV需求具有最佳的独立预测价值（HR = 5.05（95%CI，3.06 - 8.33，<0.0001）），其次是ΔSII>340（HR = 3.56，95%CI 2.21 - 5.74，<0.0001）和ΔdNLR>1（HR = 2.61，95%CI 1.7 - 4.01，<0.0001）。NLR>11对死亡的预测也最佳（HR = 2.25，95%CI：1.31 - 3.86，=0.003），其次是dNLR>6.93（HR = 1.89，95%CI：1.2 - 2.98，=0.005）和SII>3700（HR = 1.68，95%CI：1.13 - 2.49，=0.01）。
NLR、SII和dNLR的动态变化可独立预测重症COVID-19患者的IMV需求及死亡情况。
