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Xie H, Halimulati M, Dou Y, Zhang H, Jiang X, Peng L. Systemic immune-inflammation states in US adults with seropositivity to infectious pathogens: A nutrient-wide association study. JPEN J Parenter Enteral Nutr 2024. [PMID: 39380423 DOI: 10.1002/jpen.2695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2024] [Revised: 09/19/2024] [Accepted: 09/21/2024] [Indexed: 10/10/2024]
Abstract
BACKGROUND Limited understanding exists regarding the association between daily total dietary nutrient intakes and immune-inflammation states in US adults exposed to various pathogens. This study sought to examine the correlation between nutrient intakes and immune-inflammation indicators and to assess their performance in distinguishing immune-inflammation states. METHODS This study was derived from the National Health and Nutrition Examination Survey (NHANES), which included 33,804 participants aged 20 years or older between 2005 and 2018. Multivariable linear regression and restricted cubic spline regression were conducted to evaluate the association between nutrient intakes and immune-inflammation indicators. Receiver operating characteristic curve analysis was performed to evaluate the discriminatory performance of identified nutrients for various immune-inflammation states measured by the systemic immune-inflammation index (SII). RESULTS Ten key nutrients were significantly associated with immune-inflammation responses, including calcium, saturated fatty acid (SFA) 4:0, SFA 6:0, SFA 12:0, SFA 14:0, SFA 16:0, vitamin B2, total SFAs, retinol, and lutein + zeaxanthin, which show potential as dietary indicators. The area under the curve for discriminating various immune-inflammation states was improved by at least 0.03 compared with a model that included only covariates, with all P values <0.05 in the Delong tests, indicating a significant enhancement in model performance. CONCLUSIONS Ten nutrients, including calcium, various SFAs, vitamin B2, retinol, and lutein + zeaxanthin, exhibit significant association with SII and potential as dietary indicators for distinguishing between different immune-inflammation states in US adults with seropositivity to various viruses.
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Affiliation(s)
- He Xie
- Department of Preventive Health Care, Bazhong Central Hospital, Bazhong, Sichuan, China
| | - Mairepaiti Halimulati
- Department of Nutrition Science, the University of Texas at Austin, Austin, Texas, USA
| | - Yuqi Dou
- Health Systems and Equity, Eastern Health Clinical School, Monash University, Boxhill, Victoria, Australia
| | - Hanyue Zhang
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
- Section for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Xiaowen Jiang
- Department of Epidemiology, School of Clinical Oncology, Peking University, Beijing, China
| | - Lei Peng
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
- Faculty of Medicine, University of Heidelberg, Heidelberg, Germany
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2
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Danila AI, Cioca F, Gadde ST, Daruvuri SP, Timar R, Hogea E. Prognostic Utility of dNLR, ALRI, APRI, and SII in COVID-19 Patients with Diabetes: A Cross-Sectional Study. Diagnostics (Basel) 2024; 14:1685. [PMID: 39125561 PMCID: PMC11311620 DOI: 10.3390/diagnostics14151685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 07/31/2024] [Accepted: 08/02/2024] [Indexed: 08/12/2024] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has necessitated the identification of biomarkers that can predict disease severity, particularly in vulnerable populations such as individuals with diabetes. This study aims to evaluate the predictive value of inflammatory and liver function markers, specifically derived Neutrophil to Lymphocyte Ratio (dNLR), aspartate aminotransferase (AST)-to-lymphocyte ratio (ALRI), AST to Platelet Ratio Index (APRI), and Systemic Inflammation Index (SII), in COVID-19 patients with and without diabetes. This cross-sectional study included 336 participants, comprising 168 patients with diabetes matched with 168 without, based on gender, body mass index (BMI), and COVID-19 severity at hospitalization. The study was conducted at Victor Babes Hospital for Infectious Diseases and Pulmonology from January 2021 to December 2023. All participants had a confirmed SARS-CoV-2 infection and met the inclusion criteria of being 18 years or older with type 1 or type 2 diabetes as per American Diabetes Association guidelines. At 3 days post symptom onset, significant differences in inflammatory and liver function markers were observed between the two groups. The dNLR, ALRI, APRI, and SII were notably higher in diabetic patients. At a dNLR cutoff of 2.685, the sensitivity and specificity were 70.312% and 65.978%, respectively, with an AUC of 0.624 (p < 0.001). The ALRI showed a cutoff of 0.812, with a sensitivity of 76.429% and specificity of 69.541% (AUC 0.752, p < 0.001). These markers demonstrated statistically significant hazard ratios at both 3 and 7 days, indicating their predictive relevance for severe COVID-19 outcomes. For instance, at 7 days, SII demonstrated a hazard ratio of 2.62 (CI: 1.29-5.04, p < 0.001), highlighting its strong prognostic capability. The study successfully identified significant differences in inflammatory and liver function markers between COVID-19 patients with and without diabetes, with these markers showing good predictive value for disease severity. The results underscore the potential of these biomarkers, particularly ALRI and SII, as valuable tools in managing COVID-19, aiding in the timely identification of patients at increased risk of severe outcomes.
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Affiliation(s)
- Alexandra Ioana Danila
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
- Department of Anatomy and Embryology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Flavius Cioca
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
- Discipline of Medical Statistics and Bioinformatics, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Sai Teja Gadde
- Faculty of General Medicine, All India Institute of Medical Sciences (AIIMS), Mangalagiri 522503, India;
| | - Sai Praveen Daruvuri
- Faculty of General Medicine, Bukovinian State Medical University, Teatralna Square, 2, 58002 Chernivtsi, Ukraine;
| | - Romulus Timar
- Department of Internal Medicine II, Division of Diabetes, Nutrition and Metabolic Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Elena Hogea
- Discipline of Microbiology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
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Reddy RM, Suthana S, Karthikeyan A, Kulkarni A, Aslam SM, Suhail KM. Prognostic Nutritional Index (PNI) and Systemic Immune-Inflammatory Index (SII) as markers of severity among patients having COVID-19 infection. J Family Med Prim Care 2024; 13:3203-3208. [PMID: 39228591 PMCID: PMC11368287 DOI: 10.4103/jfmpc.jfmpc_20_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/22/2024] [Accepted: 03/28/2024] [Indexed: 09/05/2024] Open
Abstract
Background Prognostic nutritional index (PNI) and systemic immune-inflammatory index (SII) are two novel markers that have emerged as potential candidates as an early indication of the severity of the disease in coronavirus disease 2019 (COVID-19) patients. Objective The objective of the study is to assess the utility of the prognostic nutritional index (PNI) and systemic immune-inflammatory index (SII) as markers of severity among patients with COVID-19 infection. Methods This is a retrospective study conducted in a tertiary care centre in South India. A total of 80 patients diagnosed with COVID-19 were included in the study. The patients were divided into mild, moderate, and severe groups based on the clinical parameters as per Indian Council of Medical Research guidelines. Lab values taken at admission were obtained from patient records, using which the PNI and SII were calculated using standard formulae. These markers were correlated with the severity of the COVID-19 illness. Results PNI and SII were significantly elevated in the patients with severe COVID-19 illness as compared with mild COVID-19 illness. The mean PNI among subjects with mild COVID-19 and severe COVID-19 being 46.62 ± 6.51 and 34.09 ± 5.81, respectively. The mean SII among subjects with mild COVID-19 was 9,52,287.2 ± 1,42,113, and among subjects with severe COVID-19 was 15,39,461 ± 8,04,285. The cut-off value for PNI and SII for predicting severity of COVID-19 illness was 35.93 and 5,82,400, respectively. The sensitivity for PNI was 87.5, and the SII was 95. Conclusion The present study showed a significant correlation between the SII and PNI as markers used to determine the severity of COVID-19. Based on these findings, it can be effectively used independently of other markers to predict critical illness among COVID-19 patients.
