Predictive Role of Biomarkers in COVID-19 Mortality

Yılmaz, Ayşe; Taşkın, Öztürk; Demir, Ufuk; Soylu, Veysel Garani

doi:10.7759/cureus.34173

Cited by 8 publications

(9 citation statements)

References 23 publications

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“…However, the SII was capable of predicting mortality, but with lesser sensitivity and specificity as compared to the NLR. Such findings confirm the previous work of Ghobadi and his team [34], Gutiérrez-Pérez and colleagues [35] and Yılmaz and her team [36], as well as in Turkey [37]. In contrast, previous studies either refuted and excluded the value of the SII in the context of COVID-19 [38] or found it to be exclusively useful and to surpass the limited value of the NLR [32].…”

Section: Discussionsupporting

confidence: 88%

Assessing the Diagnostic Values of the Neutrophil-to-Lymphocyte Ratio (NLR) and Systematic Immunoinflammatory Index (SII) as Biomarkers in Predicting COVID-19 Severity: A Multicentre Comparative Study

Sayed

2024

Medicina

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COVID-19 has been notoriously unpredictable in its clinical course. Such unpredictability poses a challenge to clinicians in predicting patients who will develop severe cases and possibly die from the infection. This study aims to assess and compare the diagnostic value of the NLR and SII as biomarkers in predicting COVID-19 severity, represented by mortality, with a multicentre comparative study including 855 patients in Saudi Arabia. Descriptive and analytical statistics were used to compare haematological indices between survivors and non-survivors. The median age of patients included was 41 years old, with an almost equal ratio of men to women. Most participants were Saudis, and the mortality rate in the study cohort was 13.22%. Non-survivors, as compared to survivors, were significantly older, had lower RBC counts, haemoglobin and haematocrit levels, as well as significantly higher WBC and neutrophil counts. Both the NLR and SII were capable of differentiating between survivors and non-survivors, with the latter having significantly higher values. However, the NLR was superior to the SII in such differentiation, as it had a larger area under the curve. This study further confirms the diagnostic values of the NLR and SII as biomarkers in predicting COVID-19 severity and mortality, with the NLR being more sensitive and specific. Clinical guidelines on managing COVID-19 cases should benefit from these findings by harnessing the value of the NLR in COVID-19 management.

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Section: Discussionsupporting

confidence: 88%

Assessing the Diagnostic Values of the Neutrophil-to-Lymphocyte Ratio (NLR) and Systematic Immunoinflammatory Index (SII) as Biomarkers in Predicting COVID-19 Severity: A Multicentre Comparative Study

Sayed

2024

Medicina

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“…The study design was prospective in three studies ( 50 , 67 , 68 ), unclear in one ( 66 ), and retrospective in the remaining 36 ( 21 , 36 – 49 , 51 – 65 , 69 – 74 ). The clinical endpoints included mortality in 19 studies ( 36 , 37 , 39 , 41 , 43 , 45 , 48 , 49 , 51 , 52 , 55 , 56 , 58 , 60 , 61 , 65 , 66 , 68 , 73 ), and measures of severe disease as follows: disease severity based on existing guidelines in eight ( 42 , 44 , 63 , 64 , 67 , 70 , 72 , 74 ), transfer to the intensive care unit (ICU) in eight ( 38 , 40 , 45 , 50 , 53 , 62 , 68 , 69 ), invasive mechanical ventilation in two ( 46 , 52 ), disease progression in two ( 57 , 71 ), prolonged hospital stay in one ( 21 ), intubation in one ( 37 ), deep vein thrombosis in one ( 54 ), acute pulmonary embolism in one ( 54 ), and acute limb ischemia in one ( 39 ). All studies reported the SII on hospital admission.…”

Section: Resultsmentioning

confidence: 99%

Systemic inflammation index, disease severity, and mortality in patients with COVID-19: a systematic review and meta-analysis

Mangoni

Zinellu

2023

Front. Immunol.

