Can Hematological Indexes Predict Prognosis in Intensive Care COVID-19 Patients?

Objective: In coronavirus disease 2019, which affects the whole world, it is difficult to predict the prognosis in advance. The timing of anti-inflammatory and anti-cytokine treatments to be given in case of a bad course of the disease is very important. In this study, we aimed to determine the predictive effect of inflammation-based markers such as neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, systemic inflammatory index, and plasma atherogenic index on the prognosis of coronavirus disease 2019.

Methods: In this retrospective study, 217 patients hospitalized in the intensive care unit with a confirmed diagnosis of coronavirus disease 2019 were included. The patients were divided into 2 groups as survivors and nonsurvivors. Indices were calculated from the laboratory results of the patients. Receiver operating characteristic curve analysis was used to determine whether the indices had a diagnostic value.

Results: Males (n=133) made up 61.3% of the patients, and the average age of all patients was 70.5 ± 13.7 years. The patients were identified as survivors (group 1, n=140) and nonsurvivors (group 2, n=77). C-reactive protein, procalcitonin, ferritin, d-dimer, lactate, urea, creatine, and neutrophil values of the patients who died in group 2 were significantly higher, while highdensity lipoprotein, hemoglobin, platelet, and lymphocyte count were significantly lower. Neutrophil/lymphocyte ratio, platelet/ lymphocyte ratio, systemic inflammatory index, and plasma atherogenic index were found to be significantly higher in the group of nonsurvivor patients than in the group of surviving patients. In addition, the plasma atherogenic index (P=.024, area under the curve=0.605, cutoff=0.504) had the highest specificity with 80.3%, and the neutrophil/lymphocyte ratio was the second with 76.1% (P < .001, area under the curve=0.691, cutoff=17.5). 

Conclusion: In our study, it was determined that all the indices we measured were significantly higher in nonsurvivor patients. According to the results of study, markers such as neutrophil/ lymphocyte ratio, platelet/lymphocyte ratio, systemic inflammatory index, and plasma atherogenic index could help clinicians in predicting disease prognosis and in-hospital mortality in coronavirus disease 2019.

Cite this article as: Tosun M, Arslan YK. Can hematological indexes predict prognosis in intensive care COVID-19 patients? Arch Basic Clin Res 2022;4(3):106-113.