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Affiliation(s)
| | - Sana Suthana
- Department of General Medicine, Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Aditya Karthikeyan
- Department of General Medicine, Ramaiah Medical College, Bengaluru, Karnataka, India
| | - Ashwin Kulkarni
- Department of Medicine, Ramaiah Medical College, Bengaluru, Karnataka, India
| | | | - K Mohammed Suhail
- Department of General Medicine, Ramaiah Medical College, Bengaluru, Karnataka, India
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Gao Y, Zhao K, Liu J, Zhang X, Gong L, Zhou X, Chen G. Prediction of Clinical Severity of COVID-19 Using a Combination of Heparin-Binding Protein, Interleukin-6, and C-Reactive Protein: A Retrospective Study. THE CLINICAL RESPIRATORY JOURNAL 2024; 18:e70003. [PMID: 39187469 PMCID: PMC11347126 DOI: 10.1111/crj.70003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 06/16/2024] [Accepted: 08/05/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Systemic inflammation stands as a pivotal factor tightly interwoven with the progression of COVID-19. This study endeavors to elucidate the significance of three key inflammatory molecules, that is, heparin-binding protein (HBP), interleukin-6 (IL-6), and C-reactive protein (CRP), in assessing the severity and prognostic implications of COVID-19. METHODS The demographic, clinical, and laboratory data were retrospectively collected from a cohort of 214 adult patients diagnosed with COVID-19. Patients were divided into two groups: nonsevere (n = 93; 43.5%) and severe (n = 121; 56.5%). Additionally, based on their organ function, patients were categorized into nonorgan failure (n = 137) and organ failure (n = 77) groups. The levels of inflammation-related cytokines were then compared among these defined groups. RESULTS The severe group was characterized by a higher proportion of males, older age, and longer hospital stays compared to nonsevere cases. Additionally, severe cases exhibited a higher prevalence of underlying diseases and organ failure. Statistical analysis revealed significantly elevated levels of HBP, IL-6, and CRP in the severe group. HBP, IL-6, and CRP were identified as independent risk factors for severe COVID-19. Furthermore, a combined assessment of these biomarkers demonstrated superior diagnostic sensitivity (85.10%) and specificity (95.70%) for predicting COVID-19 severity. A positive relationship between elevated HBP, IL-6, and CRP levels and impaired organ function was also observed. The predictive efficiency significantly increased (hazard ratio = 3.631, log-rank p = 0.003) when two or more of them were combinedly used. Notably, elevated levels of HBP, IL-6, and CRP were associated with an increased risk of mortality. CONCLUSIONS In conclusion, the combined assessment of HBP, IL-6, and CRP offers enhanced accuracy and specificity in predicting the severity, organ failure, and mortality risk associated with COVID-19.
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Affiliation(s)
- Yidan Gao
- Department of HepatologyThe Affiliated Hospital of Hangzhou Normal UniversityHangzhouZhejiangChina
| | - Ke Zhao
- Department of Immunology and Pathogen Biology, School of Basic Medical SciencesHangzhou Normal UniversityHangzhouZhejiangChina
| | - Jing Liu
- Department of HepatologyThe Affiliated Hospital of Hangzhou Normal UniversityHangzhouZhejiangChina
| | - Xiangbo Zhang
- Department of HepatologyThe Affiliated Hospital of Hangzhou Normal UniversityHangzhouZhejiangChina
| | - Ling Gong
- Department of HepatologyThe Affiliated Hospital of Hangzhou Normal UniversityHangzhouZhejiangChina
| | - Xiang Zhou
- Department of HepatologyThe Affiliated Hospital of Hangzhou Normal UniversityHangzhouZhejiangChina
| | - Gongying Chen
- Department of HepatologyThe Affiliated Hospital of Hangzhou Normal UniversityHangzhouZhejiangChina
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Durán-Galea A, Cristóbal-Verdejo JI, Barrera-Chacón R, Macías-García B, González-Solís MA, Nicolás-Barceló P, García-Ibáñez AB, Ruíz-Tapia P, Duque-Carrasco FJ. Clinical importance of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and systemic immune-inflammation index in dogs with leishmaniasis. Comp Immunol Microbiol Infect Dis 2024; 107:102148. [PMID: 38430666 DOI: 10.1016/j.cimid.2024.102148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 03/05/2024]
Abstract
Leishmaniasis is a zoonotic disease caused by Leishmania spp., impacts multiple systems and organs. While hematological and biochemical profiles aren't definitive for diagnosis, recent studies have identified the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) as predictors of morbidity and mortality in critically ill human and dog patients. This study examined 100 dogs diagnosed with leishmaniasis, categorized by the International Renal Interest Society (IRIS) stages 1-4. Additionally, the dogs were divided based on whether they survived less or more than one year (L1Y and G1Y). Control group consisted of 43 dogs. The NLR increased as the disease progressed (IRIS 1-4), presenting statistically significant differences (P<0.05) when compared to the control group (2,37±2,08) IRIS 3 and 4 (4,59±13,39 and 6,99±12,86, respectively), and G1Y and L1Y (3,60±4,02 and 4,87±5,82, respectively). Significant changes in SII were only evident in short-term survivors (L1Y 951,93±1402) and advanced renal disease cases (IRIS 4 stage 1073,68±1901,09). Conversely, PLR remained largely unchanged. In conclusion, these results suggest that the neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) may serve as potential markers for assessing disease progression and prognosis in dogs diagnosed with leishmaniasis.
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Affiliation(s)
- A Durán-Galea
- Hospital clínico Veterinario, Universidad de Extremadura, Avenida de la universidad s/n, Cáceres 10003, Spain
| | - J I Cristóbal-Verdejo
- Hospital clínico Veterinario, Universidad de Extremadura, Avenida de la universidad s/n, Cáceres 10003, Spain.
| | - R Barrera-Chacón
- Departamento de Medicina Animal, Universidad de Extremadura, Avenida de la Universidad s/n, Cáceres 10003, Spain
| | - B Macías-García
- Departamento de Medicina Animal, Universidad de Extremadura, Avenida de la Universidad s/n, Cáceres 10003, Spain
| | - M A González-Solís
- Departamento de Medicina Animal, Universidad de Extremadura, Avenida de la Universidad s/n, Cáceres 10003, Spain
| | - P Nicolás-Barceló
- Hospital clínico Veterinario, Universidad de Extremadura, Avenida de la universidad s/n, Cáceres 10003, Spain
| | - A B García-Ibáñez
- Hospital clínico Veterinario, Universidad de Extremadura, Avenida de la universidad s/n, Cáceres 10003, Spain
| | - P Ruíz-Tapia
- Departamento de Medicina Animal, Universidad de Extremadura, Avenida de la Universidad s/n, Cáceres 10003, Spain
| | - F J Duque-Carrasco
- Departamento de Medicina Animal, Universidad de Extremadura, Avenida de la Universidad s/n, Cáceres 10003, Spain
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6
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Yuan H, Tian J, Wen L. Meta-analysis of the systemic immune-inflammatory index and in-hospital mortality of COVID-19 patients. Heliyon 2024; 10:e23441. [PMID: 38223728 PMCID: PMC10784146 DOI: 10.1016/j.heliyon.2023.e23441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/02/2023] [Accepted: 12/04/2023] [Indexed: 01/16/2024] Open
Abstract
Background The potential significance of immunoinflammatory factors in the prognosis of individuals afflicted with coronavirus disease 2019 (COVID-19) is worthy of examination. The systemic immune-inflammatory index (SII), a recently developed immunoinflammatory metric based on the enumeration of neutrophils, platelets, and lymphocytes in blood samples, holds promise for elucidating this relationship. Consequently, in order to explore any possible correlation between the SII levels at admission and the in-hospital mortality of patients with COVID-19, we undertook a thorough systematic review and meta-analysis. Methods In pursuit of accomplishing the aim of this meta-analysis, an extensive search was conducted to seek out pertinent observational studies featuring longitudinal follow-up across PubMed, Cochrane Library, Embase and the Web of Science databases. The I2 statistic was utilized to estimate the extent of heterogeneity and the Cochrane Q test was employed to evaluate heterogeneity between studies. The synthesis of outcomes involved the use of random-effects models, accounting for the possible influence of heterogeneity. Results Our analysis included sixteen studies, encompassing 10,007 hospitalized COVID-19 patients. Among them, 1801 patients (18.0 %) succumbed during hospitalization. The pooled results indicated that a high SII at admission was substantially linked to a higher risk of all-cause mortality (risk ratio [RR]: 2.41, 95 % confidence interval: 1.78 to 3.24, p < 0.001; I2 = 86 %). Meta-regression analysis demonstrated a negative correlation between mean SII at baseline and patient mortality in individual studies (coefficients = -0.00023 and -0.030, p < 0.05), effectively explaining the observed heterogeneity. Furthermore, in patients with lower baseline SII (<1300) and a lower risk of mortality (<20 %), we observed a more pronounced association between high SII levels and the risk of all-cause mortality. Conclusion The results of our study indicate that a high SII upon admission could potentially function as a prognostic indicator for mortality during hospitalization in patients diagnosed with COVID-19, particularly in individuals categorized as low risk.
