Can ferritin/lymphocyte percentage ratio, a new indicator, predict the clinical course of COVID-19 cases?

OBJECTIVES: COVID-19 maintains its seriousness as a global emergency with its rapid distribution worldwide. Ferritin / lymphocyte percentage ratio (FLPR) may appear as a prognostic value at the initial evaluation stage and thus can be used as a simple, effective, and reliable parameter in critical patient identification with COVID-19. METHODS: In this retrospective cohort study, we evaluated patients over 18 years old, who were hospitalized after being evaluated as COVID-19 and whose PCR results were positive. We calculated FLPRs from complete blood counts taken during emergency department admissions and classified disease severity due to emergency initial evaluation. The relationship between the severity of the thoracic tomography findings, hospitalization, and intensive care needs, and 28-day mortality with the FLPR were evaluated. RESULTS: The difference between the groups classified according to COVID-19 severity and the FLPR means was statistically significant (x2=148.284; SD=3; p=0.000). FLPR levels were found to be high in critical and serious groups. In the ROC analysis for the FLPR level, the area under the curve (AUC) value was found to be 0.909 (95% CI 0.857-0.961). When the cut off value of FLPR was 9.80, the sensitivity was found to be 97.6 %, and the specificity was 65.2 %, whereas, when the cut off value for FLPR was found to be 21.11, the sensitivity was 82.9 % and the specificity was 82.8 %. CONCLUSION: The FLPR, a new parameter, can be used as a significant marker to predict the 28-day mortality in patients (Tab. 5, Fig. 1, Ref. 25).

Clinico-Laboratory Features and Associated Factors of Lupus Mesenteric Vasculitis.

INTRODUCTION: Lupus mesenteric vasculitis (LMV) is a rare but potentially life-threatening clinical entity in systemic lupus erythematosus (SLE) patients. OBJECTIVE: The present study was initiated to explore the clinical features and associated factors of LMV in SLE patients. METHODS: We conducted a retrospective study on 50 cases of SLE patients with lupus mesenteric vasculitis (LMV) from January 2010 to December 2019 and 89 cases of non-LMV-SLE patients with similar demographic and comorbidities were included as control. All the data regarding clinical features, laboratory findings, and treatment were reviewed independently by two experts in the field. Both univariate and multivariate logistic regression analyses were employed to identify the associated factors of LMV. RESULTS: The incidence of LMV was 2.9% among hospitalized SLE patients in the current study. The most frequent symptom and physical sign of LMV were respectively abdominal pain (48, 96%) and abdominal tenderness (45, 90%). Through univariate and subsequent multivariate analysis, oral ulcer (OR, 4.25; P = 0.024), urinary tract involvement (OR, 5.23; P = 0.021), and elevated D-dimer (OR, 1.121; P = 0.008) were demonstrated to be positively associated with LMV, while percentage of lymphocytes (OR, 0.928; P = 0.004) and complement 3 (OR, 0.048; P = 0.008) were negatively correlated with LMV. CONCLUSIONS: Oral ulcer, urinary tract involvement, reduced percentage of lymphocytes and complement 3, elevated D-dimer could be associated factors for LMV in SLE patients.

Association between early nutritional risk and overall survival in patients with advanced pancreatic cancer: A single-center retrospective study.

BACKGROUND & AIMS: We investigated the predictors of overall survival (OS) among Korean patients with advanced pancreatic cancer (PC) according to their baseline nutritional status. METHODS: We retrospectively reviewed the data of 412 inpatients with PC between January 2007 and February 2015 at the Department of Oncology of the Gangnam Severance Hospital, Korea. Data on demographic and clinical parameters were collected from electronic medical records, and OS was estimated using the Kaplan-Meier method. Stepwise Cox regression analysis was used to determine the factors associated with survival. Patients with a Nutritional Risk Screening (NRS) 2002 score <3 were classified as "no-risk; " those with a score of 3 were classified as "moderate-risk; " and those with a score of ≥4 were classified as "high-risk." RESULTS: Following nutritional screening at baseline, 194 patients (47.1%, mean age 61.8 ± 9.9 years) were classified as the "no risk" group; 81 patients (19.7%, mean age 65.4 ± 10.8 years), as the "moderate risk" group; and 137 patients (33.3%, mean age 67.8 ± 12.0 years), as the "high risk" group. Predictors of survival were NRS 2002 score (hazard ratio [HR] = 1.238; 95% confidence interval [CI] = 1.143-1.341), percentage of lymphocytes (HR = 0.973; 95% CI = 0.962-0.984), C-reactive protein level (HR = 1.003; 95% CI = 1.001-1.006), carcinoembryonic antigen level (HR = 1.000; 95% CI = 1.000-1.000), and carbohydrate antigen 19-9 level (HR = 1.000; 95% CI = 1.000-1.000). Kaplan-Meier survival analysis showed significant differences in the median OS among the NRS 2002 groups: "no risk" group: 12.3 ± 0.4 months (95% CI: 11.47-13.13 months); "moderate risk" group: 6.5 ± 0.9 months (95% CI: 4.78-8.17 months); and "high risk" group: 5.5 ± 0.6 months (95% CI: 4.31-6.69 months). CONCLUSIONS: A good baseline nutritional status was associated with OS among Korean patients with advanced PC. An improvement in the nutritional status of patients with advanced PC through baseline nutritional interventions is therefore necessary to prolong OS.