Rojas-Sahagún Víctor Manuel, Núñez-Martínez Francisco Javier, Verazaluce-Rodríguez Blanca Elena, Luna-Montalbán Rafael
Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Medicina Interna. León, Guanajuato, México.
Instituto Mexicano del Seguro Social, Centro Médico Nacional del Bajío, Hospital de Especialidades No. 1, Servicio de Dermatología. León, Guanajuato, México.
Rev Med Inst Mex Seguro Soc. 2023 Sep 4;61(5):567-573. doi: 10.5281/zenodo.8316422.
Coronavirus disease 2019 (COVID-19) represents the greatest health crisis of our times; it was declared by WHO a pandemic in March 2020. The risk of presenting a severe disease is inter-individual, since it varies according to age, comorbidities, and immunological status, in addition to the type of SARS-CoV-2 variant. The neutrophil/lymphocyte ratio (NLR) and lactic dehydrogenase (LDH) are widely used markers to assess the severity and predict the course of the disease in patients with COVID-19, with a direct relationship of higher value-worse prognosis.
To verify if the LDH-neutrophil-lymphocyte index calculated from laboratory tests taken within the first 24 hours of admission is useful as a predictor of 28-day mortality in adult patients diagnosed with COVID-19.
Retrospective and analytical cohort study. All consecutive patients over 16 years of any gender, admitted to a tertiary care center from March 2020 to March 2021, who had a diagnosis of COVID-19 with a positive PCR for SARS-CoV-2, were included.
Higher levels of the LDHNL index were associated with higher mortality in patients hospitalized for COVID-19 (Q2 vs. Q1: RR 1.52 [1.24-1.87], p < 0.05; Q3 vs. Q1: RR 1.87 [1.55-2.25], p < 0.05; and Q4 vs. Q1: RR 2.74 [2.22-3-39], p < 0.05).
The serum LDHNL index taken in the first 24 hours of admission can help to predict early the risk of mortality in hospitalized patients with COVID-19.
2019年冠状病毒病（COVID-19）是我们这个时代最大的健康危机；世界卫生组织于2020年3月宣布其为大流行病。出现严重疾病的风险存在个体差异，因为它除了取决于严重急性呼吸综合征冠状病毒2（SARS-CoV-2）变体类型外，还会因年龄、合并症和免疫状态而有所不同。中性粒细胞/淋巴细胞比率（NLR）和乳酸脱氢酶（LDH）是广泛用于评估COVID-19患者疾病严重程度和预测疾病进程的指标，数值越高预后越差，二者呈直接关系。
验证入院后24小时内通过实验室检查计算得出的LDH-中性粒细胞-淋巴细胞指数是否有助于预测确诊为COVID-19的成年患者的28天死亡率。
回顾性分析队列研究。纳入2020年3月至2021年3月期间入住三级医疗中心的所有16岁以上、任何性别的连续患者，这些患者经PCR检测确诊为SARS-CoV-2阳性的COVID-19。
COVID-19住院患者中，LDHNL指数水平越高，死亡率越高（第二四分位数与第一四分位数相比：相对危险度1.52[1.24 - 1.87]，p<0.05；第三四分位数与第一四分位数相比：相对危险度1.87[1.55 - 2.25]，p<0.05；第四四分位数与第一四分位数相比：相对危险度2.74[2.22 - 3.39]，p<0.05）。
入院后24小时内检测的血清LDHNL指数有助于早期预测COVID-19住院患者的死亡风险。