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Affiliation(s)
- Hao Yuan
- Department of Respiratory and Critical Care Medicine, The Fourth Hospital of Changsha, Changsha, China
| | - Jing Tian
- Department of Respiratory and Critical Care Medicine, The Fourth Hospital of Changsha, Changsha, China
| | - Lu Wen
- Department of Hospital Infection Management, The Fourth Hospital of Changsha, Changsha, China
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Qiu X, Wang Q, Zhang Y, Zhao Q, Jiang Z, Zhou L. Prognostic Value of Neutrophils-to-Lymphocytes Ratio and Platelets-to-Lymphocytes Ratio in Sepsis Patients With Lymphopenia. Biomark Insights 2024; 19:11772719231223156. [PMID: 38186669 PMCID: PMC10768602 DOI: 10.1177/11772719231223156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/11/2023] [Indexed: 01/09/2024] Open
Abstract
Background Inflammation plays a critical role in sepsis. The integration of neutrophil-to-lymphocyte ratio (NLR) and platelets-to-lymphocytes ratio (PLR) from multiple cell types offers a novel approach to rapidly assess inflammation status. However, the predictive role of NLR and PLR in sepsis with lymphopenia remains uncertain. Objectives The purpose of this study was to explore the prognostic value of NLR and PLR in sepsis patients with lymphopenia. Design and methods In this observational retrospective study, we included 172 sepsis patients with lymphopenia and collected clinical characteristics for analysis. Through binary logistic regression analysis, we identified independent factors. Receiver-operating characteristic curves (ROC) and areas under the curves (AUC) were employed to assess the ability to predict hospital mortality risk. Results Our results showed a total hospital mortality rate of 53.49%. Multivariate analysis demonstrated that NLR (OR = 1.11, P < .001) and PLR (OR = 1.01, P = .003) were independent predictors associated with hospital mortality in sepsis patients with lymphopenia. The AUCs of NLR and PLR were 0.750 (95% CI: 0.634-0.788, P < .001) and 0.662 (95% CI: 0.580-0.743, P < .001), respectively. Notably, an optimal cut-off value of 18.93 for NLR displayed a sensitivity of 75.0% and specificity of 63.0% in discriminating hospital mortality in sepsis patients with lymphopenia, while the optimal cut-off value for PLR was 377.50, with a sensitivity of 67.5% and specificity of 64.1%. Conclusion NLR and PLR serve as independent predictors of hospital mortality in sepsis patients with lymphopenia.
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Affiliation(s)
- Xianming Qiu
- Department of Critical Care Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
- Shandong Institute of Respiratory Diseases, Jinan, China
| | - Quanzhen Wang
- Department of Critical Care Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
- Shandong Institute of Anesthesia and Respiratory Critical Medicine, Jinan, China
| | - Yuke Zhang
- Department of Critical Care Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
- Shandong Institute of Respiratory Diseases, Jinan, China
| | - Qiannan Zhao
- Department of Critical Care Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
- Shandong Institute of Respiratory Diseases, Jinan, China
| | - Zhiming Jiang
- Department of Critical Care Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
- Shandong Institute of Anesthesia and Respiratory Critical Medicine, Jinan, China
| | - Lei Zhou
- Department of Critical Care Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China
- Shandong Institute of Respiratory Diseases, Jinan, China
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Bergamaschi G, Barteselli C, Calabretta F, Lenti MV, Merli S, Rossi CM, Di Sabatino A. Haematological sequelae in the post-acute phase of symptomatic SARS-CoV-2 infection. Intern Emerg Med 2024; 19:125-133. [PMID: 38001354 DOI: 10.1007/s11739-023-03459-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 10/10/2023] [Indexed: 11/26/2023]
Abstract
Many patients surviving SARS-CoV-2 infection suffer from long-term symptoms (long COVID or post COVID) such as shortness of breath, fatigue, loss of taste or smell and cognitive deterioration. However, few data are available concerning blood cell counts and haematological parameters during the post-COVID period. We analysed haematological data from 83 patients previously admitted to the internal medicine unit of our institution because of symptomatic SARS-CoV-2 infection; all data were obtained within 1-12 months from disease onset. A control group of 70 apparently healthy, age- and sex-matched COVID-19 negative individuals was assessed for comparison. Blood cell counts improved in the post-COVID period, but 81% of patients had persistent abnormalities, compared with 50% in the control group, p < 0.001. Most common haematological findings included anaemia (40%), reduced lymphocyte (43%) or eosinophil counts (38%) and low IgM memory B cells and correlated with advanced age, number of chronic comorbidities, female gender, altered renal function, reduced baseline Hb and procalcitonin concentrations and increased RDW. Data on lymphocytes and IgM memory B cells show that impaired immune responses may persist for up to one year in the post-COVID period, possibly contributing to long-term symptoms, especially in female patients.
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Affiliation(s)
- Gaetano Bergamaschi
- Internal Medicine Unit, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi, Pavia, Italy.
| | - Chiara Barteselli
- Internal Medicine Unit, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi, Pavia, Italy
| | - Francesca Calabretta
- Internal Medicine Unit, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi, Pavia, Italy
| | - Marco Vincenzo Lenti
- Internal Medicine Unit, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi, Pavia, Italy
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
| | - Stefania Merli
- Internal Medicine Unit, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi, Pavia, Italy
| | - Carlo Maria Rossi
- Internal Medicine Unit, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi, Pavia, Italy
| | - Antonio Di Sabatino
- Internal Medicine Unit, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi, Pavia, Italy
- Department of Internal Medicine and Medical Therapy, University of Pavia, Pavia, Italy
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Cao L, Liu X, Sun T, Zhang Y, Bao T, Cheng H, Tian Z. Predictive and Diagnostic Values of Systemic Inflammatory Indices in Bronchopulmonary Dysplasia. CHILDREN (BASEL, SWITZERLAND) 2023; 11:24. [PMID: 38255338 PMCID: PMC10814477 DOI: 10.3390/children11010024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/19/2023] [Accepted: 12/23/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND Bronchopulmonary dysplasia (BPD) is the most common respiratory complication in preterm infants, and there is a lag in the diagnosis of BPD. Inflammation is a vital pathogenic factor for BPD; we aim to evaluate the predictive and diagnostic values of systemic inflammatory indices in BPD. METHODS Between 1 January 2019 and 31 May 2023, the clinical data of 122 premature infants with a gestational age of <32 weeks in the Department of Neonatology, the Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, were retrospectively collected and classified into non-BPD (n = 72) and BPD (n = 50) groups based on the National Institute of Child Health and Human Development 2018 criteria. To compare the general characteristics of each group, we identified the independent risk variables for BPD using multivariate logistic regression analysis, compared the systemic inflammatory indices at birth, 72 h, 1 week, 2 weeks, and 36 weeks postmenstrual age (PMA), and constructed the receiver operating characteristic curves of neutrophil-to-lymphocyte ratio (NLR) diagnosis of BPD at different time points. RESULTS ① The independent risk factors for BPD in preterm infants were birth weight, small for gestational age, and days of oxygen therapy (all p < 0.05). ② At 72 h and 1 week after birth, the serum NLR of the BPD group was higher than for the non-BPD group (p < 0.05). Furthermore, the neutrophil count (N), NLR, monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index, systemic inflammation response index (SIRI), and pan-immune-inflammation value of infants with BPD were higher than the non-BPD group at 3 weeks after birth (p < 0.05). Moreover, at 36 weeks of PMA, the serum N, NLR, MLR, and SIRI of BPD infants were higher than those of non-BPD infants (p < 0.05). ③ The NLR of infants with and without BPD gradually increased after birth, reaching a peak at 72 h and 1 week, respectively. At 3 weeks postnatal, the NLR had the highest predictive power for BPD, with an area under the curve (AUC) of 0.717 (p < 0.001); the sensitivity was 56% and specificity was 86.1%. In addition, the NLR at 36 weeks of PMA exhibited some diagnostic value for BPD. The AUC was 0.693 (p < 0.001), the sensitivity was 54%, and specificity was 83.3%. CONCLUSIONS At 3 weeks after birth and 36 weeks of PMA, some systemic inflammation indices (like N, NLR, SIRI) of preterm infants with BPD have specific predictive and diagnostic values; these indices may help the management of high-risk preterm infants with BPD.
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Affiliation(s)
| | | | | | | | | | | | - Zhaofang Tian
- Department of Neonatology, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huai’an 223300, China; (L.C.); (X.L.); (T.S.); (Y.Z.); (T.B.); (H.C.)
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Xia W, Jiang T, Tan Y, Li C, Wu S, Mei B. Characteristics of hematological parameters on admission in COVID-19 Omicron variant infected in Chinese population: a large-scale retrospective study. BMC Infect Dis 2023; 23:835. [PMID: 38012548 PMCID: PMC10683119 DOI: 10.1186/s12879-023-08771-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The Omicron variant of SARS-CoV-2, currently the most prevalent strain, has rapidly spread in Jingzhou, China, due to changes in the country's epidemic prevention policy, resulting in an unprecedented increase in cases. Previous studies reported hematological parameters' predictive value in COVID-19 severity and prognosis, but their relevance for early diagnosis in patients infected by the Omicron variant, particularly in high-risk pneumonia cases, remains unclear. Our study aimed to evaluate these parameters as early warning indicators for Omicron-infected patients in fever clinics and those with pulmonary infections (PI). METHODS A total of 2,021 COVID-19 patients admitted to the fever clinic and infectious disease department of Jingzhou Hospital Affiliated to Yangtze University from November 1, 2022, to December 31, 2022, were retrospectively recruited. Demographic and hematological parameters were obtained from the electronic medical records of eligible patients. These hematological parameters were analyzed by receiver operating characteristic (ROC) curves to determine whether they can be used for early diagnosis of COVID-19 patients in fever clinics and the presence of PI in COVID-19 patients. RESULTS Statistical differences in hematological parameters were observed between COVID-19 patients with fever and PI and control groups (P < 0.01). The ROC curve further demonstrated that lymphocyte (LYM) counts, neutrophil (NEU) counts, monocyte-to-lymphocyte ratios (MLR), platelet-to-lymphocyte ratios (PLR), white blood cell counts (WBC), and mean corpuscular hemoglobin concentration (MCHC) were the top 6 indicators in diagnosing Omicron infection with fever, with area under the curve (AUC) values of 0.738, 0.718, 0.713, 0.702, 0.700, and 0.687, respectively (P < 0.01). Furthermore, the mean platelet volume (MPV) with an AUC of 0.764, red blood cell count (RBC) with 0.753, hematocrit (HCT) with 0.698, MLR with 0.694, mean corpuscular hemoglobin (MCH) with 0.676, and systemic inflammation response indexes (SIRI) with 0.673 were the top 6 indicators for the diagnosis of COVID-19 patients with PI (P < 0.01). CONCLUSIONS LYM, NEU, MLR, PLR, WBC, and MCHC can serve as potential prescreening indicators for Omicron infection in fever clinics. Additionally, MPV, RBC, HCT, MLR, MCH, and SIRI can predict the presence of PI in COVID-19 patients infected by the Omicron variant.
