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Sci Rep . Validation of the age, neutrophil to lymphocyte ratio, C reactive protein score on 28 day mortality in the National COVID cohort collabor

tetano

Editor, Senior Moderator
Sci Rep


. 2025 Aug 2;15(1):28254.
doi: 10.1038/s41598-025-08822-5. Validation of the age, neutrophil to lymphocyte ratio, C reactive protein score on 28 day mortality in the National COVID cohort collaborative

Benjamin J Sines[SUP] 1 [/SUP], Kunal K Jakharia[SUP] 2 [/SUP], Chih-Huan Lu[SUP] 3 [/SUP], Leslie Appleton[SUP] 3 [/SUP], Colleen Rice[SUP] 2 [/SUP], William A Fischer[SUP] 2 [/SUP], Shannon M Wallet[SUP] 4 [/SUP], G Stephen DeCherney[SUP] 5 [/SUP], Jason R Mock[SUP] 2 [/SUP], M Bradley Drummond[SUP] 2 [/SUP]



Affiliations
Abstract

Identifying patients at high mortality risk can improve outcomes in SARS-CoV-2 pneumonia (COVID-19). We validate a prognostic model for mortality in patients hospitalized with COVID-19 receiving dexamethasone using a retrospective multi-centered study. This is a retrospective cohort study using the National COVID Cohort Collaborative (NC3) including 9,708 adult patients admitted for COVID-19 who received dexamethasone within 24 h of admission and remained hospitalized for 72 h. Previous work from a single-center cohort informed selection of prognostic variables including Age, day 3 neutrophil-lymphocyte Ratio, and day 3 C-reactive protein level (ARC Score). Variables from the development cohort were analyzed in a training cohort, and the resulting model was tested in a validation cohort. Age and day 3 measures of the neutrophil-lymphocyte ratio and C-reactive protein level were included in a logistic regression model to predict 28-day mortality. The 28-day mortality in this patient population was 15.4%. The area under the curve for the ARC model was 0.77 (95% confidence interval, 0.74-0.79). The Age, neutrophil-lymphocyte Ratio, and C-reactive protein (ARC) score identifies COVID-19 patients with a high risk of mortality within 28 days of hospitalization using clinical information on day 3 of hospitalization. ARC scores perform well across all variants of concern.

Keywords: Acute respiratory distress syndrome; COVID-19; Critical care; SARS-CoV-2; Viral pneumonia.

 
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