Hemogram-derived ratios as prognostic markers of ICU admission in COVID-19.
BMC Emerg Med
; 21(1): 89, 2021 07 27.
Article
in English
| MEDLINE | ID: covidwho-1329107
ABSTRACT
BACKGROUND:
The vast impact of COVID-19 call for the identification of clinical parameter that can help predict a torpid evolution. Among these, endothelial injury has been proposed as one of the main pathophysiological mechanisms underlying the disease, promoting a hyperinflammatory and prothrombotic state leading to worse clinical outcomes. Leukocytes and platelets play a key role in inflammation and thrombogenesis, hence the objective of the current study was to study whether neutrophil-to-lymphocyte ratio (NLR), platelets-to-lymphocyte ratio (PLR), the systemic immune-inflammation index (SII) as well as the new parameter neutrophil-to-platelet ratio (NPR), could help identify patients who at risk of admission at Intensive Care Units.METHODS:
A retrospective observational study was performed at HM Hospitales including electronic health records from 2245 patients admitted due to COVID-19 from March 1 to June 10, 2020. Patients were divided into two groups, admitted at ICU or not.RESULTS:
Patients who were admitted at the ICU had significantly higher values in all hemogram-derived ratios at the moment of hospital admission compared to those who did not need ICU admission. Specifically, we found significant differences in NLR (6.9 [4-11.7] vs 4.1 [2.6-7.6], p < 0.0001), PLR (2 [1.4-3.3] vs 1.9 [1.3-2.9], p = 0.023), NPR (3 [2.1-4.2] vs 2.3 [1.6-3.2], p < 0.0001) and SII (13 [6.5-25.7] vs 9 [4.9-17.5], p < 0.0001) compared to those who did not require ICU admission. After multivariable logistic regression models, NPR was the hemogram-derived ratio with the highest predictive value of ICU admission, (OR 1.11 (95% CI 0.98-1.22, p = 0.055).CONCLUSIONS:
Simple, hemogram-derived ratios obtained from early hemogram at hospital admission, especially the novelty NPR, have shown to be useful predictors of risk of ICU admission in patients hospitalized due to COVID-19.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Severity of Illness Index
/
COVID-19
/
Intensive Care Units
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Adult
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
BMC Emerg Med
Journal subject:
Emergency Medicine
Year:
2021
Document Type:
Article
Affiliation country:
S12873-021-00480-w
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