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Could Some Laboratory Parameters Predict Mortality in COVID-19?
Insights
Neutrophil/Lymphocyte Ratio (NLR), C-reactive protein (CRP), and age are key indicators for COVID-19 mortality. Evaluating these factors aids in predicting disease prognosis and guiding treatment strategies for better patient outcomes.
Area of Science:
- Medical Science
- Infectious Diseases
- Hematology
Background:
- COVID-19 pandemic poses a significant global public health threat.
- Understanding disease severity and mortality predictors is crucial for effective management.
- Laboratory and hematological parameters may correlate with COVID-19 outcomes.
Purpose of the Study:
- To investigate the association between specific laboratory parameters and hematological ratios with COVID-19 severity.
- To identify predictors of hospital mortality in COVID-19 patients.
Main Methods:
- Retrospective cohort study of 743 hospitalized COVID-19 patients.
- Analysis of clinical data including Neutrophil/Lymphocyte Ratio (NLR), Platelet/Lymphocyte Ratio (PLR), Monocyte/Lymphocyte Ratio (MLR), C-reactive protein (CRP), and ferritin.
- Logistic regression and ROC curve analysis to determine risk factors and predictive values.
Main Results:
- Significant differences in age, WBC, neutrophil, lymphocyte, NLR, PLR, MLR, CRP, and ferritin between discharged and deceased patients.
- NLR demonstrated high predictive value (AUC: 0.892) for mortality.
- Increased NLR, CRP, and age were independently associated with higher in-hospital mortality risk.
Conclusions:
- Neutrophil/Lymphocyte Ratio (NLR), C-reactive protein (CRP), and age are independent predictors of COVID-19 mortality.
- Combined evaluation of these parameters can aid in prognosis prediction.
- Findings support the use of NLR, CRP, and age in clinical decision-making for COVID-19 patients.
Background:
The number of confirmed cases of COVID-19 continues to increase worldwide and threatens public health. Our aim in this study is to examine the relationship between some laboratory parameters and hematological ratios with the severity of the disease and hospital mortality.
Methods:
This study was designed as a retrospective cohort. The clinical data of 743 COVID-19 diagnosed patients who were eligible for hospitalization between March 16, and May 15, 2020 analyzed, retrospectively. The patients were separated into two groups as discharged from hospital (n = 681) and dead in hospital (n = 62). ROC curves and cutoff values of NLR (Neutrophil/Lymphocyte Ratio), PLR (Platelet/Lymphocyte Ratio), MLR (Monocyte/ Lymphocyte Ratio), CRP, and ferritin upon admission to hospital were calculated for the two groups. Binary Logistic Regression used to determine independent risk factors for mortality.
Results:
The difference between both groups for age, duration in hospital, WBC, neutrophil, lymphocyte, NLR, PLR, MLR, CRP, and ferritin values were statistically significant. NLR had the highest area under the curve with a cutoff of 5.5 in the ROC curve [(AUC: 0.892, 95% CI: 0.844 - 0.939); Sensitivity = 85%, Specificity = 84%]. NLR, MLR, PLR, CRP and Ferritin groups have significant effects on the survival times of the Covid-19 patients. According to logistic regression analysis, increments of NLR (OR = 18.1, 95% CI: 6.4 - 51.4), CRP (OR = 5.5, 95% CI: 2.5 - 12.2), and age (OR = 2.7 95% CI: 1.3 - 5.5) values proportionally increase the death probability.
Conclusions:
NLR, CRP, and age are independent risk factors for mortality from COVID-19. We believe that evaluating these parameters together during diagnosis will be important in predicting the prognosis of the disease and in treatment approaches.
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