Significance of hemogram‐derived ratios for predicting in‐hospital mortality in COVID‐19: A multicenter study

Abstract

Background To address the problem of resource limitation, biomarkers having a potential for mortality prediction are urgently required. This study was designed to evaluate whether hemogram‐derived ratios could predict in‐hospital deaths in COVID‐19 patients. Materials and Methods This multicenter retrospective study included hospitalized COVID‐19 patients from four COVID‐19 dedicated hospitals in Sylhet, Bangladesh. Data on clinical characteristics, laboratory parameters, and survival outcomes were analyzed. Logistic regression models were fitted to identify the predictors of in‐hospital death. Results Out of 442 patients, 55 (12.44%) suffered in‐hospital death. The proportion of male was higher in nonsurvivor group (61.8%). The mean age was higher in nonsurvivors (69 ± 13 vs. 59 ± 14 years, p < 0.001). Compared to survivors, nonsurvivors exhibited higher frequency of comorbidities, such as chronic kidney disease (34.5% vs. 15.2%, p ≤ 0.001), chronic obstructive pulmonary disease (23.6% vs. 10.6%, p = 0.011), ischemic heart disease (41.8% vs. 19.4%, p < 0.001), and diabetes mellitus (76.4% vs. 61.8%, p = 0.05). Leukocytosis and lymphocytopenia were more prevalent in nonsurvivors ( p < 0.05). Neutrophil‐to‐lymphocyte ratio (NLR), derived NLR (d‐NLR), and neutrophil‐to‐platelet ratio (NPR) were significantly higher in nonsurvivors ( p < 0.05). After adjusting for potential covariates, NLR (odds ratio [OR] 1.05; 95% confidence interval [CI] 1.009‐1.08), d‐NLR (OR 1.08; 95% CI 1.006‐1.14), and NPR (OR 1.20; 95% CI 1.09‐1.32) have been found to be significant predictors of mortality in hospitalized COVID‐19 patients. The optimal cut‐off points for NLR, d‐NLR, and NPR for prediction of in‐hospital mortality for COVID‐19 patients were 7.57, 5.52 and 3.87, respectively. Conclusion Initial assessment of NLR, d‐NLR, and NPR values at hospital admission is of good prognostic value for predicting mortality of patients with COVID‐19.

Circulating mid-regional proadrenomedullin is a predictor of mortality in patients with COVID-19: a systematic review and meta-analysis

“…COVID-19 patients have a high mortality rate. The mortality rate of in-hospital patients was 12.44% [ 36 ], that of ICU patients was 26% [ 37 ], and that of patients with acute respiratory distress syndrome (ARDS) was 50% [ 38 ]. The study population we included had different severities of illness, and the overall mortality rate was 19%.…”

Evaluation of NLR, d-NLR, and PLR in terms of disease severity in COVID-19 patients

“…NLR'den farklı olarak d-NLR, nötrofil sayısı ile beyaz küre sayısından çıkarılan nötrofil sayısının oranlanmasıyla hesaplanmaktadır. Yapılan çalışmalarda yüksek d-NLR seviyelerinin COVID-19 mortalitesini öngörmede anlamlı prediktif değere sahip olduğu gösterilmiştir (2,4) . Çalışmamızla uyumlu olarak hastaneye 4 Duyarlılık Özgüllük başvurudaki yüksek d-NLR'nin, ciddi COVID-19 hastalarının erken teşhisi için önemli bir belirteç olarak kabul edilebileceğini gösteren literatür verileri de mevcuttur (14,18) .…”

COVID-19 Biomarkers at the Crossroad between Patient Stratification and Targeted Therapy: The Role of Validated and Proposed Parameters

“…As the SARS-CoV-2 infection spread around the world, the scientific knowledge of its pathophysiology grew accordingly, allowing for the validation of new biomarkers that quickly entered in the routine blood tests (i.e., interleukin 6—IL6, etc.) [ 12 , 17 ].…”

“…Since the beginning of the COVID-19 emergency, many studies have identified advanced age and pre-existing comorbidities as important predictors of mortality in these patients [ 12 , 17 , 18 , 19 , 20 ]. To support the early and correct triage of patients, clinicians soon began to look for early diagnostic tools able to provide a precise stratification of SARS-CoV-2-positive patients upon their hospital admission.…”