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IntroductionAn excessive systemic pro-inflammatory state increases the risk of severe disease and mortality in patients with coronavirus disease 2019 (COVID-19). However, there is uncertainty regarding whether specific biomarkers of inflammation can enhance risk stratification in this group. We conducted a systematic review and meta-analysis to investigate an emerging biomarker of systemic inflammation derived from routine hematological parameters, the systemic inflammation index (SII), in COVID-19 patients with different disease severity and survival status.MethodsA systematic literature search was conducted in PubMed, Web of Science, and Scopus, between the 1st of December 2019 and the 15th of March 2023. Risk of bias and certainty of evidence were assessed using the Joanna Briggs Institute Critical Appraisal Checklist and the Grades of Recommendation, Assessment, Development and Evaluation, respectively (PROSPERO registration number: CRD42023420517).ResultsIn 39 studies, patients with a severe disease or non-survivor status had significantly higher SII values on admission compared to patients with a non-severe disease or survivor status (standard mean difference (SMD)=0.91, 95% CI 0.75 to 1.06, p<0.001; moderate certainty of evidence). The SII was also significantly associated with the risk of severe disease or death in 10 studies reporting odds ratios (1.007, 95% CI 1.001 to 1.014, p=0.032; very low certainty of evidence) and in six studies reporting hazard ratios (1.99, 95% CI 1.01 to 3.92, p=0.047; very low certainty of evidence). Pooled sensitivity, specificity, and area under the curve for severe disease or mortality were 0.71 (95% CI 0.67 to 0.75), 0.71 (95% CI 0.64 to 0.77), and 0.77 (95% CI 0.73 to 0.80), respectively. In meta-regression, significant correlations were observed between the SMD and albumin, lactate dehydrogenase, creatinine, and D-dimer.DiscussionOur systematic review and meta-analysis has shown that the SII on admission is significantly associated with severe disease and mortality in patients with COVID-19. Therefore, this inflammatory biomarker derived from routine haematological parameters can be helpful for early risk stratification in this group.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO, identifier CRD42023420517.

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“…dNLR incorporates the total number of WBC into its calculation, making it a potentially more comprehensive indicator of infammation compared to NLR [16]. In infammatory diseases such as COVID-19, dNLR can not only refect the severity of the disease but also predict mortality of the disease [16], and dNLR displays a better predictive performance than NLR in prognosis of COVID-19 infected patients [20,21]. Our research fndings suggest that dNLR can also be an indicator of occult PsA, and this single factor has an extremely high sensitivity of 95.5%.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Significance of the Derived Neutrophil‐to‐Lymphocyte Ratio in Differentiating Occult Psoriatic Arthritis from Psoriasis Alone

Yu,

Huang,

Jiang

et al. 2023

Dermatologic Therapy

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Background. Occult psoriatic arthritis (PsA) refers to a subset of psoriasis patients showing lesions on imaging but do not exhibit arthritis symptoms. Objective. This study was aimed to discover a simple biomarker that could be easily incorporated in clinical practice to identify occult PsA patients, defined as psoriasis patients with lesions on imaging but without arthritis symptoms, among silent psoriasis (PsO) patients, defined as psoriasis patients without any arthritis symptoms. Methods. A total of 149 silent PsO patients, including 83 PsO alone patients, defined as psoriasis patients without any arthritis symptoms and evidence of lesions on imaging, and 66 occult PsA patients, were enrolled in this cross-sectional study, and they all underwent blood tests to determine hematological inflammation biomarkers. Results. Occult PsA patients had a higher derived neutrophil-to-lymphocyte ratio (dNLR) (1.6 (1.3–2.2) vs. 1.3 (0.9–1.8), p < 0.001), body mass index (BMI) (25.2 (23.7–28.1) vs. 24.0 (21.9–26.0), p = 0.002), diabetes mellitus (DM) rate (30.3% vs. 7.2%, p < 0.001), and nail involvement rate (65.2% vs. 41.0%, p = 0.003) than patients with PsO alone. A prediction nomogram was established, and the area under the curve (AUC) was 0.843. The sensitivity and specificity of the model for identifying occult PsA patients were 77.3% and 81.9%, respectively. Conclusion. Our findings suggest that dNLR is a valuable diagnostic biomarker for occult PsA, and our prediction nomogram could provide clinicians with a useful tool for differentiating occult PsA patients from PsO alone patients.

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Predictive Role of Biomarkers in COVID-19 Mortality

Cited by 8 publications

References 23 publications

Assessing the Diagnostic Values of the Neutrophil-to-Lymphocyte Ratio (NLR) and Systematic Immunoinflammatory Index (SII) as Biomarkers in Predicting COVID-19 Severity: A Multicentre Comparative Study

Assessing the Diagnostic Values of the Neutrophil-to-Lymphocyte Ratio (NLR) and Systematic Immunoinflammatory Index (SII) as Biomarkers in Predicting COVID-19 Severity: A Multicentre Comparative Study

Systemic inflammation index, disease severity, and mortality in patients with COVID-19: a systematic review and meta-analysis

The Clinical Significance of the Derived Neutrophil‐to‐Lymphocyte Ratio in Differentiating Occult Psoriatic Arthritis from Psoriasis Alone

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