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Affiliation(s)
- Wei Xia
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, China
| | - Tao Jiang
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, China
| | - Yafeng Tan
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, China
| | - Chengbin Li
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, China
| | - Song Wu
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, China
| | - Bing Mei
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, Hubei, 434020, China.
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Erdede Ö, Sarı E, Külcü NU, Yamanel RGS. Neutrophil-to-Lymphocyte Ratio and the Systemic Immune-Inflammation Index: Biomarkers in Infants with Bronchiolitis: a Cross-Sectional Study. Jpn J Infect Dis 2023; 76:351-357. [PMID: 37518068 DOI: 10.7883/yoken.jjid.2023.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
The use of a novel inflammatory indicator, the systemic immune-inflammatory index (SII), in pediatric patients with bronchiolitis remains unreported. Therefore, this study investigated the relationship between the SII and the neutrophil-to-lymphocyte ratio (NLR) in patients with respiratory syncytial virus (RSV) and non-RSV bronchiolitis and clinical severity prediction. This study analyzed the data of 155 patients aged <2 years who were hospitalized for viral bronchiolitis caused by RSV and/or other viral pathogens. The SII (platelet count × [neutrophil/lymphocyte]) was calculated and compared among patients with RSV mono-infections, other viral mono-infections, and RSV co-infections. Severity was defined by the number of days of supplemental oxygen treatment. The NLR and SII were significantly higher in the non-RSV mono-infection group than in the RSV mono-infection group, and the number of days of supplemental oxygen therapy was significantly higher in the RSV mono-infection group. No significant differences in the NLR, SII, or days of supplemental oxygen therapy were found between the RSV mono-infection and RSV co-infection groups. Although patients with RSV mono-infection showed more severe clinical findings than those without non-RSV mono-infection, the NLR and SII values were significantly higher in the non-RSV mono-infection group. Therefore, the NLR and SII do not appear to be very useful measurements for determining the severity of acute bronchiolitis attacks; however, lower NLR and SII values in the RSV group compared to the non-RSV group may be potential biomarkers for RSV infection. Therefore, further studies are warranted.
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Affiliation(s)
- Özlem Erdede
- Department of Pediatrics, Zeynep Kamil Maternity and Children's Disease Training and Research Hospital, University of Health Sciences, Turkey
| | - Erdal Sarı
- Department of Pediatrics, Zeynep Kamil Maternity and Children's Disease Training and Research Hospital, University of Health Sciences, Turkey
| | - Nihan Uygur Külcü
- Department of Pediatrics, Zeynep Kamil Maternity and Children's Disease Training and Research Hospital, University of Health Sciences, Turkey
| | - Rabia Gönül Sezer Yamanel
- Department of Pediatrics, Zeynep Kamil Maternity and Children's Disease Training and Research Hospital, University of Health Sciences, Turkey
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Serban D, Stoica PL, Dascalu AM, Bratu DG, Cristea BM, Alius C, Motofei I, Tudor C, Tribus LC, Serboiu C, Tudosie MS, Tanasescu D, Vancea G, Costea DO. The Significance of Preoperative Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Systemic Inflammatory Index (SII) in Predicting Severity and Adverse Outcomes in Acute Calculous Cholecystitis. J Clin Med 2023; 12:6946. [PMID: 37959411 PMCID: PMC10648653 DOI: 10.3390/jcm12216946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023] Open
Abstract
The prediction of severity in acute calculous cholecystitis (AC) is important in therapeutic management to ensure an early recovery and prevent adverse postoperative events. We analyzed the value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammatory index (SII) to predict advanced inflammation, the risk for conversion, and postoperative complications in AC. Advanced AC was considered the cases with empyema, gangrene, perforation of the gallbladder, abscesses, or difficulties in achieving the critical view of safety. A 3-year retrospective was performed on 235 patients admitted in emergency care for AC. The NLR was superior to the PLR and SII in predicting advanced inflammation and risk for conversion. The best predictive value was found to be at an NLR "cut-off" value of >4.19, with a sensitivity of 85.5% and a specificity of 66.9% (AUC = 0.824). The NLR, SII, and TG 13/18 correlate well with postoperative complications of Clavien-Dindo grade IV (p < 0.001 for all variables) and sepsis. For predicting early postoperative sepsis, TG 13/18 grading >2 and NLR > 8.54 show the best predicting power (AUC = 0.931; AUC = 0.888, respectively), although not significantly higher than that of the PLR and SII. The NLR is a useful biomarker in assessing the severity of inflammation in AC. The SII and PLR may be useful in the prediction of systemic inflammatory response.
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Affiliation(s)
- Dragos Serban
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania; (D.S.); (B.M.C.); (C.A.); (I.M.); (C.S.); (G.V.)
- Fourth General Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania
| | - Paul Lorin Stoica
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania; (D.S.); (B.M.C.); (C.A.); (I.M.); (C.S.); (G.V.)
| | - Ana Maria Dascalu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania; (D.S.); (B.M.C.); (C.A.); (I.M.); (C.S.); (G.V.)
| | - Dan Georgian Bratu
- Faculty of Medicine, University Lucian Blaga Sibiu, 550169 Sibiu, Romania;
- Department of Surgery, Emergency County Hospital Sibiu, 550245 Sibiu, Romania
| | - Bogdan Mihai Cristea
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania; (D.S.); (B.M.C.); (C.A.); (I.M.); (C.S.); (G.V.)
| | - Catalin Alius
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania; (D.S.); (B.M.C.); (C.A.); (I.M.); (C.S.); (G.V.)
- Fourth General Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania
| | - Ion Motofei
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania; (D.S.); (B.M.C.); (C.A.); (I.M.); (C.S.); (G.V.)
- Department of General Surgery, Emergency Clinic Hospital “Sf. Pantelimon” Bucharest, 021659 Bucharest, Romania
| | - Corneliu Tudor
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania; (D.S.); (B.M.C.); (C.A.); (I.M.); (C.S.); (G.V.)
- Fourth General Surgery Department, Emergency University Hospital Bucharest, 050098 Bucharest, Romania
| | - Laura Carina Tribus
- Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania
- Department of Internal Medicine, Ilfov Emergency Clinic Hospital Bucharest, 022104 Bucharest, Romania
| | - Crenguta Serboiu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania; (D.S.); (B.M.C.); (C.A.); (I.M.); (C.S.); (G.V.)
| | - Mihail Silviu Tudosie
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania; (D.S.); (B.M.C.); (C.A.); (I.M.); (C.S.); (G.V.)
| | - Denisa Tanasescu
- Department of Nursing and Dentistry, Faculty of General Medicine, University Lucian Blaga Sibiu, 550169 Sibiu, Romania;
| | - Geta Vancea
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania; (D.S.); (B.M.C.); (C.A.); (I.M.); (C.S.); (G.V.)
