Non-Conventional Prognostic Markers in Life-Threatening COVID-19 Cases-When Less Is More

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Hematology

Background:

• Severe SARS-CoV-2 infection presents a significant mortality risk.
• Identifying reliable predictors of disease progression and mortality is crucial for patient management.
• Conventional inflammatory markers and novel non-conventional markers require comparative evaluation.

Purpose of the Study:

• To compare the predictive power of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) for mortality in severe COVID-19.
• To assess the utility of these markers in predicting disease progression.
• To evaluate the potential of NLR as a practical tool for risk stratification.

Main Methods:

• Prospective observational study involving critically ill COVID-19 patients requiring ICU admission.
• Daily blood sample collection to monitor inflammatory markers including NLR, PLR, CRP, PCT, and IL-6.
• Statistical analysis using SPSS with non-normal distribution methods, including ROC and multivariate logistic regression.

Main Results:

• A high mortality rate of 76.6% was observed in the cohort, predominantly infected with the Delta variant.
• Procalcitonin (PCT) and neutrophil-to-lymphocyte ratio (NLR) demonstrated the highest predictive power for mortality via ROC analysis.
• Multivariate analysis identified NLR, PCT, CRP, and IL-6 as significant predictors of mortality, with NLR showing consistent association with increased risk.

Conclusions:

• Neutrophil-to-lymphocyte ratio (NLR) is a valuable, accessible, and simple marker for monitoring inflammation in viral infections.
• NLR analysis can enhance early identification of high-risk severe COVID-19 patients, improving management and outcomes.
• Integrating NLR into routine clinical practice may optimize patient care strategies for severe SARS-CoV-2.