The Role of Neutrophil Indices in the Prognosis of Covid-19 with a Focus on Diabetes Mellitus

ABSTRACT

Background and Aims: Many reviews show impaired response of metabolic and immune systems in patient with diabetes that leads to more severe clinical course of COVID-19. One of such early predictors could be neutrophil indices that derives from hemogram. Our study aims to investigate the predictive value of neutrophil ratios in a diabetic cohort hospitalized with COVID-19. Method(s) We retrospectively examined data from 229 diabetic patients with COVID-19 hospitalized at the regional clinical hospital of Karaganda between May and August 2021. We analyzed the relationship between inflammation markers (neutrophil- lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), neutrophil-platelets ratio (NPR), systemic immune-inflammation index (SII)), disease severity, and early outcomes. Result(s) In multivariate regression analysis, patients with high NLR (p = 0.018), NPR (p = 0.006), and SII (p = 0.022) had more severe COVID-19, an increase in NLR (p = 0.0001), NPR (p = 0.0001) and SII (p = 0.001) was associated with the development of early mortality. The role of PLR in predicting COVID- 19 was not significant (p = 0.388).The ROC curve result showed that higher NLR (AUC = 0.637, 95% CI = 0.554-0.719, p = 0.002) and NPR (AUC = 0.674, 95%CI = 0.600-0.749, p = 0.0001) scores predicted the COVID-19 severity and mortality (NLR AUC= 0.687, 95% CI = 0.587-0.787, p = 0.0001 and NPR AUC= 0.703, 95% CI = 0.614-0.791, p = 0.0001), increasing of SII predicted only early mortality (AUC = 0.652, 95% CI = 0.541-0.764, p = 0.004). Conclusion(s) NLR and NPR can be considered as optimal and readily available parameters for predicting the severity and early mortality among diabetic patients with COVID-19.