- Clinical Hospital of Infectious and Tropical Diseases “Dr. Victor Babes”, 030303 Bucharest, Romania
| | - Daniel Ovidiu Costea
- Faculty of Medicine, Ovidius University Constanta, 900470 Constanta, Romania;
- General Surgery Department, Emergency County Hospital Constanta, 900591 Constanta, Romania
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13
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Ünal Ç, Tunçer G, Çopur B, Pilanci KN, Okutur KS, Yararbaş K, Alan Ö, Sakin A, Simsek M, Ünal İÖ, Topçu A, Alaca Topçu Z, Duymaz T, Ordu Ç. Clinical and inflammation marker features of cancer patients with COVID-19: data of Istanbul, Turkey multicenter cancer patients (2020-2022). Curr Med Res Opin 2023; 39:987-996. [PMID: 37300513 DOI: 10.1080/03007995.2023.2223917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVE We aimed to identify a rapid, accurate, and accessible biomarker in the early stages of COVID-19 that can determine the prognosis of the disease in cancer patients. METHODS A total number of 241 patients with solid cancers who had a COVID-19 diagnosis between March 2020 and February 2022 were included in the study. Factors and ten different markers of inflammation were analyzed by year of diagnosis of COVID-19 and grouped by severity of infection. RESULTS Hospitalization, referral to the intensive care unit (ICU), mechanical ventilation, and death were more frequent in 2020 than in 2021 and 2022 (mortality rates, respectively, were 18.8%, 3.8%, and 2.5%). Bilateral lung involvement and chronic lung disease were independent risk factors for severe disease in 2020. In 2021-2022, only bilateral lung involvement was found as an independent risk factor for severe disease. The neutrophil-to-lymphocyte platelet ratio (NLPR) with the highest area under the curve (AUC) value in 2020 had a sensitivity of 71.4% and specificity of 73.3% in detecting severe disease (cut-off > 0.0241, Area Under the Curve (AUC) = 0.842, p <.001). In 2021-2022, the sensitivity of the C-reactive protein-to-lymphocyte ratio (CRP/L) with the highest AUC value was 70.0%, and the specificity was 73.3% (cut-off > 36.7, AUC = 0.829, p = .001). CONCLUSIONS This is the first study to investigate the distribution and characteristics of cancer patients, with a focus on the years of their COVID-19 diagnosis. Based on the data from our study, bilateral lung involvement is an independent factor for severe disease, and the CRP/L inflammation index appears to be the most reliable prognostic marker.
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Affiliation(s)
- Çağlar Ünal
- Division of Medical Oncology, Department of Internal Medicine, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey
| | - Gülşah Tunçer
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Betül Çopur
- Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Kezban Nur Pilanci
- Division of Medical Oncology, Department of Internal Medicine, Memorial Bahçelievler Hospital, Istanbul, Turkey
| | - Kerem Sadi Okutur
- Division of Medical Oncology, Department of Internal Medicine, Memorial Bahçelievler Hospital, Istanbul, Turkey
| | - Kanay Yararbaş
- Department of Medical Genetics, Demiroglu Bilim University, Istanbul, Turkey
| | - Özkan Alan
- Division of Medical Oncology, Department of Internal Medicine, Koc University Hospital, Istanbul, Turkey
| | - Abdullah Sakin
- Division of Medical Oncology, Department of Internal Medicine, Bahçelievler Medipol Hospital, Istanbul, Turkey
| | - Melih Simsek
- Division of Medical Oncology, Department of Internal Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | | | - Atakan Topçu
- Division of Medical Oncology, Department of Internal Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Zeynep Alaca Topçu
- Division of Medical Oncology, Department of Internal Medicine, Göztepe Medeniyet University, Istanbul, Turkey
| | - Tomris Duymaz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Bilgi University, Istanbul, Turkey
| | - Çetin Ordu
- Division of Medical Oncology, Department of Internal Medicine, Gayrettepe Florence Nightingale Hospital, Istanbul, Turkey
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14
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Yushchuk A, Pykaliuk V, Korzhyk O. Hematocytological, biochemical, and hemostasis parameters' role in predicting the possibility of the various forms of the COVID-19 course in hospitalized Ukrainian patients: A cross-sectional study. Health Sci Rep 2023; 6:e1403. [PMID: 37415673 PMCID: PMC10321232 DOI: 10.1002/hsr2.1403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 06/25/2023] [Accepted: 06/26/2023] [Indexed: 07/08/2023] Open
Abstract
Background and Aims The main objective of this study is to establish the characteristics of blood laboratory parameters in hospitalized coronavirus disease 2019 (COVID-19) Ukrainian patients and the significance of the above-mentioned parameters for predicting the course of the disease. Methods Hematocytological, biochemical, and hemostasis methods of research have been used. Groups of patients with different forms of the coronavirus disease course have been analyzed (lethality - recovery, recovery with a severe and mild course). Results and Conclusion Age is one of the risk factors for COVID-19 mortality. Absolute values of neutrophils, neutrophil-lymphocyte ratio (NLR), systemic inflammation index, d-dimer, C-reactive protein, and soluble fibrin complex can be used by clinicians to effectively differentiate between two possible outcomes (lethality vs. recovery). A higher number of stab leukocytes, d-NLR, and platelets concentration have been recorded in patients with severe COVID-19 cases, compared to mild ones. The risk of adverse COVID-19 outcome (lethality) is significantly linked with d-dimer and NLR (odds ratio 1.42). The risk of a severe course of the disease was significantly associated with the count of leukocytes (odds ratio 4.96).
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Affiliation(s)
- Anna Yushchuk
- Clinical and Diagnostic Laboratory of the Municipal Enterprise Volyn Regional Infectious Diseases Hospital of the Volyn Regional Council, Faculty of MedicineLesya Ukrainka Volyn National UniversityLutskUkraine
| | - Vasyl Pykaliuk
- Department of Human Anatomy, Faculty of MedicineLesya Ukrainka Volyn National UniversityLutskUkraine
| | - Olha Korzhyk
- Department of Human and Animal Physiology, Faculty of Biology and ForestryLesya Ukrainka Volyn National UniversityLutskUkraine
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15
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Mangoni AA, Zinellu A. Systemic inflammation index, disease severity, and mortality in patients with COVID-19: a systematic review and meta-analysis. Front Immunol 2023; 14:1212998. [PMID: 37415980 PMCID: PMC10320859 DOI: 10.3389/fimmu.2023.1212998] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/06/2023] [Indexed: 07/08/2023] Open
Abstract
Introduction An excessive systemic pro-inflammatory state increases the risk of severe disease and mortality in patients with coronavirus disease 2019 (COVID-19). However, there is uncertainty regarding whether specific biomarkers of inflammation can enhance risk stratification in this group. We conducted a systematic review and meta-analysis to investigate an emerging biomarker of systemic inflammation derived from routine hematological parameters, the systemic inflammation index (SII), in COVID-19 patients with different disease severity and survival status. Methods A systematic literature search was conducted in PubMed, Web of Science, and Scopus, between the 1st of December 2019 and the 15th of March 2023. Risk of bias and certainty of evidence were assessed using the Joanna Briggs Institute Critical Appraisal Checklist and the Grades of Recommendation, Assessment, Development and Evaluation, respectively (PROSPERO registration number: CRD42023420517). Results In 39 studies, patients with a severe disease or non-survivor status had significantly higher SII values on admission compared to patients with a non-severe disease or survivor status (standard mean difference (SMD)=0.91, 95% CI 0.75 to 1.06, p<0.001; moderate certainty of evidence). The SII was also significantly associated with the risk of severe disease or death in 10 studies reporting odds ratios (1.007, 95% CI 1.001 to 1.014, p=0.032; very low certainty of evidence) and in six studies reporting hazard ratios (1.99, 95% CI 1.01 to 3.92, p=0.047; very low certainty of evidence). Pooled sensitivity, specificity, and area under the curve for severe disease or mortality were 0.71 (95% CI 0.67 to 0.75), 0.71 (95% CI 0.64 to 0.77), and 0.77 (95% CI 0.73 to 0.80), respectively. In meta-regression, significant correlations were observed between the SMD and albumin, lactate dehydrogenase, creatinine, and D-dimer. Discussion Our systematic review and meta-analysis has shown that the SII on admission is significantly associated with severe disease and mortality in patients with COVID-19. Therefore, this inflammatory biomarker derived from routine haematological parameters can be helpful for early risk stratification in this group. Systematic review registration https://www.crd.york.ac.uk/PROSPERO, identifier CRD42023420517.
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Affiliation(s)
- Arduino A. Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Department of Clinical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
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16
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Aghbash PS, Rasizadeh R, Shirvaliloo M, Nahand JS, Baghi HB. Dynamic alterations in white blood cell counts and SARS-CoV-2 shedding in saliva: an infection predictor parameter. Front Med (Lausanne) 2023; 10:1208928. [PMID: 37396915 PMCID: PMC10313227 DOI: 10.3389/fmed.2023.1208928] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction The recent coronavirus (COVID-19) outbreak posed a global threat and quickly escalated to a pandemic. However, accurate information on potential relationships between SARS-CoV-2 shedding in body fluids, especially saliva, and white blood cell (WBC) count is limited. In the present study we investigated the potential correlation between alterations in blood cell counts and viral shedding in saliva in a cohort of COVID-19 patients. Method In this preliminary clinical research, 24 age-matched COVID-19 patients without comorbidities, 12 (50%) men and 12 (50%) women, were followed up for a period of 5 days to investigate whether changes in the level of viral shedding in saliva might parallel with temporal alterations in WBC count. Viral shedding in saliva was qualitatively measured by performing SARS-CoV-2 rapid antigen tests on patient saliva samples, using SARS-CoV-2 Rapid Antigen Test Kit (Roche, Basel, Switzerland). These patients were classified into two groups with sputum and non-sputum cough. WBCs counts including leukocyte (LYM), neutrophil (NEU), and LYM counts were recorded for each patient on days 1, 3, and 5. Results The results of the present study showed that the levels of WBC, LYM, and NEU as well as erythrocyte sedimentation rate (ESR) increased significantly on the 5th day compared to the first day in both groups with sputum. However, the levels of C-reactive protein (CRP), Neutrophil-to-Lymphocyte Ratio (NLR) and lactate dehydrogenase (LDH) did not show significant changes. Conclusion This study proves that investigating the change in the number of blood LYMs as well as laboratory parameters such as CRP, LDH, and ESR as biomarkers is an accurate indicator to detect the amount of viral shedding in people with sputum and non-sputum. The results of our study denote that the measured parameters exhibit the intensity of viral shedding in people with sputum.
