Guzel Efraim, Mete Burak, Baydar Toprak Oya, Ates Ayhan Nazire, Firat Ahmet, Bulut Yurdaer, Bayrakci Sinem, Ozel Yesilyurt Aysun, Ozyilmaz Ezgi
Department of Chest Diseases, Cukurova University, Adana, Turkey.
Department of Public Health, Cukurova University, Adana, Turkey.
Int J Immunopathol Pharmacol. 2024 Jan-Dec;38:3946320241303331. doi: 10.1177/03946320241303331.
This study primarily aimed to examine the significance of the C-reactive protein to lymphocyte ratio (CLR), a key marker of inflammation, in relation to the disease progression and management of COVID-19 patients admitted to the intensive care unit (ICU). A total of 464 patients aged 18 years or older, diagnosed with COVID-19 and admitted to the ICU between April 1, 2021, and February 1, 2022, were included in the study. Sociodemographic, laboratory, radiological, and clinical data were collected for each patient. The cohort was then divided into two groups-those who survived and those who did not-and analyzed accordingly. Among the patients included in the study, 58.2% were male, and the mean age was 62.39 ± 15.65 years. The mortality rate was 42%. The analysis revealed that the need for high-flow oxygen and mechanical ventilation increased the risk of death by 9.64 times. Furthermore, for each 1-point increase in the SOFA Score, Charlson Comorbidity Index, and Nutric Score, the risk of death increased by 1.27, 1.18, and 1.40 times, respectively. Intravenous immunoglobulin, administered to a select group of patients, reduced the risk of death by 23.8 times. The optimal threshold value for CLR was identified as 103.05, with values above this increasing the risk of death by 1.84 times. Critically ill patients with CLR values exceeding the identified threshold should receive more intensive monitoring and timely adjustments in treatment. Given that CLR is a simple, accessible, and cost-effective marker, it holds particular value in managing aggressive diseases like COVID-19.
本研究主要旨在探讨炎症关键标志物C反应蛋白与淋巴细胞比值（CLR）在入住重症监护病房（ICU）的新冠肺炎患者疾病进展及管理方面的意义。研究纳入了2021年4月1日至2022年2月1日期间确诊为新冠肺炎并入住ICU的464例18岁及以上患者。收集了每位患者的社会人口学、实验室、放射学和临床数据。然后将该队列分为两组，即存活组和非存活组，并进行相应分析。在纳入研究的患者中，58.2%为男性，平均年龄为62.39±15.65岁。死亡率为42%。分析显示，需要高流量吸氧和机械通气会使死亡风险增加9.64倍。此外，序贯器官衰竭评估（SOFA）评分、查尔森合并症指数和营养评分每增加1分，死亡风险分别增加1.27倍、1.18倍和1.40倍。对部分患者使用静脉注射免疫球蛋白可使死亡风险降低23.8倍。CLR的最佳阈值确定为103.05，高于此值会使死亡风险增加1.84倍。CLR值超过确定阈值的重症患者应接受更密切的监测并及时调整治疗。鉴于CLR是一种简单、易获取且具有成本效益的标志物，它在管理像新冠肺炎这样的侵袭性疾病方面具有特殊价值。
