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Role of hemogram-derived ratios in predicting intensive care unit admission in COVID-19 patients: a multicenter study
M D Asaduzzaman1, Mohammad Romel Bhuia2, Zhm Nazmul Alam1
1Department of Medicine, Sylhet MAG Osmani Medical College Hospital, Sylhet-3100, Bangladesh.
Insights
Cost-effective hemogram ratios can predict intensive care unit (ICU) admission in COVID-19 patients. These markers, including the neutrophil-to-lymphocyte ratio, help identify high-risk individuals early.
Area of Science:
- Medical research
- Clinical diagnostics
- Inflammation markers
Background:
- Hyperinflammation is a key factor in severe COVID-19.
- Monitoring inflammation markers is crucial for patient management.
- Hemogram-derived ratios offer a potentially cost-effective approach.
Purpose of the Study:
- To assess the effectiveness of hemogram-derived ratios in predicting ICU admission for COVID-19 patients.
- To identify simple, inexpensive laboratory markers for risk stratification.
- To aid in early identification of patients requiring intensive care.
Main Methods:
- Multicenter retrospective study of 442 hospitalized COVID-19 patients.
- Analysis of demographic, clinical, and laboratory data.
- Logistic regression used to determine the predictive significance of hemogram ratios for ICU admission.
Main Results:
- 22.17% of patients required ICU admission.
- ICU patients had higher neutrophil counts and lower lymphocyte/platelet counts.
- Neutrophil-to-lymphocyte ratio, derived neutrophil-to-lymphocyte ratio, neutrophil-to-platelet ratio, and systemic immune-inflammation index significantly predicted ICU admission.
Conclusions:
- Hemogram-derived ratios are effective tools for early risk categorization in COVID-19.
- These ratios facilitate timely interventions for high-risk patients.
- Cost-effective hemogram markers can improve patient management strategies.
Purpose:
As hyperinflammation is recognized as a driver of severe COVID-19 disease, checking markers of inflammation is gaining more attention. Our study aimed to evaluate the utility of cost-effective hemogram-derived ratios in predicting intensive care unit (ICU) admission in COVID-19 patients.
Methods:
This multicenter retrospective study included hospitalized COVID-19 patients from four dedicated COVID-19 hospitals in Sylhet, Bangladesh. Data on demographics, clinical characteristics, laboratory parameters and survival outcomes were analyzed. Logistic regression analysis was used to identify the significance of each hemogram-derived ratio in predicting ICU admission.
Results:
Of 442 included patients, 98 (22.17%) required ICU admission. At the time of admission, patients requiring ICU had a higher neutrophil count and lower lymphocyte and platelet counts than patients not requiring ICU. Peripheral capillary oxygen saturation at admission was significantly lower in those who subsequently required ICU admission. Neutrophil-to-lymphocyte ratio, derived neutrophil-to-lymphocyte ratio, neutrophil-to-platelet ratio, and systemic immune-inflammation index were significant predictors of ICU admission.
Conclusion:
Hemogram-derived ratios can be an effective tool in facilitating the early categorization of at-risk patients, enabling timely measures to be taken early in the disease course.
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