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Prognostic accuracy of inflammatory markers in predicting risk of ICU admission for COVID-19: application of time-dependent receiver operating characteristic curves.
Geraili, Zahra; Hajian-Tilaki, Karimollah; Bayani, Masomeh; Hosseini, Seyed Reza; Khafri, Soraya; Ebrahimpour, Soheil; Javanian, Mostafa; Babazadeh, Arefeh; Shokri, Mehran.
  • Geraili Z; Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
  • Hajian-Tilaki K; Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
  • Bayani M; Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran.
  • Hosseini SR; Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
  • Khafri S; Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
  • Ebrahimpour S; Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran.
  • Javanian M; Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
  • Babazadeh A; Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
  • Shokri M; Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
J Int Med Res ; 50(6): 3000605221102217, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1892101
ABSTRACT

OBJECTIVE:

Intensive care unit (ICU) admission occurs at different times during hospitalization among patients with COVID-19. We aimed to evaluate the time-dependent receive operating characteristic (ROC) curve and area under the ROC curve, AUC(t), and accuracy of baseline levels of inflammatory markers C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR) in predicting time to an ICU admission event in patients with severe COVID-19 infection.

METHODS:

In this observational study, we evaluated 724 patients with confirmed severe COVID-19 referred to Ayatollah Rohani Hospital, affiliated with Babol University of Medical Sciences, Iran.

RESULTS:

The AUC(t) of CRP and NLR reached 0.741 (95% confidence interval [CI] 0.661-0.820) and 0.690 (95% CI 0.607-0.772), respectively, in the first 3 days after hospital admission. The optimal cutoff values of CRP and NLR for stratification of ICU admission outcomes in patients with severe COVID-19 were 78 mg/L and 5.13, respectively. The risk of ICU admission was significantly greater for patients with these cutoff values (CRP hazard ratio = 2.98; 95% CI 1.58-5.62; NLR hazard ratio = 2.90; 95% CI 1.45-5.77).

CONCLUSIONS:

Using time-dependent ROC curves, CRP and NLR values at hospital admission were important predictors of ICU admission. This approach is more efficient than using standard ROC curves.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: J Int Med Res Year: 2022 Document Type: Article Affiliation country: 03000605221102217

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Humans Language: English Journal: J Int Med Res Year: 2022 Document Type: Article Affiliation country: 03000605221102217