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Affiliation(s)
- Parisa Shiri Aghbash
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reyhaneh Rasizadeh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Milad Shirvaliloo
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Javid Sadri Nahand
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Bannazadeh Baghi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Daorattanachai K, Hirunrut C, Pirompanich P, Weschawalit S, Srivilaithon W. Association of Monocyte Distribution Width with the Need for Respiratory Support in Hospitalized COVID-19 Patients. Indian J Crit Care Med 2023; 27:352-357. [PMID: 37214109 PMCID: PMC10196649 DOI: 10.5005/jp-journals-10071-24447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/04/2023] [Indexed: 05/24/2023] Open
Abstract
Background The monocyte distribution width (MDW), a novel inflammatory biomarker reflecting morphological changes in response to inflammation, has been shown to be useful in identifying COVID-19 infection or predicting death. However, data on the association with predicting the need for respiratory support are still limited. The aim of this study was to determine the association of MDW with the need for respiratory support in patients with SARS-CoV-2 infection. Patients and methods This is a single-center retrospective cohort study. Consecutive hospitalized COVID-19 adult patients who presented at the outpatient department (OPD) or emergency department (ED) between May and August 2021 were enrolled. Respiratory support was defined as any one of the following: conventional oxygen therapy, high-flow oxygen nasal cannula, noninvasive, or invasive mechanical ventilation. The performance of MDW was measured using the area under the receiver operating characteristic (AuROC) curve. Results Of the 250 enrolled patients, 122 (48.8%) patients received respiratory support. The mean MDW was significantly higher in the respiratory support group: 27.2 ± 4.6 vs 23.6 ± 4.1 (p < 0.001). The MDW ≥ 25 had the best AuROC characteristics of 0.70 (95% CI: 0.65-0.76). Conclusions The MDW is a potential biomarker that may aid in identifying individuals at risk of requiring oxygen support in COVID-19 and can be easily implemented in clinical practice. How to cite this article Daorattanachai K, Hirunrut C, Pirompanich P, Weschawalit S, Srivilaithon W. Association of Monocyte Distribution Width with the Need for Respiratory Support in Hospitalized COVID-19 Patients. Indian J Crit Care Med 2023;27(5):352-357.
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Affiliation(s)
| | - Chachchom Hirunrut
- Department of Emergency Medicine, Thammasat University, Pathum Thani, Thailand
| | - Pattarin Pirompanich
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Thammasat University, Thailand
| | - Sinee Weschawalit
- Division of Dermatology, Department of Medicine, Thammasat University, Thailand
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Tanacan A, Oluklu D, Laleli Koc B, Sinaci S, Menekse Beser D, Uyan Hendem D, Yildirim M, Sakcak B, Besimoglu B, Tugrul Ersak D, Akgun Aktas B, Gulen Yildiz E, Unlu S, Kara O, Alyamac Dizdar E, Canpolat FE, Ates İ, Moraloglu Tekin O, Sahin D. The utility of systemic immune-inflammation index and systemic immune-response index in the prediction of adverse outcomes in pregnant women with coronavirus disease 2019: Analysis of 2649 cases. J Obstet Gynaecol Res 2023; 49:912-919. [PMID: 36582132 DOI: 10.1111/jog.15533] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022]
Abstract
AIM To investigate the association of systemic immune-inflammation index (SII) and systemic immune-response index (SIRI) with adverse perinatal outcomes in pregnant women with coronavirus disease 2019 (COVID-19). METHODS The cases were divided into (1) the Mild-moderate COVID-19 group (n = 2437) and (2) the Severe-critical COVID-19 group (n = 212). Clinical characteristics, perinatal outcomes, SII (neutrophilXplatelet/lymphocyte), and SIRI (neutrophilXmonocyte/lymphocyte) were compared between the groups. Afterward, SII and SIRI values were compared between subgroups based on pregnancy complications, neonatal intensive care unit (NICU) admission, and maternal mortality. A receiver operator characteristic analysis was performed for the determination of optimal cutoff values for SII and SIRI in the prediction of COVID-19 severity, pregnancy complications, NICU admission, and maternal mortality. RESULTS Both SII and SIRI were significantly higher in complicated cases (p < 0.05). Cutoff values in the prediction of severe-critical COVID-19 were 1309.8 for SII, and 2.3 for SIRI. For pregnancy complications, optimal cutoff values were 973.2 and 1.6. Cutoff values of 1045.4 and 1.8 were calculated for the prediction of NICU admission. Finally, cut-off values of 1224.2 and 2.4 were found in the prediction of maternal mortality. CONCLUSION SII and SIRI might be used in combination with other clinical findings in the prediction of poor perinatal outcomes.
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Affiliation(s)
- Atakan Tanacan
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Deniz Oluklu
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Bergen Laleli Koc
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Selcan Sinaci
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Dilek Menekse Beser
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Derya Uyan Hendem
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Muradiye Yildirim
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Bedri Sakcak
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Berhan Besimoglu
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Duygu Tugrul Ersak
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Betul Akgun Aktas
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Esra Gulen Yildiz
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Serpil Unlu
- Department of Infectious Diseases, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Ozgur Kara
- Perinatology Clinic, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Evrim Alyamac Dizdar
- Neonatal Intensive Care Unit, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Fuat Emre Canpolat
- Neonatal Intensive Care Unit, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - İhsan Ates
- Department of Internal Medicine, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Ozlem Moraloglu Tekin
- Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Dilek Sahin
- Department of Obstetrics and Gynecology, University of Health Sciences, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
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Segalo S, Kiseljakovic E, Papic E, Joguncic A, Pasic A, Sahinagic M, Lepara O, Sporisevic L. The Role of Hemogram-derived Ratios in COVID-19 Severity Stratification in a Primary Healthcare Facility. Acta Inform Med 2023; 31:41-47. [PMID: 37038490 PMCID: PMC10082658 DOI: 10.5455/aim.2023.31.41-47] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 03/15/2023] [Indexed: 04/12/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) can cause a wide clinical spectrum, ranging from asymptomatic to severe disease with a high mortality rate. In view of the current pandemic and the increasing influx of patients into healthcare facilities, there is a need to identify simple and reliable tools for stratifying patients. Objective Study aimed to analyze whether hemogram-derived ratios (HDRs) can be used to identify patients with a risk of developing a severe clinical form and admission to hospital. Methods This cross-sectional and observational study included 500 patients with a confirmed diagnosis of COVID-19. Data on clinical features and laboratory parameters were collected from medical records and 13 HDRs were calculated and analyzed. Descriptive and inferential statistics were included in the analysis. Results Of the 500 patients, 43.8% had a severe form of the disease. Lymphocytopenia, monocytopenia, higher C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were found in severe patients (p < 0.05). Significantly higher neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), neutrophil-to-platelet ratio (NPR), neutrophil-to-lymphocyte-to-platelet ratio (NLPR) and CRP-to-lymphocyte ratio (CRP/Ly) values were found in severe patients (p < 0.001). In addition, they have statistically significant prognostic potential (p < 0.001). The area under the curve (AUC) for CRP/Ly, dNLR, NLPR, NLR, and NPR were 0.693, 0.619, 0.619, 0.616, and 0.603, respectively. The sensitivity and specificity were 65.7% and 65.6% for CRP/Ly, 51.6% and 70.8 for dNLR, 61.6% and 57.3% for NLPR, 40.6% and 80.4% for NLR, and 48.8% and 69.1% for NPR. Conclusion The results of the study suggest that NLR, dNLR, CRP/Ly, NPR, and NLPR can be considered as potentially useful markers for stratifying patients with a severe form of the disease. HDRs derived from routine blood tests results should be included in common laboratory practice since they are readily available, easy to calculate, and inexpensive.
