Kurtipek Ercan, Mermer Mehmet, Yıldırım Bilgenur, Yazar Mehmet Akif, Duran Mustafa, Duksal Faysal
Department of Chest Diseases, University of Health Sciences, Konya City Hospital, Karatay, Konya, Turkey.
Department of Anesthesiology and Reanimation, University of Health Sciences, Konya City Hospital, Karatay, Konya, Turkey.
Int J Gen Med. 2023 Mar 13;16:929-936. doi: 10.2147/IJGM.S406021. eCollection 2023.
Extensive research has been conducted to identify the predictive criteria for COVID-19 disease. White blood cell, C-reactive protein, CRP/albumin ratio, neutrophil-to-lymphocyte ratio and ferritin are among the indicators of increased inflammatory response; hence, they could be used to determine the prognosis of COVID-19 cases. Within the scope of this study, we aimed to elucidate the predictivity of NLR, CAR and other laboratory parameters on the duration of hospital stay and mortality in patients with COVID-19.
The data of 1516 COVID-19 patients who were hospitalized in our institution have been analyzed retrospectively. Patients were divided into two groups those who deceased within the first 10 days of hospitalization (Group I, ≤10 days) and those who deceased in the later period (Group II, >10 days). Age, gender, time to mortality after hospitalization, neutrophil count, CRP, neutrophil-to-lymphocyte ratio (NLR), CRP/albumin ratio (CAR), and d-dimer values were obtained from blood samples taken during hospitalization.
NLR and CAR values were significantly higher in those who died in the first 10 days compared to the other group (<0.02 and <0.001, respectively). In addition, WBC, neutrophil, CRP and d-dimer levels were statistically significantly higher than the other group (<0.05). Logistic regression analysis results for NLR and CAR were significant. The cut-off values were calculated (5.74 and 4.27, respectively) for both parameters. Among the most common comorbid diseases were hypertension (HT) in 41%, coronary artery disease (CAD) in 41.7%, asthma-chronic obstructive pulmonary disease (COPD) in 36.7%, diabetes mellitus (DM) in 36.1%.
NLR and CAR may have a decisive influence in determining the length of stay in hospital for patients who die in hospital due to COVID-19. In addition, it is recommended that COVID-19 cases with diabetes be followed closely.
已开展大量研究以确定新冠病毒疾病的预测标准。白细胞、C反应蛋白、CRP/白蛋白比值、中性粒细胞与淋巴细胞比值及铁蛋白均为炎症反应增强的指标；因此，它们可用于判定新冠病毒病例的预后。在本研究范围内，我们旨在阐明中性粒细胞与淋巴细胞比值（NLR）、C反应蛋白与白蛋白比值（CAR）及其他实验室参数对新冠病毒患者住院时长和死亡率的预测能力。
对在我院住院的1516例新冠病毒患者的数据进行回顾性分析。患者被分为两组，即住院后10天内死亡的患者（第一组，≤10天）和后期死亡的患者（第二组，>10天）。从住院期间采集的血样中获取年龄、性别、住院后至死亡的时间、中性粒细胞计数、C反应蛋白、中性粒细胞与淋巴细胞比值（NLR）、C反应蛋白/白蛋白比值（CAR）及D-二聚体值。
与另一组相比，在最初10天内死亡的患者中，NLR和CAR值显著更高（分别<0.02和<0.001）。此外，白细胞、中性粒细胞、C反应蛋白和D-二聚体水平在统计学上显著高于另一组（<0.05）。NLR和CAR的逻辑回归分析结果具有显著性。计算出这两个参数的临界值（分别为5.74和4.27）。最常见的合并症包括高血压（HT）占41%、冠状动脉疾病（CAD）占41.7%、哮喘-慢性阻塞性肺疾病（COPD）占36.7%、糖尿病（DM）占36.1%。
NLR和CAR可能对因新冠病毒在医院死亡的患者的住院时长判定具有决定性影响。此外，建议对糖尿病新冠病毒病例进行密切随访。
