Routine laboratory parameters, including complete blood count, predict COVID-19 in-hospital mortality in geriatric patients

Olivieri, Fabiola; Bonfigli, Anna Rita; Sarzani, Riccardo; Giordano, Piero C.; Cherubini, Antonio; Antonicelli, Roberto; Rosati, Y.; Prete, Simona Del; Rosa, Mirko Di; Corsonello, Andrea; Galeazzi, Roberta; Procopio, Antonio Domenico; Lattanzio, Fabrizia

doi:10.1016/j.mad.2022.111674

Cited by 23 publications

(26 citation statements)

References 72 publications

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“…Previous clinical studies have reported that dNLR ( 25 ), NLR ( 26 ), SII ( 27 ), SIRI ( 28 ), PLR ( 29 ), MLR ( 30 ), were valuable for the prognosis of COVID-19 patients. However, the use of ROC analysis to evaluate the predictive power of inflammatory markers (considering time dependence) has not been fully addressed for COVID-19 Omicron BA.2.…”

Section: Discussionmentioning

confidence: 99%

The derived neutrophil to lymphocyte ratio can be the predictor of prognosis for COVID-19 Omicron BA.2 infected patients

et al. 2022

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BackgroundSeveral systemic inflammatory biomarkers have been associated with poor overall survival (OS) and disease severity in patients with coronavirus disease 2019 (COVID-19). However, it remains unclear which markers are better for predicting prognosis, especially for COVID-19 Omicron BA.2 infected patients. The present study aimed to identify reliable predictors of prognosis of COVID-19 Omicron BA.2 from inflammatory indicators.MethodsA cohort of 2645 COVID-19 Omicron BA.2 infected patients were retrospectively analyzed during the Omicron BA.2 surge in Shanghai between April 12, 2022, and June 17, 2022. The patients were admitted to the Shanghai Fourth People’s Hospital, School of Medicine, Tongji University. Six systemic inflammatory indicators were included, and their cut-off points were calculated using maximally selected rank statistics. The analysis involved Kaplan-Meier curves, univariate and multivariate Cox proportional hazard models, and time-dependent receiver operating characteristic curves (time-ROC) for OS-associated inflammatory indicators.ResultsA total of 2347 COVID-19 Omicron BA.2 infected patients were included. All selected indicators proved to be independent predictors of OS in the multivariate analysis (all P < 0.01). A high derived neutrophil to lymphocyte ratio (dNLR) was associated with a higher mortality risk of COVID-19 [hazard ratio, 4.272; 95% confidence interval (CI), 2.417-7.552]. The analyses of time-AUC and C-index showed that the dNLR (C-index: 0.844, 0.824, and 0.718 for the 5th, 10th, and 15th day, respectively) had the best predictive power for OS in COVID-19 Omicron BA.2 infected patients. Among different sub-groups, the dNLR was the best predictor for OS regardless of age (0.811 for patients aged ≥70 years), gender (C-index, 0.880 for men and 0.793 for women) and disease severity (C-index, 0.932 for non-severe patients and 0.658 for severe patients). However, the platelet to lymphocyte ratio was superior to the other indicators in patients aged <70 years.ConclusionsThe prognostic ability of the dNLR was higher than the other evaluated inflammatory indicators for all COVID-19 Omicron BA.2 infected patients.

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Section: Discussionmentioning

confidence: 99%

The derived neutrophil to lymphocyte ratio can be the predictor of prognosis for COVID-19 Omicron BA.2 infected patients

et al. 2022

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“…Notably, sNfL levels were not correlated with the most common routinary analyzed biomarkers that we identified as associated with increased short-term mortality risk in this setting of patients in our previous report, i.e. neutrophil, lymphocyte, and eosinophil count, blood glucose, C-reactive protein, procalcitonin, and ferritin [ 12 ].…”

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confidence: 68%

“…The present study was performed on a subset of samples from the already published Report-Age COVID observational study, which was conducted at the Italian National Center on Aging (IRCCS INRCA, Ancona, Italy) to understand the predictors of adverse outcomes in older patients hospitalized and diagnosed with COVID-19 [ 12 ]. Samples were collected between 1st March 2020 and 24th June 2021.…”

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confidence: 99%

“…Informed consent was obtained from all individual participants included in the study. Demographic and anamnestic data, biochemical and hematological variables, information on treatments, comorbidities, and survival were collected in a retrospective manner and anonymized before release, as previously described [ 12 ]. The Clinical Frailty Scale (CFS), an ordinal 9-point scale in which the assessor evaluates the degree of frailty from clinical data, was employed to assess frailty [ 19 ].…”

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Association of admission serum levels of neurofilament light chain and in-hospital mortality in geriatric patients with COVID-19

et al. 2022

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“…This finding has generated great interest in employing these indexes as biomarkers to establish prognosis and appropriate level of care, particularly because they are cheap and easily evaluated through routine blood tests [ 24 , 25 ]. In particular, the neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), systemic inflammation index (SII), and aggregate index of systemic inflammation (AISI) have so far produced the most promising evidence in terms of their potential use for early risk stratification of COVID-19 patients [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Clinical Features, Complete Blood Count Parameters, and Outcomes between Two Distinct Waves of COVID-19: A Monocentric Report from Italy

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Zinellu

et al. 2022

Healthcare

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Background: Since the beginning of the SARS-CoV-2 pandemic, the ability to predict the trajectory of the disease has represented a major challenge for clinicians. There is recent evidence that complete blood cell count (CBC)-derived inflammation indexes have predictive value in COVID-19. We aimed to describe any changes in the clinical features, CBC-derived ratios, and outcomes of patients admitted to our hospital across two temporally distinct waves. Methods: We retrospectively assessed and compared the clinical characteristics and blood cell count values of patients hospitalized during the second and fourth waves of COVID-19, and explored any outcome differences in terms of the level of respiratory support required and transfer to intensive care. Results: We observed that fourth-wave patients were older, less male-predominant, and carried more comorbidities compared to the second-wave patients but, nevertheless, experienced more favorable outcomes. A strong internal correlation was documented for both waves between outcomes and CBC-derived ratios, with the fourth-wave cases displaying lower admission values of the neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammation index (SII). No significant differences were found for lymphocyte-to-monocyte ratio (LMR), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI). Conclusions: We observed that both admission values of CBC-derived indexes and adverse respiratory outcomes decreased from the second to the fourth wave of COVID-19. These data represent a contribution to the existing knowledge on the role of CBC-derived indexes as a potential tool to help clinicians to quickly differentiate in-hospital patients at increased risk of serious illness and death.

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Routine laboratory parameters, including complete blood count, predict COVID-19 in-hospital mortality in geriatric patients

Cited by 23 publications

References 72 publications

The derived neutrophil to lymphocyte ratio can be the predictor of prognosis for COVID-19 Omicron BA.2 infected patients

The derived neutrophil to lymphocyte ratio can be the predictor of prognosis for COVID-19 Omicron BA.2 infected patients

Association of admission serum levels of neurofilament light chain and in-hospital mortality in geriatric patients with COVID-19

Comparison of Clinical Features, Complete Blood Count Parameters, and Outcomes between Two Distinct Waves of COVID-19: A Monocentric Report from Italy

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