Rozanovic Martin, Várady-Szabó Kata, Domokos Kamilla, Kiss Tamás, Loibl Csaba, Márovics Gergely, Rendeki Szilárd, Csontos Csaba
Department of Anaesthesiology and Intensive Care, University of Pécs Medical School, 7624 Pécs, Hungary.
Department of Public Health Medicine, University of Pécs Medical School, 7624 Pécs, Hungary.
J Clin Med. 2024 Sep 11;13(18):5369. doi: 10.3390/jcm13185369.
: In this study, we aimed to compare the predictive power of non-conventional (neutrophil/lymphocyte ratio-NLR; platelet/lymphocyte ratio-PLR) and conventional markers (C-reactive protein-CRP; procalcitonin-PCT; interleukin-6-IL-6) in terms of disease progression and mortality in severe SARS-CoV-2 patients. : In this prospective observatory study, blood samples were collected daily, focusing on the established inflammatory markers. Critically ill COVID-19 patients who required ICU admission were included. Patient treatment followed established COVID-19 protocols, and the data analysis was performed using SPSS with non-normal distribution methods. The study cohort primarily included patients infected with the delta variant. : A mortality rate of 76.6% was observed among 167 patients during the study period. Significant differences in conventional and non-conventional markers between survivor and non-survivor groups were observed. The PCT levels were significantly elevated ( < 0.005) in the deceased group. Among the non-conventional markers, the NLR was consistently higher in non-survivors and emerged as a significant predictor of mortality, whereas the PLR was not elevated among the non-survivors. ROC analyses indicated that PCT and the NLR were the markers with the highest predictive power for mortality. The multivariate logistic regression analysis identified NLR, PCT, CRP, and IL-6 as significant predictors of mortality across different days. The NLR showed a consistent, though not always statistically significant, association with increased mortality risk, particularly on Days 2 and 5. : The NLR's accessibility and simplicity of determination make it a valuable and practical tool for monitoring inflammatory processes in viral infections. Our findings suggest that incorporating NLR analysis into routine clinical practice could enhance the early identification of high-risk patients, thereby improving patient management and outcomes.
在本研究中，我们旨在比较非传统标志物（中性粒细胞/淋巴细胞比率-NLR；血小板/淋巴细胞比率-PLR）和传统标志物（C反应蛋白-CRP；降钙素原-PCT；白细胞介素-6-IL-6）对重症SARS-CoV-2患者疾病进展和死亡率的预测能力。在这项前瞻性观察研究中，每天采集血样，重点关注已确定的炎症标志物。纳入需要入住重症监护病房的危重症COVID-19患者。患者治疗遵循既定的COVID-19方案，数据分析采用非正态分布方法的SPSS进行。研究队列主要包括感染德尔塔变异株的患者。在研究期间，167例患者的死亡率为76.6%。观察到幸存者和非幸存者组之间传统和非传统标志物存在显著差异。死亡组的PCT水平显著升高（<0.005）。在非传统标志物中，非幸存者的NLR一直较高，并成为死亡率的显著预测指标，而非幸存者的PLR未升高。ROC分析表明，PCT和NLR是死亡率预测能力最高的标志物。多因素逻辑回归分析确定NLR、PCT、CRP和IL-6是不同日期死亡率的显著预测指标。NLR与死亡风险增加呈一致但并非总是具有统计学意义的关联，尤其是在第2天和第5天。NLR的易获取性和测定的简便性使其成为监测病毒感染炎症过程的有价值且实用的工具。我们 的研究结果表明，将NLR分析纳入常规临床实践可增强对高危患者的早期识别，从而改善患者管理和预后。
