Dynamic Changes of the Neutrophil-to-Lymphocyte Ratio, Systemic Inflammation Index, and Derived Neutrophil-to-Lymphocyte Ratio Independently Predict Invasive Mechanical Ventilation Need and Death in Critically Ill COVID-19 Patients

Overview

Journal Biomedicines

Specialty Biomedical Engineering

Date 2021 Nov 27

PMID 34829883

Citations 29

Authors

Emanuel Moisa

Dan Corneci

Silvius Negoita

Cristina Raluca Filimon

Andreea Serbu

Mihai Ionut Negutu

Ioana Marina Grintescu

Affiliations

Soon will be listed here.

Abstract

Background: Hematological indices can predict disease severity, progression, and death in patients with coronavirus disease-19 (COVID-19).

Objectives: To study the predictive value of the dynamic changes (first 48 h after ICU admission) of the following ratios: neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR), monocyte-to-lymphocyte (MLR), systemic inflammation index (SII), and derived neutrophil-to-lymphocyte (dNLR) for invasive mechanical ventilation (IMV) need and death in critically ill COVID-19 patients.

Methods: Observational, retrospective, and multicentric analysis on 272 patients with severe or critical COVID-19 from two tertiary centers. Hematological indices were adjusted for confounders through multivariate analysis using Cox regression.

Results: Patients comprised 186 males and 86 females with no difference across groups ( > 0.05). ΔNLR > 2 had the best independent predictive value for IMV need (HR = 5.05 (95% CI, 3.06-8.33, < 0.0001)), followed by ΔSII > 340 (HR = 3.56, 95% CI 2.21-5.74, < 0.0001) and ΔdNLR > 1 (HR = 2.61, 95% CI 1.7-4.01, < 0.0001). Death was also best predicted by an NLR > 11 (HR = 2.25, 95% CI: 1.31-3.86, = 0.003) followed by dNLR > 6.93 (HR = 1.89, 95% CI: 1.2-2.98, = 0.005) and SII > 3700 (HR = 1.68, 95% CI: 1.13-2.49, = 0.01).

Conclusions: Dynamic changes of NLR, SII, and dNLR independently predict IMV need and death in critically ill COVID-19 patients.

Citing Articles

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