Multi-inflammatory Index as a Novel Mortality Predictor in Critically Ill COVID-19 Patients

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Biomarkers

Background:

• Systemic inflammation significantly impacts COVID-19 pathogenesis and mortality.
• The Multi-Inflammatory Index (MII) is a novel indicator of systemic inflammation.
• Predicting mortality in intensive care unit (ICU) patients with COVID-19 is crucial.

Purpose of the Study:

• To investigate the association between the Multi-Inflammatory Index (MII) and in-hospital mortality in COVID-19 patients admitted to the ICU.
• To evaluate MII's efficacy as a predictor of mortality compared to other inflammatory markers.

Main Methods:

• Retrospective analysis of medical records for 348 COVID-19 patients admitted to the ICU between April 2020 and October 2021.
• Classification of patients into survivor and non-survivor groups based on mortality status.
• Comparison of various inflammatory parameters and assessment of their predictive value for mortality using logistic regression.

Main Results:

• The study included 348 patients, with 24.7% survivors and 75.3% non-survivors.
• The non-survivor group had a significantly higher median age (76 vs. 65.5 years, P < .001).
• MII demonstrated the highest efficacy in predicting mortality (OR: 0.999; 95% CI: 0.9991-0.9998; P = .003) among all inflammatory parameters analyzed.

Conclusions:

• The Multi-Inflammatory Index (MII), a combination of Neutrophil to Lymphocyte Ratio (NLR) and C-reactive protein (CRP), is a valuable and practical biomarker.
• MII can aid in predicting mortality for COVID-19 patients managed in the ICU.
• This simple index offers a promising tool for risk stratification in critically ill COVID-19 patients.