Role of Hemogram-Derived Ratios and Systemic-Immune Inflammation Index in Prediction of COVID-19 Progression in Egyptian Patients

Abstract

Background: Early detection of COVID-19 patients with potentially severe disease is crucial for predicting the disease's course and prioritizing medical resources, lowering overall disease mortality. Objectives: To explore the role of hemogram-derived ratios and systemic-immune inflammation index (SII), in addition to C-reactive protein (CRP), in predicting COVID-19 severity and prognosis. Methods: In this retrospective study, data were collected from the medical records of 425 COVID-19 patients. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and SII, together with the CRP, were investigated and compared. Results: NLR, PLR, SII, and CRP increased significantly in severe cases and with ICU admission (p ≤ 0.001). But, in non-survivors only NLR and CRP were significantly elevated (p < 0.05). By interpreting area under the receiver operating characteristic curve (ROC-AUC), CRP and NLR were better predictors of disease severity (AUC: 0.7 for both), the need for ICU admission (AUC: 0.763 and 0.727, respectively) and in-hospital mortality (AUC: 0.812 and 0.75, respectively). SII was significantly associated with the risk of severe disease development (odds ratio (OR): 3.143; 95% confidence interval (CI): 1.101-8.976); CRP (OR: 2.902; CI95%: 1.342-6.273) and NLR (OR: 2.662; CI95%, 1.072-6.611) were significantly associated with ICU admission risk; and only CRP was significantly associated with in-hospital mortality risk (OR: 3.988; CI95%: 1.460-10.892). Conclusions: Values of CRP, SII, and NLR at the time of hospital admission could be independent prognostic biomarkers to predict COVID-19 progression. The integration of CRP, SII, and NLR into prognostic nomograms may lead to improved prediction.

Can Complete Blood Count Picture Tell Us More About the Activity of Rheumatological Diseases?

“…[9][10][11] Moreover, the red cell distribution width (RDW), the mean platelet volume (MPV), and the systemic immuneinflammation index (SII) have emerged as biomarkers of inflammation and disease activity in a variety of diseases. [11][12][13][14] MPV is a surrogate marker of platelet activation, 15 and has been associated with a number of inflammatory conditions, including functional bowel diseases, 16 obesity, 17 infections, 18 diabetes mellitus (DM), 19 vertebral disk conditions, 20 and cardiac diseases. 21 On the other hand, RDW is a marker of anisocytosis 22 and is associated with certain inflammatory conditions, such as thyroiditis, 23 autoimmune hepatitis, 24 malignant conditions, 25 and type 2 DM.…”

Evaluation of the Predictive Value of C-reactive Protein, Interleukin-6 and Their Derived Immune-Inflammatory Indices in COVID-19 Egyptian Patients

“…Coronavirus disease 2019 progression may be facilitated by an abnormal inflammatory response and cytokine storm that can lead to multiorgan failure and death in people with severe illness [4]. Inflammatory indicators like C-reactive protein (CRP) and interleukin (IL)-6 were proved to be elevated in this hyper-inflammatory state [5,6], and IL-6 have been linked to lymphopenia by causing widespread lymphocyte mortality [7]. Another study found a link between high IL-6 serum levels and impaired T and natural killer (NK) cell cytotoxicity in COVID-19 patients [8].…”