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Novel Systemic Inflammation Markers to Predict COVID-19 Prognosis
Amirali Karimi1,2, Parnian Shobeiri1,2,3,4, Arutha Kulasinghe5
1School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Frontiers in Immunology
|November 8, 2021
Summary
The neutrophil to lymphocyte ratio (NLR) is a robust marker for predicting COVID-19 outcomes, including disease severity and mortality. While other inflammatory markers show promise, NLR remains the most reliable indicator for patient risk stratification.
Area of Science:
- Infectious Diseases
- Immunology
- Critical Care Medicine
Background:
- COVID-19 pandemic caused by SARS-CoV-2 has led to significant global health challenges.
- The disease is characterized by an excessive inflammatory response, impacting patient prognosis.
- Understanding inflammatory markers is crucial for managing COVID-19 patients.
Purpose of the Study:
- To review evidence on 11 groups of systemic inflammatory markers for COVID-19 risk stratification.
- To evaluate the prognostic capabilities of these markers in predicting patient outcomes.
- To compare the effectiveness of various markers against the neutrophil-to-lymphocyte ratio (NLR).
Main Methods:
- Systematic review of studies investigating systemic inflammatory markers in COVID-19 patients.
- Analysis of data on markers such as NLR, SII, PNI, CAR, hsCAR, CPAR, and hsCPAR.
- Comparison of the predictive performance of different markers for COVID-19 prognosis.
Main Results:
- Neutrophil-to-lymphocyte ratio (NLR) effectively prognosticates outcomes like severe disease, hospitalization, ICU admission, intubation, and death.
- Systemic Immune-Inflammation Index (SII), Prognostic Nutritional Index (PNI), CRP to Albumin Ratio (CAR), and CRP to Prealbumin Ratio (CPAR) also demonstrated prognostic value.
- Limited comparative studies exist for markers other than NLR, necessitating larger validation studies.
Conclusions:
- Most studied systemic inflammatory markers can predict COVID-19 prognosis.
- NLR emerges as the most consistently robust marker for assessing COVID-19 patient outcomes.
- Further research is needed to validate the comparative effectiveness of other markers against NLR.
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