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Inflammation-based Indices Predicting Mortality in COVID-19

Gokhan Cakirca1, Tuba Damar Cakirca2, Ahmet Bindal3

  • 1Department of Biochemistry, Sanliurfa Mehmet Akif Inan Training and Research Hospital, Sanliurfa, Turkey.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|January 4, 2023
PubMed

Insights

Prognostic nutritional index (PNI), C-reactive protein/lymphocyte ratio (CLR), and neutrophil/lymphocyte ratio (NLR) effectively predict COVID-19 mortality. These inflammation-based markers offer valuable insights for patient outcomes.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Critical Care Medicine

Background:

  • COVID-19 poses a significant global health threat, with mortality influenced by complex host responses.
  • Inflammation-based indices are increasingly explored as prognostic markers in critical illnesses.

Purpose of the Study:

  • To evaluate the efficiency of various inflammation-based indices in predicting mortality among COVID-19 patients.
  • To identify independent predictors of mortality in a cohort of COVID-19 patients.

Main Methods:

  • Retrospective analysis of 827 COVID-19 patients (733 survivors, 94 non-survivors).
  • Assessment of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), C-reactive protein/lymphocyte ratio (CLR), albumin/globulin ratio (AGR), HALP, systemic immune-inflammatory index (SII), and prognostic nutritional index (PNI).
  • Multivariate analysis to determine independent predictors of mortality.

Main Results:

  • Non-survivors exhibited significantly higher NLR, PLR, CLR, and SII compared to survivors.
  • Non-survivors had significantly lower LMR, PNI, HALP, and AGR.
  • Multivariate analysis identified PNI, NLR, CLR, older age, male gender, and dyslipidemia as independent mortality predictors.
  • PNI demonstrated the largest area under the curve for mortality prediction, followed by CLR and NLR.

Conclusions:

  • PNI, NLR, and CLR are identified as independent and significant predictors of mortality in COVID-19 patients.
  • These inflammation-based indices can aid in risk stratification and management of severe COVID-19 cases.
  • Further research can explore the clinical utility of these markers in COVID-19 prognosis.

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