Novel Systemic Inflammation Markers to Predict COVID-19 Prognosis

Karimi, Amirali; Shobeiri, Parnian; Kulasinghe, Arutha; Rezaei, Nima

doi:10.3389/fimmu.2021.741061

Cited by 106 publications

(91 citation statements)

References 114 publications

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“…Moreover, other biomarkers, such as PDW and NLR, were significantly higher in patients with PE as compared to patients without PE. Interestingly, both PDW and NRL have also been described as severity markers in COVID-19 (33,34), with more increased NLR among PE cases (35). Higher PDW, a surrogate marker of platelet activation, has also been found in non-COVID-19 PE patients (36).…”

Section: D-dimer and Other Potential Biomarkers Of Pulmonary Embolism...mentioning

confidence: 97%

A Prospective Study Evaluating Cumulative Incidence and a Specific Prediction Rule in Pulmonary Embolism in COVID-19

et al. 2022

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RationaleAbnormal values of hypercoagulability biomarkers, such as D-dimer, have been described in Coronavirus Disease 2019 (COVID-19), which has also been associated with disease severity and in-hospital mortality. COVID-19 patients with pneumonia are at greater risk of pulmonary embolism (PE). However, the real incidence of PE is not yet clear, since studies have been limited in size, mostly retrospective, and PE diagnostic procedures were only performed when PE was clinically suspected.Objectives(1) To determine the incidence, clinical, radiological, and biological characteristics, and clinical outcomes of PE among patients hospitalized for COVID-19 pneumonia with D-dimer > 1,000 ng/mL. (2) To develop a prognostic model to predict PE in these patients.MethodsSingle-center prospective cohort study. Consecutive confirmed cases of COVID-19 pneumonia with D-dimer > 1,000 ng/mL underwent computed tomography pulmonary angiography (CTPA). Demographic and laboratory data, comorbidities, CTPA scores, treatments administered, and clinical outcomes were analyzed and compared between patients with and without PE. A risk score was constructed from all these variables.ResultsBetween 6 April 2020 and 2 February 2021, 179 consecutive patients were included. The overall incidence of PE was 39.7% (71 patients) (CI 95%, 32–47%). In patients with PE, emboli were located mainly in segmental/subsegmental arteries (67%). Patients with PE did not differ from the non-PE group in sex, age, or risk factors for thromboembolic disease. Higher urea, D-Dimer, D-dimer-to-ferritin and D-dimer-to-lactate dehydrogenase (LDH) ratios, platelet distribution width (PDW), and neutrophil-to-lymphocyte ratio (NLR) values were found in patients with PE when compared to patients with non-PE. Besides, lymphocyte counts turned out to be lower in patients with PE. A score for PE prediction was constructed with excellent overall performance [area under the ROC curve-receiver operating characteristic (AUC-ROC) 0.81 (95% CI: 0.73–0.89)]. The PATCOM score stands for Pulmonary Artery Thrombosis in COVID-19 Mallorca and includes platelet count, PDW, urea concentration, and D-dimer-to-ferritin ratio.ConclusionCOVID-19 patients with pneumonia and D-dimer values > 1,000 ng/mL were presented with a very high incidence of PE, regardless of clinical suspicion. Significant differences in urea, D-dimer, PDW, NLR, and lymphocyte count were found between patients with PE and non-PE. The PATCOM score is presented in this study as a promising PE prediction rule, although validation in further studies is required.

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Section: D-dimer and Other Potential Biomarkers Of Pulmonary Embolism...mentioning

confidence: 97%

A Prospective Study Evaluating Cumulative Incidence and a Specific Prediction Rule in Pulmonary Embolism in COVID-19