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Affiliation(s)
- Sabina Segalo
- University of Sarajevo, Faculty of Health Studies, Sarajevo, Bosnia and Herzegovina
| | - Emina Kiseljakovic
- University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina
| | - Emsel Papic
- University of Sarajevo, Faculty of Health Studies, Sarajevo, Bosnia and Herzegovina
| | - Anes Joguncic
- University of Sarajevo, Faculty of Health Studies, Sarajevo, Bosnia and Herzegovina
- Public Health Institute of Canton Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Aleksandra Pasic
- University of Sarajevo, Faculty of Health Studies, Sarajevo, Bosnia and Herzegovina
- Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Mubera Sahinagic
- Public Institution Medical Center of Sarajevo Canton, Sarajevo, Bosnia and Herzegovina
| | - Orhan Lepara
- University of Sarajevo, Faculty of Medicine, Sarajevo, Bosnia and Herzegovina
| | - Lutvo Sporisevic
- Public Institution Medical Center of Sarajevo Canton, Sarajevo, Bosnia and Herzegovina
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20
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Coşkun S, Güngörer V, Öner N, Sezer M, Karagöl C, Tekin ZE, Tekgöz PN, Kaplan MM, Polat MC, Çelikel E, Acar BÇ. The role of indices in predicting disease severity and outcomes of multisystem inflammatory syndrome in children. Pediatr Int 2023; 65:e15609. [PMID: 37674297 DOI: 10.1111/ped.15609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/23/2023] [Accepted: 06/23/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the role of the systemic immune inflammation index (SII), C-reactive protein/albumin ratio (CAR), the monocyte/lymphocyte ratio (MLR), and the neutrophil/lymphocyte ratio (NLR) in predicting disease severity, treatment, and prognosis in multisystem inflammatory syndrome in children (MIS-C). METHODS This medical record review retrospectively evaluated the clinical and laboratory findings of 191 MIS-C patients followed in the Department of Pediatric Rheumatology at Ankara City Hospital, Turkey. The patients were grouped by disease severity: mild, moderate, and severe. SII, CAR, MLR, and NLR were calculated for each group. RESULTS All patients had fever at the time of admission; 153 (80.1%) had gastrointestinal tract involvement, 74 (38.7%) had rash, 63 (33%) had conjunctivitis, 107 (56%) had cardiac involvement, 32 (15.6%) had renal involvement, and 143 (74.9%) had hematological involvement. According to logistic regression analysis, SII, NLR, MLR, and CAR were found to be predictive indexes for disease severity, need for intensive care, need for inotropes, and anakinra treatment in MIS-C. The cut-off values of ≥1605.3 for SII, ≥9.1 for NLR, and ≥3.9 for CAR increased the risk of severe disease by 3.4, 7.1, and 5.7 times, respectively. CONCLUSION NLR, SII, MLR, and CAR are effective and useful for predicting the severity of MIS-C, the need for intensive care, and the need for anakinra treatment.
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Affiliation(s)
- Serkan Coşkun
- Division of Pediatric Rheumatology, Department of Pediatrics, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Vildan Güngörer
- Division of Pediatric Rheumatology, Department of Pediatrics, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Nimet Öner
- Division of Pediatric Rheumatology, Department of Pediatrics, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Müge Sezer
- Division of Pediatric Rheumatology, Department of Pediatrics, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Cüneyt Karagöl
- Division of Pediatric Rheumatology, Department of Pediatrics, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Zahide Ekici Tekin
- Division of Pediatric Rheumatology, Department of Pediatrics, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Pakize Nilüfer Tekgöz
- Division of Pediatric Rheumatology, Department of Pediatrics, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Melike Mehveş Kaplan
- Division of Pediatric Rheumatology, Department of Pediatrics, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Merve Cansu Polat
- Division of Pediatric Rheumatology, Department of Pediatrics, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Elif Çelikel
- Division of Pediatric Rheumatology, Department of Pediatrics, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Banu Çelikel Acar
- Division of Pediatric Rheumatology, Department of Pediatrics, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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21
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Qiu W, Shi Q, Chen F, Wu Q, Yu X, Xiong L. The derived neutrophil to lymphocyte ratio can be the predictor of prognosis for COVID-19 Omicron BA.2 infected patients. Front Immunol 2022; 13:1065345. [PMID: 36405724 PMCID: PMC9666892 DOI: 10.3389/fimmu.2022.1065345] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 10/20/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Several systemic inflammatory biomarkers have been associated with poor overall survival (OS) and disease severity in patients with coronavirus disease 2019 (COVID-19). However, it remains unclear which markers are better for predicting prognosis, especially for COVID-19 Omicron BA.2 infected patients. The present study aimed to identify reliable predictors of prognosis of COVID-19 Omicron BA.2 from inflammatory indicators. METHODS A cohort of 2645 COVID-19 Omicron BA.2 infected patients were retrospectively analyzed during the Omicron BA.2 surge in Shanghai between April 12, 2022, and June 17, 2022. The patients were admitted to the Shanghai Fourth People's Hospital, School of Medicine, Tongji University. Six systemic inflammatory indicators were included, and their cut-off points were calculated using maximally selected rank statistics. The analysis involved Kaplan-Meier curves, univariate and multivariate Cox proportional hazard models, and time-dependent receiver operating characteristic curves (time-ROC) for OS-associated inflammatory indicators. RESULTS A total of 2347 COVID-19 Omicron BA.2 infected patients were included. All selected indicators proved to be independent predictors of OS in the multivariate analysis (all P < 0.01). A high derived neutrophil to lymphocyte ratio (dNLR) was associated with a higher mortality risk of COVID-19 [hazard ratio, 4.272; 95% confidence interval (CI), 2.417-7.552]. The analyses of time-AUC and C-index showed that the dNLR (C-index: 0.844, 0.824, and 0.718 for the 5th, 10th, and 15th day, respectively) had the best predictive power for OS in COVID-19 Omicron BA.2 infected patients. Among different sub-groups, the dNLR was the best predictor for OS regardless of age (0.811 for patients aged ≥70 years), gender (C-index, 0.880 for men and 0.793 for women) and disease severity (C-index, 0.932 for non-severe patients and 0.658 for severe patients). However, the platelet to lymphocyte ratio was superior to the other indicators in patients aged <70 years. CONCLUSIONS The prognostic ability of the dNLR was higher than the other evaluated inflammatory indicators for all COVID-19 Omicron BA.2 infected patients.
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Affiliation(s)
- Weiji Qiu
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, China,Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai, China,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, China,Clinical Research Centre for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
| | - Qiqing Shi
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, China,Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai, China,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, China,Clinical Research Centre for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
| | - Fang Chen
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, China,Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai, China,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, China,Clinical Research Centre for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
| | - Qian Wu
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, China,Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai, China,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, China,Clinical Research Centre for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
| | - Xiya Yu
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, China,Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai, China,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, China,Clinical Research Centre for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China,*Correspondence: Xiya Yu, ; Lize Xiong,
| | - Lize Xiong
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, China,Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai, China,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, China,Clinical Research Centre for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China,*Correspondence: Xiya Yu, ; Lize Xiong,
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22
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Fabre B, Fernandez Machulsky N, Olano C, Jacobsen D, Gómez ME, Perazzi B, Zago V, Zopatti D, Ferrero A, Schreier L, Berg G. Remnant cholesterol levels are associated with severity and death in COVID-19 patients. Sci Rep 2022; 12:17584. [PMID: 36266451 PMCID: PMC9584251 DOI: 10.1038/s41598-022-21177-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 09/23/2022] [Indexed: 01/13/2023] Open
Abstract
Coronavirus disease-19 (COVID-19) patients with severe complications present comorbidities like cardiovascular-disease, hypertension and type-2 diabetes mellitus (DM), sharing metabolic alterations like insulin resistance (IR) and dyslipidemia. Our objective was to evaluate the association among different components of the lipid-lipoprotein profile, such as remnant lipoprotein (RLP)-cholesterol, in patients with COVID-19, and to analyze their associations with the severity of the disease and death. We studied 193 patients (68 (29-96) years; 49.7% male) hospitalized for COVID-19 and 200 controls (46 (18-79) years; 52.5% male). Lipoprotein profile, glucose and procalcitonin were assessed. Patients presented higher glucose, TG, TG/HDL-cholesterol and RLP-cholesterol levels, but lower total, LDL, HDL and no-HDL-cholesterol levels (p < 0.001). When a binary logistic regression was performed, age, non-HDL-cholesterol, and RLP-cholesterol were associated with death (p = 0.005). As the COVID-19 condition worsened, according to procalcitonin tertiles, a decrease in all the cholesterol fractions (p < 0.03) was observed with no differences in TG, while levels of RLP-cholesterol and TG/HDL-cholesterol increased (p < 0.001). Lower levels of all the cholesterol fractions were related with the presence and severity of COVID-19, except for RLP-cholesterol levels and TG/HDL-cholesterol index. These alterations indicate a lipid metabolic disorder, characteristic of IR states in COVID-19 patients. RLP-cholesterol levels predicted severity and death in these patients.
