Department of Internal Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran.
Inflammopharmacology. 2023 Oct;31(5):2337-2348. doi: 10.1007/s10787-023-01308-8. Epub 2023 Aug 7.
The principal etiology of mortality in COVID-19 patients is the systemic pro-inflammatory processes which may lead to acute respiratory distress syndrome. Hematologic indices are reachable representatives of inflammation in patients with COVID-19 infection. The purpose of the current study was to evaluate the potential predictive value of these inflammatory indices in the in-hospital mortality of ICU-admitted COVID-19 patients. The studied indexes included AISI, dNLR, NLPR, NLR, SII, and SIRI.
315 COVID-19 patients admitted to ICU managed in Imam Khomeini Hospital of Urmia, Iran, during the last 6 months of 2020 were retrospectively enrolled in the study and divided into two subgroups based on their final outcome, discharge or death.
Total leucocyte count (TLC), absolute neutrophil count (NLC), urea, Cr, RDW, AISI, dNLR, NLPR, NLR, SII, and SIRI were drastically elevated in the dead patients (P < 0.05). The optimal cut-off points for AISI (378.81), dNLR (5.66), NLPR (0.03), NLR (5.97), SII (1589.25), and SIRI (2.31) were obtained using ROC curves. NLR and SII had the highest sensitivity (71.4%) and specificity (73.6%), respectively. Patients with above-cut-off levels of ISI, dNLR, NLPR, NLR, and SII had lower average survival time. Age (OR = 1.057, CI95%: 1.030-1.085, p < 0.001) and dNLR (OR = 1.131, CI95%: 1.061-1.206, p < 0.001) were the independent predictors for mortality in the studied COVID-19 patients based on multivariate logistic regression.
Age and dNLR are valuable predictive factors for in-hospital death of ICU-admitted COVID-19 patients. Besides, other indices, AISI, NLPR, NLR, SII, and SIRI, may have an additional role that requires further investigation.
COVID-19 患者死亡的主要病因是全身性促炎过程，这可能导致急性呼吸窘迫综合征。血液学指标是 COVID-19 感染患者炎症的可及代表。本研究的目的是评估这些炎症指标在 ICU 收治的 COVID-19 患者住院死亡率中的潜在预测价值。研究指标包括 AISI、dNLR、NLPR、NLR、SII 和 SIRI。
回顾性纳入 2020 年最后 6 个月在伊朗乌尔米亚伊玛目霍梅尼医院 ICU 收治的 315 例 COVID-19 患者，并根据最终结局（出院或死亡）将其分为两组。
死亡患者的总白细胞计数（TLC）、绝对中性粒细胞计数（NLC）、尿素、Cr、RDW、AISI、dNLR、NLPR、NLR、SII 和 SIRI 明显升高（P<0.05）。使用 ROC 曲线获得 AISI（378.81）、dNLR（5.66）、NLPR（0.03）、NLR（5.97）、SII（1589.25）和 SIRI（2.31）的最佳截断值。NLR 和 SII 的敏感性最高（71.4%）和特异性（73.6%）。ISI、dNLR、NLPR、NLR 和 SII 水平高于截断值的患者平均生存时间较短。年龄（OR=1.057，95%CI：1.030-1.085，p<0.001）和 dNLR（OR=1.131，95%CI：1.061-1.206，p<0.001）是基于多变量逻辑回归的研究 COVID-19 患者死亡的独立预测因子。
年龄和 dNLR 是 ICU 收治的 COVID-19 患者住院死亡的有价值的预测因素。此外，AISI、NLPR、NLR、SII 和 SIRI 等其他指标可能具有额外的作用，需要进一步研究。
