Aggregate Index of Systemic Inflammation (AISI), Disease Severity, and Mortality in COVID-19: A Systematic Review and Meta-Analysis

Abstract

Combined indices of different haematological cell types appear to be particularly promising for investigating the link between systemic inflammation and coronavirus disease 2019 (COVID-19). We conducted a systematic review and meta-analysis to assess the aggregate index of systemic inflammation (AISI), an emerging index derived from neutrophil, monocyte, platelet, and lymphocyte counts, in hospitalized COVID-19 patients with different disease severity and survival status. We searched electronic databases between the 1st of December 2019 and the 10th of June 2023 and assessed the risk of bias and the certainty of evidence. In 13 studies, severe disease/death was associated with significantly higher AISI values on admission vs. non-severe disease/survival (standard mean difference (SMD) = 0.68, 95% CI 0.38 to 0.97, p < 0.001). The AISI was also significantly associated with severe disease/death in five studies reporting odds ratios (4.39, 95% CI 2.12 to 9.06, p ˂ 0.001), but not in three studies reporting hazard ratios (HR = 1.000, 95% CI 0.999 to 1.002, p = 0.39). The pooled sensitivity, specificity, and area under the curve values for severe disease/death were 0.66 (95% CI 0.58 to 0.73), 0.78 (95% CI 0.73 to 0.83), and 0.79 (95% CI 0.76 to 0.83), respectively. Our study has shown that the AISI on admission can effectively discriminate between patients with different disease severity and survival outcome (PROSPERO registration number: CRD42023438025).

Inflammation Indexes PLR, SII, AISI, MLR, NLPR and MCVL in Peripartum Treated Thrombophilia Patients Undergoing Cesarean Section at Term-STROBE Compliant

“…As for AISI, in patients with COVID-19, increased values upon admission predict severe or fatal evolution [47]; therefore, determining the AISI value upon admission can help triage the patients with a bad prognosis [48]. In patients with hemophagocytic lymphohistiocytosis, the aggregate index of systemic inflammation (AISI) was also an independent risk factor for 28-day mortality [49].…”

Inflammation Indexes PLR, SII, AISI, MLR, and MCVL in Peripartum Treated Thrombophilia Peripartum Patients Undergoing Cesarean Section at Term

“…As for AISI, in patients with COVID-19, increased values upon admission predict severe or fatal evolution [35]; therefore, determining the AISI value upon admission can help triage the patients with a bad prognosis [36]. In with hemophagocytic lymphohistiocytosis, the aggregate index of systemic inflammation (AISI) was also an independent risk factor for 28-day mortality [37].…”

Inflammatory Profile Assessment in a Highly Selected Athyreotic Population Undergoing Controlled and Standardized Hypothyroidism

“…Recently, novel blood inflammatory indexes (hereafter BIIXs) based on the correlation among blood count parameters, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune inflammatory index (SII), system inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI), have been investigated in almost all fields of clinical research and reported as reliable in quantifying inflammation, the status of systemic illness, and the prognosis [10][11][12][13][14][15][16][17][18]. Hypothyroidism is a well-known inflammatory and oxidative trigger.…”