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Affiliation(s)
- Bibiana Fabre
- grid.7345.50000 0001 0056 1981Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Cátedra de Bioquímica Clínica I, Junín 956 (C1113AAD), Buenos Aires, Argentina ,grid.7345.50000 0001 0056 1981Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Nahuel Fernandez Machulsky
- grid.7345.50000 0001 0056 1981Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Cátedra de Bioquímica Clínica I, Junín 956 (C1113AAD), Buenos Aires, Argentina ,grid.7345.50000 0001 0056 1981Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Carolina Olano
- grid.7345.50000 0001 0056 1981Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Cátedra de Bioquímica Clínica I, Junín 956 (C1113AAD), Buenos Aires, Argentina ,grid.7345.50000 0001 0056 1981Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Darío Jacobsen
- grid.7345.50000 0001 0056 1981Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Cátedra de Bioquímica Clínica I, Junín 956 (C1113AAD), Buenos Aires, Argentina
| | - María Eugenia Gómez
- grid.7345.50000 0001 0056 1981Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Cátedra de Bioquímica Clínica I, Junín 956 (C1113AAD), Buenos Aires, Argentina
| | - Beatriz Perazzi
- grid.7345.50000 0001 0056 1981Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Cátedra de Bioquímica Clínica I, Junín 956 (C1113AAD), Buenos Aires, Argentina ,grid.7345.50000 0001 0056 1981Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Valeria Zago
- grid.7345.50000 0001 0056 1981Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Cátedra de Bioquímica Clínica I, Junín 956 (C1113AAD), Buenos Aires, Argentina ,grid.7345.50000 0001 0056 1981Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Universidad de Buenos Aires, Buenos Aires, Argentina ,grid.7345.50000 0001 0056 1981Facultad de Farmacia y Bioquímica, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Damián Zopatti
- grid.7345.50000 0001 0056 1981Facultad de Medicina, Dirección de Estadística y Archivo Médico, Hospital de Clínicas José de San Martin, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Andrés Ferrero
- grid.7345.50000 0001 0056 1981Facultad de Medicina, Director Adjunto Hospital de Clínicas José de San Martin, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Laura Schreier
- grid.7345.50000 0001 0056 1981Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Cátedra de Bioquímica Clínica I, Junín 956 (C1113AAD), Buenos Aires, Argentina ,grid.7345.50000 0001 0056 1981Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Gabriela Berg
- grid.7345.50000 0001 0056 1981Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Cátedra de Bioquímica Clínica I, Junín 956 (C1113AAD), Buenos Aires, Argentina ,grid.7345.50000 0001 0056 1981Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Universidad de Buenos Aires, Buenos Aires, Argentina ,grid.7345.50000 0001 0056 1981Facultad de Farmacia y Bioquímica, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad de Buenos Aires, Buenos Aires, Argentina
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23
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Xiang J, He L, Li D, Wei S, Wu Z. Value of the systemic immune-inflammation index in predicting poor postoperative outcomes and the short-term prognosis of heart valve diseases: a retrospective cohort study. BMJ Open 2022; 12:e064171. [PMID: 36220322 PMCID: PMC9557268 DOI: 10.1136/bmjopen-2022-064171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Systemic immune-inflammation index (SII) is a novel biomarker that can predict poor outcomes in tumours, nervous system diseases and chronic heart failure. Here, we investigated the predictive value of SII on the poor postoperative outcomes and short-term prognosis of heart valve diseases (HVDs). DESIGN, SETTING AND PARTICIPANTS This retrospective cohort study enrolled all consecutive patients with HVDs (aortic stenosis, aortic regurgitation, mitral stenosis and mitral regurgitation) who underwent surgery (valve replacement or valve repair) at the Affiliated Hospital of North Sichuan Medical College between 2017 and 2020. MAIN OUTCOMES AND MEASURES Major complications in the perioperative period, all-cause mortality within 30 days and readmission within 30 days. RESULTS A total of 431 patients with HVDs were enrolled in this study, including 202 males and 229 females, aged 58.9±27.3 years. SII levels of patients in the poor outcomes group were significantly higher than those of patients in the favourable outcomes group (658.40±436.29 vs 335.72±174.76, respectively; p<0.001). Multivariate logistic regression analysis showed that age (OR 1.064, 95% CI 1.026 to 1.104, p=0.025), SII (OR 1.034, 95% CI 1.012 to 1.631, p=0.008) and aortic cross-clamping time (OR 1.013, 95% CI 1.004 to 1.023, p=0.006) were independent risk factors for poor outcomes and short-term prognosis in patients with HVD. The area under the curve of poor outcomes predicted by SII in patients with HVD was 0.806 (95% CI 0.763 to 0.848) and the optimised cut-off value 423.8×109 /L, with a sensitivity of 70.3% and specificity of 81.1%. The incidence of poor outcomes (p<0.001), 30-day mortality (p<0.001) and 30-day readmission rate (p=0.026) in the high SII group was significantly higher than that in the low SII group. CONCLUSIONS SII is closely related to poor postoperative outcomes and short-term prognosis of HVD and can serve as an independent predictive factor.
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Affiliation(s)
- Jun Xiang
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Cardiovascular Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Ling He
- Department of Paediatrics, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Donglin Li
- Department of Cardiovascular Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Shuliang Wei
- Department of Cardiovascular Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Zhong Wu
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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24
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Zhang B, Yao W. Prognostic role of the systemic immune-inflammation index in biliary tract cancers: a meta-analysis of 3,515 patients. World J Surg Oncol 2022; 20:320. [PMID: 36171621 PMCID: PMC9519406 DOI: 10.1186/s12957-022-02783-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/12/2022] [Indexed: 11/10/2022] Open
Abstract
Background The systemic immune-inflammation index (SII) is an inflammatory parameter calculated as platelet count × neutrophil count/lymphocyte count in the peripheral blood. In recent years, the prognostic role of the SII in patients with biliary tract cancer (BTC) has been gradually investigated. However, the results were controversial. This meta-analysis aimed to illustrate the prognostic value of the SII in BTC. Methods The electronic databases of PubMed, the Web of Science, Embase, and the Cochrane Library were thoroughly retrieved up to April 15, 2022. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were used to evaluate the prognostic value of the SII for clinical outcomes. The association between the SII and overall survival (OS) and recurrence-free survival (RFS)/progression-free survival (PFS) was evaluated. Results Thirteen studies involving 3515 patients were included in this meta-analysis. The pooled results indicated that an elevated SII was significantly associated with poor OS (HR, 1.77; 95% CI, 1.47–2.14; p<0.001) and RFS/PFS (HR, 1.66; 95% CI, 1.38–1.99; p<0.001) in patients with BTC. Subgroup analysis stratified by country, sample size, and cutoff value showed similar results. The sensitivity analysis and publication bias test confirmed the reliability of our results. Conclusions An elevated pretreatment SII was significantly associated with worse OS and RFS/PFS in patients with BTC. Our results suggest that the SII is a valuable and cost-effective prognostic parameter for the treatment of patients with BTC. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-022-02783-z.
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Affiliation(s)
- Buwen Zhang
- Department of Oncology, Changxing People's Hospital, Huzhou, 313100, Zhejiang, China
| | - Weiyun Yao
- Department of Hepatobiliary Surgery, Changxing People's Hospital, Huzhou, 313100, Zhejiang, China.
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25
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Feng W, Hou J, Xiang C, Die X, Sun J, Guo Z, Liu W, Wang Y. Correlation of systemic immune-inflammation Index with surgical necrotizing enterocolitis. Front Pediatr 2022; 10:1044449. [PMID: 36419917 PMCID: PMC9676951 DOI: 10.3389/fped.2022.1044449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Systemic Immune-Inflammation Index (SII), known as an easy, economical and useful marker, correlates with the severity of inflammatory response. However, the usefulness of SII in necrotizing enterocolitis (NEC) remains unclear. Therefore, we evaluated the correlation of SII at NEC diagnosis and subsequent surgery. METHODS Retrospective review of 131 neonates with NEC in a tertiary-level pediatric referral hospital was conducted with assessments of demographic data, general blood examination results at NEC diagnosis, treatment strategies and clinical outcomes. The receiver operating characteristic (ROC) curve determined the optimal cut-off values of SII, platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio. Univariate/multivariate logistic regression analysis and ROC curve were conducted to evaluate the predictive significance of SII in identifying the patients who eventually received surgery. Additionally, NEC-related deaths were assessed. RESULTS Overall, 49 (37.4%) cases received surgical intervention and mortality was 12.3% (14/131). The area under ROC curve of SII at NEC diagnosis to predict subsequent surgery was 0.833 (optimal cut-off value: 235.85). The SII value in surgical intervention group was significantly higher than that in medical treatment group (332.92 ± 158.52 vs. 158.84 ± 106.82, P < 0.001). Independent influencing factors for surgical NEC were SII (95% confidence interval [CI]: 4.568∼36.449, odds ratio [OR]:12.904, P < 0.001) and PLR (95% CI: 1.071∼7.356, OR:2.807, P = 0.036). SII ≤ 235.85 could identify patients at high risk for surgery, with 87.76% sensitivity, 73.17% specificity, outperformed PLR. Furthermore, mortality was significantly higher in patients with SII ≤ 235.85 than those with SII > 235.85 (20.0% vs. 1.5%, P < 0.001). CONCLUSION SII and PLR at NEC diagnosis were independent influencing factors for subsequent surgery. SII ≤ 235.85 may be a useful predictive marker for the identification of surgical NEC and mortality.
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Affiliation(s)
- Wei Feng
- Department of General & Neonatal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Jinping Hou
- Department of General & Neonatal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Chenzhu Xiang
- Department of General & Neonatal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Xiaohong Die
- Department of General & Neonatal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Jing Sun
- Department of General & Neonatal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Zhenhua Guo
- Department of General & Neonatal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Wei Liu
- Department of General & Neonatal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Yi Wang
- Department of General & Neonatal Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
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