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J Crit Care Med (Targu Mures) . Predictive Value of Systemic Immune-inflammation Index in Determining Mortality in COVID-19 Patients

tetano

Editor, Senior Moderator
J Crit Care Med (Targu Mures)


. 2022 Aug 12;8(3):156-164.
doi: 10.2478/jccm-2022-0013. eCollection 2022 Jul.
Predictive Value of Systemic Immune-inflammation Index in Determining Mortality in COVID-19 Patients


Tahsin Karaaslan[SUP] 1 [/SUP], Esra Karaaslan[SUP] 2 [/SUP]



Affiliations

Abstract

Aim: The aim of this study was to evaluate whether systemic immune-inflammation index (SII) could predict mortality in patients with novel coronavirus 2019 (COVID-19) disease.
Methods: This two-center, retrospective study included a total of 191 patients with confirmed diagnosis of COVID-19 via nucleic acid test (NAT). The SII was calculated based on the complete blood parameters (neutrophil × platelet/lymphocyte) during hospitalization. The relationship between the SII and other inflammatory markers and mortality was investigated.
Results: The mortality rate was 18.3%. The mean age was 54.32±17.95 years. The most common symptoms were fever (70.7%) and dry cough (61.3%), while 8 patients (4.2%) were asymptomatic. The most common comorbidities were hypertension (37.7%), diabetes (23.0%), chronic renal failure (14.7%), and heart failure (7.9%) which all significantly increased the mortality rate (p<0.001). There was a highly positive correlation between the SII and polymorphonuclear leukocyte (PNL), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) (r=0.754, p<0.001; r=0.812, p<0.001; r=0.841, p<0.001, respectively), while a moderate, positive correlation was found between the SII and C-reactive protein (CRP) (r=0.439, p<0.001). There was a significant correlation between the SII and mortality (U=1,357, p<0.001). The cut-off value of SII was 618.8 (area under the curve=0.751, p<0.001) with 80.0% sensitivity and 61.5% specificity. A cut-off value of >618.8 was associated with a 4.68-fold higher mortality.
Conclusion: Similar to NLR and PLR, the SII is a proinflammatory marker of systemic inflammation and can be effectively used in independent predicting COVID-19 mortality.

Keywords: COVID-19; inflammatory markers; mortality; neutrophil/lymphocyte ratio; systemic immune-inflammation index.
 
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