tetano
Editor, Senior Moderator
Clin Epidemiol Glob Health
. Jul-Sep 2021;11:100803.
doi: 10.1016/j.cegh.2021.100803. Epub 2021 Jun 8.
Prognostic value of inflammatory markers in patients with COVID-19 in Indonesia
Ignatius Bima Prasetya[SUP] 1 [/SUP], Cucunawangsih[SUP] 2 [/SUP], Jane Olivia Lorens[SUP] 1 [/SUP], Veli Sungono[SUP] 2 [/SUP], Korri Elvanita El-Khobar[SUP] 3 [/SUP], Ratna Sari Wijaya[SUP] 2 [/SUP]
Affiliations
Abstract
Background & aims: Coronavirus disease 2019 (COVID-19) has a wide clinical spectrum, ranging from asymptomatic infection to severe diseases with high mortality rate. Early identification of high-risk COVID-19 patients may be beneficial to reduce morbidity and in-hospital mortality. This study aimed to investigate whether baseline levels of inflammatory markers such as C-reactive protein (CRP) and immune-cell-based inflammatory indices, neutrophil to lymphocyte ratio (NLR), derived-NLR (d-NLR), and platelet to lymphocyte ratio (PLR) at hospital admission are associated with adverse disease outcomes in COVID-19 patients.
Methods: Clinical data from 391 hospitalized COVID-19 patients in three Siloam Hospitals in Indonesia were retrospectively collected and analysed from March 20 to October 30, 2020.
Results: Fifty-four (13.8%) hospitalized patients had clinical deterioration and required ICU treatment, categorizing them as severe COVID-19 cases. Older age, presence of underlying diseases, and increased inflammatory markers values at admission were significantly associated with severe cases. After adjustment of sociodemographic and comorbidities factors, CRP, NLR, and d-NLR values, but not PLRs, were identified as independent risk factors for disease severity and death in COVID-19 patients. The area under curve (AUC) of CRP, NLR, and d-NLR were 0.854, 0.848, and 0.854, respectively. The optimal cut-off points for CRP, NLR, and d-NLR for identification of COVID-19 patients with potential worse disease outcomes were 47 mg/L, 6, and 4, respectively.
Conclusion: Initial assessment of CRP, NLR, and d-NLR values at hospital admission may be important predictors for adverse disease outcomes in COVID-19 patients.
Keywords: C-reactive protein; COVID-19; Neutrophil to lymphocyte ratio; Risk factors.
. Jul-Sep 2021;11:100803.
doi: 10.1016/j.cegh.2021.100803. Epub 2021 Jun 8.
Prognostic value of inflammatory markers in patients with COVID-19 in Indonesia
Ignatius Bima Prasetya[SUP] 1 [/SUP], Cucunawangsih[SUP] 2 [/SUP], Jane Olivia Lorens[SUP] 1 [/SUP], Veli Sungono[SUP] 2 [/SUP], Korri Elvanita El-Khobar[SUP] 3 [/SUP], Ratna Sari Wijaya[SUP] 2 [/SUP]
Affiliations
- PMID: 34124411
- PMCID: PMC8186126
- DOI: 10.1016/j.cegh.2021.100803
Abstract
Background & aims: Coronavirus disease 2019 (COVID-19) has a wide clinical spectrum, ranging from asymptomatic infection to severe diseases with high mortality rate. Early identification of high-risk COVID-19 patients may be beneficial to reduce morbidity and in-hospital mortality. This study aimed to investigate whether baseline levels of inflammatory markers such as C-reactive protein (CRP) and immune-cell-based inflammatory indices, neutrophil to lymphocyte ratio (NLR), derived-NLR (d-NLR), and platelet to lymphocyte ratio (PLR) at hospital admission are associated with adverse disease outcomes in COVID-19 patients.
Methods: Clinical data from 391 hospitalized COVID-19 patients in three Siloam Hospitals in Indonesia were retrospectively collected and analysed from March 20 to October 30, 2020.
Results: Fifty-four (13.8%) hospitalized patients had clinical deterioration and required ICU treatment, categorizing them as severe COVID-19 cases. Older age, presence of underlying diseases, and increased inflammatory markers values at admission were significantly associated with severe cases. After adjustment of sociodemographic and comorbidities factors, CRP, NLR, and d-NLR values, but not PLRs, were identified as independent risk factors for disease severity and death in COVID-19 patients. The area under curve (AUC) of CRP, NLR, and d-NLR were 0.854, 0.848, and 0.854, respectively. The optimal cut-off points for CRP, NLR, and d-NLR for identification of COVID-19 patients with potential worse disease outcomes were 47 mg/L, 6, and 4, respectively.
Conclusion: Initial assessment of CRP, NLR, and d-NLR values at hospital admission may be important predictors for adverse disease outcomes in COVID-19 patients.
Keywords: C-reactive protein; COVID-19; Neutrophil to lymphocyte ratio; Risk factors.