Bota Adrian Vasile, Marc Felicia, Adelina Mavrea, Nicolescu Laura, Tudora Adelina Georgiana, Cotoraci Coralia
Doctoral School, Faculty of Medicine, "Vasile Goldis" Western University, Bulevardul Revolutiei 94, 310025 Arad, Romania.
Department of Medical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania.
Healthcare (Basel). 2024 Dec 3;12(23):2429. doi: 10.3390/healthcare12232429.
: Patients aged 80 years and above are at increased risk for severe COVID-19 outcomes. This study aimed to evaluate the prognostic utility of the derived neutrophil-to-lymphocyte ratio (dNLR), aspartate-aminotransferase-to-lymphocyte ratio index (ALRI), aspartate-aminotransferase-to-platelet ratio index (APRI), and systemic immune inflammation index (SII) in predicting severe disease, intensive care unit (ICU) admission, and mortality among COVID-19 patients aged 80 years and older. : In this retrospective cohort study, 138 elderly patients (≥80 years) and 215 younger controls (<65 years) with confirmed COVID-19 were included. Laboratory data at admission were collected, and the dNLR, ALRI, APRI, and SII scores were calculated. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive performance of these indices. : The SII had the highest area under the ROC curve (AUC) for predicting severe disease in elderly patients (AUC = 0.857, 95% CI: 0.795-0.919, < 0.001), with an optimal cutoff value of 920 × 10⁹/L (sensitivity 86%, specificity 78%). Elevated SII was significantly associated with increased risk of ICU admission (hazard ratio (HR): 2.9, 95% CI: 1.8-4.6, < 0.001) and mortality (HR: 3.2, 95% CI: 1.9-5.2, < 0.001). Similarly, dNLR showed good predictive value (AUC = 0.792, 95% CI: 0.722-0.862, < 0.001). : SII and dNLR are valuable prognostic biomarkers for predicting severe outcomes in COVID-19 patients aged 80 years and above. Early identification using these indices can assist clinicians in risk stratification and management decisions to improve patient outcomes.
80岁及以上的患者发生严重新冠病毒病（COVID-19）结局的风险增加。本研究旨在评估衍生中性粒细胞与淋巴细胞比率（dNLR）、天冬氨酸转氨酶与淋巴细胞比率指数（ALRI）、天冬氨酸转氨酶与血小板比率指数（APRI）以及全身免疫炎症指数（SII）在预测80岁及以上COVID-19患者的重症疾病、入住重症监护病房（ICU）和死亡率方面的预后效用。：在这项回顾性队列研究中，纳入了138例确诊COVID-19的老年患者（≥80岁）和215例年轻对照者（<65岁）。收集入院时的实验室数据，并计算dNLR、ALRI、APRI和SII评分。进行受试者操作特征（ROC）曲线分析以评估这些指标的预测性能。：SII在预测老年患者重症疾病方面的ROC曲线下面积（AUC）最高（AUC = 0.857，95%置信区间：0.795 - 0.919，P < 0.001），最佳截断值为920×10⁹/L（敏感性86%，特异性78%）。SII升高与入住ICU风险增加（风险比（HR）：2.9，95%置信区间：1.8 - 4.6，P < 0.001）和死亡率增加（HR：3.2，95%置信区间：1.9 - 5.2，P < 0.001）显著相关。同样，dNLR显示出良好的预测价值（AUC = 0.792，95%置信区间：0.722 - 0.862，P < 0.001）。：SII和dNLR是预测80岁及以上COVID-19患者严重结局的有价值的预后生物标志物。使用这些指标进行早期识别可帮助临床医生进行风险分层和管理决策，以改善患者结局。
