Halmaciu Ioana, Arbănași Emil Marian, Kaller Réka, Mureșan Adrian Vasile, Arbănași Eliza Mihaela, Bacalbasa Nicolae, Suciu Bogdan Andrei, Cojocaru Ioana Iulia, Runcan Andreea Ioana, Grosu Florin, Vunvulea Vlad, Russu Eliza
Department of Radiology, Mureș County Emergency Hospital, 540136 Targu-Mures, Romania.
Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu-Mures, Romania.
Diagnostics (Basel). 2022 Aug 29;12(9):2089. doi: 10.3390/diagnostics12092089.
Background: Numerous tools, including inflammatory biomarkers and lung injury severity scores, have been evaluated as predictors of disease progression and the requirement for intensive therapy in COVID-19 patients. This study aims to verify the predictive role of inflammatory biomarkers [monocyte to lymphocyte ratio (MLR), neutrophil to lymphocyte ratio (NLR), systemic inflammatory index (SII), Systemic Inflammation Response Index (SIRI), Aggregate Index of Systemic Inflammation (AISI), and interleukin-6 (IL-6)] and the total system score (TSS) in the need for invasive mechanical ventilation (IMV) and mortality in COVID-19 patients. Methods: The present study was designed as an observational, analytical, retrospective cohort study and included all patients over 18 years of age with a diagnosis of COVID-19 pneumonia, confirmed through real time-polymerase chain reaction (RT-PCR) and radiological chest CT findings admitted to County Emergency Clinical Hospital of Targu-Mureș, Romania, and Modular Intensive Care Unit of UMFST “George Emil Palade” of Targu Mures, Romania between January 2021 and December 2021. Results: Non-Survivors patients were associated with higher age (p = 0.01), higher incidence of cardiac disease [atrial fibrillation (AF) p = 0.0008; chronic heart failure (CHF) p = 0.01], chronic kidney disease (CKD; p = 0.02), unvaccinated status (p = 0.001), and higher pulmonary parenchyma involvement (p < 0.0001). Multivariate analysis showed a high baseline value for MLR, NLR, SII, SIRI, AISI, IL-6, and TSS independent predictor of adverse outcomes for all recruited patients. Moreover, the presence of AF, CHF, CKD, and dyslipidemia were independent predictors of mortality. Furthermore, AF and dyslipidemia were independent predictors of IMV need. Conclusions: According to our findings, higher MLR, NLR, SII, SIRI, AISI, IL-6, and TSS values at admission strongly predict IMV requirement and mortality. Moreover, patients above 70 with AF, dyslipidemia, and unvaccinated status highly predicted IMV need and fatality. Likewise, CHF and CKD were independent predictors of increased mortality.
包括炎症生物标志物和肺损伤严重程度评分在内的众多工具已被评估为新冠肺炎患者疾病进展和强化治疗需求的预测指标。本研究旨在验证炎症生物标志物[单核细胞与淋巴细胞比值（MLR）、中性粒细胞与淋巴细胞比值（NLR）、全身炎症指数（SII）、全身炎症反应指数（SIRI）、全身炎症聚集指数（AISI）和白细胞介素-6（IL-6）]以及总系统评分（TSS）对新冠肺炎患者有创机械通气（IMV）需求和死亡率的预测作用。方法：本研究设计为一项观察性、分析性、回顾性队列研究，纳入了2021年1月至2021年12月期间在罗马尼亚特尔古穆列什县紧急临床医院和罗马尼亚特尔古穆列什“乔治·埃米尔·帕拉德”医科大学临床中心模块化重症监护病房收治的所有18岁以上经实时聚合酶链反应（RT-PCR）和胸部CT影像学检查确诊为新冠肺炎肺炎的患者。结果：非幸存者患者年龄较大（p = 0.01），心脏病发病率较高[心房颤动（AF）p = 0.0008；慢性心力衰竭（CHF）p = 0.01]，慢性肾脏病（CKD；p = 0.02），未接种疫苗状态（p = 0.001），以及肺实质受累程度较高（p < 0.0001）。多因素分析显示，MLR、NLR、SII、SIRI、AISI、IL-6和TSS的高基线值是所有纳入患者不良结局的独立预测指标。此外，AF、CHF、CKD和血脂异常的存在是死亡率的独立预测指标。此外，AF和血脂异常是IMV需求的独立预测指标。结论：根据我们的研究结果，入院时较高的MLR、NLR、SII、SIRI、AISI、IL-6和TSS值强烈预测IMV需求和死亡率。此外，70岁以上患有AF、血脂异常且未接种疫苗的患者高度预测IMV需求和死亡。同样，CHF和CKD是死亡率增加的独立预测指标。
