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Performance of D-dimer to lymphocyte ratio in predicting the mortality of COVID-19 patients
Fei Peng1, Qiong Yi1, Quan Zhang1
1Department of Respiratory Medicine, The Second Xiangya Hospital of Central South University, Changsha, China.
Insights
The D-dimer to lymphocyte ratio (DLR) shows significant prognostic utility for COVID-19 mortality. Higher DLR levels are associated with increased mortality risk in COVID-19 patients.
Area of Science:
- Biomedical research
- Clinical diagnostics
- Infectious disease epidemiology
Background:
- Effective treatments for COVID-19 remain limited, underscoring the importance of early detection and supportive care.
- Prognostic markers are crucial for managing COVID-19 morbidity and mortality.
- This study introduces the D-dimer to lymphocyte ratio (DLR) as a novel prognostic indicator for COVID-19.
Purpose of the Study:
- To evaluate the prognostic utility of the D-dimer to lymphocyte ratio (DLR) in COVID-19 patients.
- To compare the predictive value of DLR against other established risk factors for COVID-19 mortality.
- To assess the relationship between DLR levels and patient survival outcomes.
Main Methods:
- Retrospective analysis of 611 COVID-19 patients, categorized into survivors and non-survivors.
- Utilized receiver operating characteristic (ROC) curves to compare the area under the curve (AUC) of various prognostic predictors.
- Employed Kaplan-Meier (KM) curves to analyze the association between DLR and survival in COVID-19 patients.
Main Results:
- Independent risk factors for COVID-19 mortality included age, NLR, CRP, PT, and DLR (P < 0.05 for all).
- D-dimer to lymphocyte ratio (DLR) demonstrated the highest predictive value for mortality, with an AUC of 0.924.
- Kaplan-Meier analysis revealed significantly lower survival rates in patients with higher DLR levels (Log Rank P < 0.001).
Conclusions:
- The D-dimer to lymphocyte ratio (DLR) serves as a valuable prognostic indicator for COVID-19 mortality.
- Elevated DLR levels are significantly associated with increased mortality risk in patients diagnosed with COVID-19.
- DLR can aid in identifying high-risk COVID-19 patients requiring closer monitoring and intensive supportive care.
Background:
Nowadays, there is still no effective treatment developed for COVID-19, and early identification and supportive therapies are essential in reducing the morbidity and mortality of COVID-19. This is the first study to evaluate D-dimer to lymphocyte ratio (DLR) as a prognostic utility in patients with COVID-19.
Methods:
We retrospectively analyzed 611 patients and separated them into groups of survivors and non-survivors. The area under the curve (AUC) of various predictors integrated into the prognosis of COVID-19 was compared using the receiver operating characteristic (ROC) curve. In order to ascertain the interaction between DLR and survival in COVID-19 patients, the Kaplan-Meier (KM) curve was chosen.
Results:
Age (OR = 1.053; 95% CI, 1.022-1.086; P = 0.001), NLR (OR = 1.045; 95% CI, 1.001-1.091; P = 0.046), CRP (OR = 1.010; 95% CI, 1.005-1.016; P < 0.001), PT (OR = 1.184; 95% CI, 1.018-1.377; P = 0.029), and DLR (OR = 1.048; 95% CI, 1.018-1.078; P = 0.001) were the independent risk factors related with the mortality of COVID-19. DLR had the highest predictive value for COVID-19 mortality with the AUC of 0.924. Patients' survival was lower when compared to those with lower DLR (Log Rank P <0.001).
Conclusion:
DLR might indicate a risk factor in the mortality of patients with COVID-19.
