Fan Yuyan, Yang Ning, Zhuo Jialu, Han Ting
Department of Clinical Nutrition, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Department of Clinical Nutrition, Shanghai Tenth People's Hospital, Tongji University of Medicine, Shanghai, China.
Front Med (Lausanne). 2025 May 1;11:1474236. doi: 10.3389/fmed.2024.1474236. eCollection 2024.
Inflammatory indices are pivotal markers in gaging the harm of the COVID-19 trajectory. The definitive impact of inflammatory indices on forecasting the period required for a negative shift in nucleic acid status during the Omicron wave remains ambiguous. This research endeavors to delineate the relationship between the Systemic Inflammatory Index (SII) and the timeline for conversion to negative nucleic acid status in Omicron variant-infected patients, and to scrutinize the prognostic validity of SII for such conversion.
Adult patients hospitalized at the Shanghai Public Health Clinical Center with mild cases attributed to the Omicron variant were studied from March to December 2022. They were stratified into early-conversion (with mild cases attributed to (>10 days) groups). Analyzing patient information, clinical traits, and laboratory results, we divided patients into two groups. We used logistic regression to find the link between SII and virus test timing and built ROC curves to measure predictive value via AUC.
A total of 2,603 patients were enrolled. Univariate analysis found big differences in pulse rates, respiratory rates, prealbumin levels, HS-CRP levels, IL-6 levels, SII, and PNI ( < 0.05) between the groups. Adjusting for confounders, logistic regression revealed that the highest SII group had a 1.46 greater risk of not clearing a 10-day PCR test than the lowest group (OR = 1.46; 95% CI, 1.173-1.817, = 0.001). Each one-unit rise in SII raised the risk of 10-day PCR failure by 0.1% ( < 0.0001). The ROC curve showed SII's AUC as 0.603 (95% CI: 0.576-0.630), predicting virus test turn-around with a cut-off of 920.5, 61.9% specificity, and 52.5% sensitivity. Compared to other indicators such as IL-6 and HS-CRP, SII exhibited the highest AUC value and specificity.
In mild cases caused by the Omicron wave, there was a discernible link between the SII and the period leading to a negative nucleic acid test outcome, with higher SII values indicating an increased risk of prolonged conversion time. SII might help guide treatment better than other indicators by predicting disease course.
炎症指标是衡量新冠病毒感染病程危害的关键标志物。在奥密克戎毒株流行期间，炎症指标对预测核酸转阴所需时间的决定性影响仍不明确。本研究旨在阐明全身炎症指数（SII）与奥密克戎毒株感染患者核酸转阴时间的关系，并探讨SII对这种转阴情况的预后预测效度。
对2022年3月至12月在上海公共卫生临床中心住院的奥密克戎毒株轻症成年患者进行研究。将他们分为早期转阴组（核酸转阴时间≤10天）和晚期转阴组（核酸转阴时间>10天）。通过分析患者信息、临床特征和实验室检查结果，将患者分为两组。采用逻辑回归分析来寻找SII与病毒检测时间之间的联系，并绘制ROC曲线，通过曲线下面积（AUC）来衡量预测价值。
共纳入2603例患者。单因素分析发现，两组患者的脉搏率、呼吸频率、前白蛋白水平、超敏C反应蛋白（HS-CRP）水平、白细胞介素-6（IL-6）水平、SII和预后营养指数（PNI）存在显著差异（P<0.05）。在对混杂因素进行校正后，逻辑回归分析显示，SII最高组核酸检测10天仍未转阴的风险比最低组高1.46倍（比值比[OR]=1.46；95%置信区间[CI]为1.1731.817，P=0.001）。SII每升高一个单位，核酸检测10天仍未转阴的风险增加0.1%（P<0.0001）。ROC曲线显示，SII的AUC为0.603（95%CI：0.5760.630），以920.5为截断值预测病毒检测转阴情况，特异性为61.9%，敏感性为52.5%。与IL-6和HS-CRP等其他指标相比，SII的AUC值和特异性最高。
在奥密克戎毒株引起的轻症病例中，SII与核酸检测转阴所需时间之间存在明显关联，SII值越高，转阴时间延长的风险越高。SII在预测疾病进程方面可能比其他指标更有助于指导治疗。
