Serial Changes in Blood-Cell-Count-Derived and CRP-Derived Inflammatory Indices of COVID-19 Patients

Area of Science:

• Infectious Diseases
• Hematology
• Biochemistry

Background:

• COVID-19 is associated with significant inflammatory responses.
• Blood cell count-derived inflammatory indices and C-reactive protein (CRP) are utilized in patient monitoring.
• Predicting COVID-19 outcomes remains a critical clinical challenge.

Purpose of the Study:

• To investigate serial changes in inflammatory indices in COVID-19 patients.
• To compare these changes between patients with good and poor outcomes.
• To determine the predictive value of these indices over time.

Main Methods:

• Retrospective analysis of 169 COVID-19 patients.
• Evaluation of serial inflammatory indices including CRP to lymphocyte ratio (CLR), multi-inflammatory index (MII), neutrophil to lymphocyte ratio (NLR), and systemic inflammation response index (SIRI).
• Comparative analysis of indices at admission, discharge/death, and serially from day 1 to day 30 post-symptom onset.

Main Results:

• Non-survivors exhibited higher CLR and MII on admission compared to survivors.
• Neutrophil-to-lymphocyte ratio (NLR), SIRI, and MII showed the largest differences at discharge/death.
• Survivors demonstrated decreased NLR, CLR, and MII, while non-survivors showed increased NLR.
• NLR remained a significant differentiator between groups from days 7-30.
• Correlation with outcome was observed from days 13-15, with serial changes proving more predictive than admission values.

Conclusions:

• Serial monitoring of inflammatory indices, particularly NLR, is more valuable for predicting COVID-19 outcomes than single measurements.
• The predictive utility of these indices becomes reliable around days 13-15 of the disease.
• Changes in inflammatory indices over time offer crucial prognostic information for COVID-19 patients.