Background Our study aimed to investigate the prognostic value of a novel in ammatory index, systemic immune-in ammation index (SII), with the clinical outcomes of patients infected with coronavirus disease 2019 (COVID-19). Methods We evaluated a cohort study of COVID-19 patients (18-95 years old) in Tongji Hospital of Huazhong University of Science and Technology from January 28th 2020 to February 29th 2020. The enrolled patients were divided into two groups (including low-SII group and high-SII group) according to the cutoff point which is analyzed by receiver operating characteristic (ROC) curve. Univariate and multivariate COX regression analysis were performed to identify the factors associated with the outcomes of patients with COVID-19 infection. The primary and secondary outcome were in-hospital mortality and the development of acute respiratory distress syndrome (ARDS), respectively. Results A number of 326 adult patients (43.87% males, 61.22 ± 0.86 years) were enrolled in the nal analyses. There were 147 cases (45.09%) died in hospital and 116 patients (35.58%) developed ARDS. ROC curve analysis indicated that the SII had a greater prediction accuracy in predicting the in-hospital mortality (area under the curve [AUC] = 0.789, sensitivity = 69.90%, speci city = 70.80%) and the development of ARDS (AUC = 0.736, sensitivity = 67.80%, speci city = 71.10%). Kaplan-Meier analysis revealed that patients in high-SII group had a greater risk of adverse clinical outcomes (all P < 0.001). The multivariate Cox regression analysis indicated that elevated SII was found as the risk predictor of inhospital mortality (hazard ratio [HR] = 2.839, 95% con dence interval [CI] = 1.116-7.222, P = 0.028) and the developed ARDS (HR = 6.832, 95%CI = 2.583-18.074, P < 0.001). Additional signi cant independent predictor for adverse outcomes was the lymphocyte proportion. What's more, it suggests that the invasive mechanical ventilation performed in the early stage of the disease progression may be bene cial for patients. Conclusion SII, a novel biomarker, might be a remarkable prognostic indicator to assess the in-hospital mortality and the development of ARDS in patients with COVID-19 and help for clinical risk assessment. however, it is much more infectious [5]. The primary way that SARS-CoV-2 appears to spread is mainly by close person-to-person contact via droplets [6]. The clinical features of COVID-19 covered from asymptomatic or mild symptoms, to severe cases with acute respiratory distress syndrome (ARDS) or organ failure [7]. The underlying mechanism of the disease is still unclear. Preliminary studies showed that system in ammatory response played an important role in the progression of the disease [8, 9]. According to Matthew Zirui Tay et al research, for the immune system damage and the uncontrolled in ammatory response brought to human, COVID-19 could cause damage and functional impairment of major organs [10]. Therefore, it is essential to nd sensitive biomarkers, which associate with the in ammatory status and are ...

BackgroundThe coronavirus infectious disease (COVID-19) pandemic is an ongoing global health care challenge. Up to one third of hospitalised patients develop severe pulmonary complications and ARDS. Pulmonary outcomes following COVID-19 are unknown.MethodsThe Swiss COVID-19 lung study is a multicentre prospective cohort investigating pulmonary sequela of COVID-19. We report on initial follow-up 4 months after mild/moderate or severe/critical COVID-19 according to the WHO severity classification.Results113 COVID-19 survivors were included (mild/moderate 47, severe/critical 66). We confirmed several comorbidities as risk factors for severe/critical disease. Severe/critical disease was associated with impaired pulmonary function, i.e. diffusing capacity (DLCO) %-predicted, reduced 6-MWD, and exercise-induced oxygen desaturation. After adjustment for potential confounding by age, sex, and BMI, patients after severe/critical COVID-19 had a 20.9 (95% CI 12.4–29.4, p=0.01) lower DLCO %-predicted at follow up. DLCO %-predicted was the strongest independent factor associated with previous severe/critical disease when age, sex, BMI, 6MWD, and minimal SpO2 at exercise, were included in the multivariable model (adjusted odds ratio [OR] per 10%-predicted 0.59 [95% CI 0. 37–0.87], p=0.01). Mosaic hypoattenuation on chest computed tomography at follow-up was significantly associated with previous severe/critical COVID-19 including adjustment for age and sex (adjusted OR 11.7 [95%CI 1.7–239), p=0.03).ConclusionsFour months after SARS CoV-2 infection, severe/critical COVID-19 was associated with significant functional and radiological abnormalities, potentially due to small airway and lung parenchymal disease. A systematic follow-up for survivors needs to be evaluated to optimise care for patients recovering from COVID-19.

Pes monitoring provides unique bedside measures for a better understanding of the pathophysiology of acute respiratory failure patients. Including Pes monitoring in the intensivist's clinical armamentarium may enhance treatment to improve clinical outcomes.