et al. 2022

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“…Serum biochemical analysis and blood count analysis are commonly used blood tests, which could be faster, easier to use, and low-cost techniques that can facilitate the diagnosis and prognosis of this disease [ 11 ]. From these routine tests, inflammatory markers have been used for predicting the severity of COVID-19 such as neutrophil to lymphocyte ratio (NLR), derivate neutrophil to lymphocyte ratio (dNLR), monocyte to lymphocyte ratio (MLR), and platelet to lymphocyte ratio (PLR) [ 11 , 12 ]. NLR and PLR are biomarkers reflecting systemic inflammation, neutrophil and platelet activation, and are associated with increased mortality in cardiovascular disease and poor prognosis in various cancers or in polycythemia vera [ 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…The systemic inflammatory response index (SIRI) may also reflect the host’s immune and inflammatory balance [ 20 ]. In addition, systemic immune-inflammation index (SII), defined as platelet count × NLR, is effective in reflecting inflammatory status, being a basic biomarker for predicting the prognosis [ 12 ]. The current study assesses the utility of various inflammatory markers in predicting mortality among hospitalized patients with COVID-19.…”

Section: Introductionmentioning

confidence: 99%

The Predictive Role of NLR, d-NLR, MLR, and SIRI in COVID-19 Mortality

et al. 2022

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(1) Background: Since its discovery, COVID-19 has caused more than 256 million cases, with a cumulative death toll of more than 5.1 million, worldwide. Early identification of patients at high risk of mortality is of great importance in saving the lives of COVID-19 patients. The study aims to assess the utility of various inflammatory markers in predicting mortality among hospitalized patients with COVID-19. (2) Methods: A retrospective observational study was conducted among 108 patients with laboratory-confirmed COVID-19 hospitalized between 1 May 2021 and 31 October 2021 at Municipal Emergency Clinical Hospital of Timisoara, Romania. Blood cell counts at admission were used to obtain NLR, dNLR, MLR, PLR, SII, and SIRI. The association of inflammatory index and mortality was assessed via Kaplan–Maier curves univariate Cox regression and binominal logistic regression. (3) Results: The median age was 63.31 ± 14.83, the rate of in-hospital death being 15.7%. The optimal cutoff for NLR, dNLR, MLR, and SIRI was 9.1, 9.6, 0.69, and 2.2. AUC for PLR and SII had no statistically significant discriminatory value. The binary logistic regression identified elevated NLR (aOR = 4.14), dNLR (aOR = 14.09), and MLR (aOR = 3.29), as independent factors for poor clinical outcome of COVID-19. (4) Conclusions: NLR, dNLR, MLR have significant predictive value in COVID-19 mortality.

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“…The NLR is widely used across almost all medical disciplines as a reliable marker of the immune response to various infectious and non-infectious stimuli [24]. However, the application of the NLR in patients with viral infection is mostly limited to the prognostication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and associated patient outcomes [25][26][27]. Considering eosinophils attenuate viral infectivity through production of nitric oxide [9] and a high NLR is associated with excessive levels of reactive oxygen species [28], we speculated that eosinopenia and the increase of NLR were associated with a decrease in antioxidant defences, which can promote inflammation and oxidative damage during infection.…”

Section: Discussionmentioning

confidence: 99%

Predictive role of blood eosinophils in adult varicella patients

et al. 2022

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The study aimed to explore the relationship between eosinophils and the prognosis of varicella in adults. We retrospectively reviewed the medical records of patients who were hospitalized in The Fifth People's Hospital of Suzhou with a diagnosis of adult varicella during the period between 1 January 2012 and 31 December 2020. Of the 359 patients, 228 (63.51%) had eosinopenia. The proportion of patients with mild type disease was significantly lower in the eosinopenia group than in the noneosinopenia group (50.44% vs. 65.65%, P=0.006). The proportion of the patients with common type disease was significantly higher in the eosinopenia group than in the noneosinopenia group (39.47% vs. 28.24%, P=0.039).The proportion of the patients with severe type disease was higher in the eosinopenia group, although the difference did not reach statistical significance (10.09% vs. 6.11%, P = 0.243).

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Novel Systemic Inflammation Markers to Predict COVID-19 Prognosis

Cited by 106 publications

References 114 publications

A Prospective Study Evaluating Cumulative Incidence and a Specific Prediction Rule in Pulmonary Embolism in COVID-19

A Prospective Study Evaluating Cumulative Incidence and a Specific Prediction Rule in Pulmonary Embolism in COVID-19

The Predictive Role of NLR, d-NLR, MLR, and SIRI in COVID-19 Mortality

Predictive role of blood eosinophils in adult varicella patients

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