The Value of Lymphocyte-CRP Ratio Predicting the Prognosis in COVID-19 Patients
El valor de la relación linfocito-PCR para predecir el pronóstico en pacientes con COVID-19
Alper Tahmaz, Ayşegül Şeremet Keskin, Filiz Kizilateş, Nefise Öztorpak
Abstract
Introduction: Although prevention of the disease and its spread is the primary goal in the fight against the pandemic, studies on the correct management of those who have the disease and the predictability of the prognosis are also important. This study aimed to determine whether lymphocyte-C-reactive protein ratio, together with other inflammation markers, would be useful in predicting intensive care unit admission and mortality in Coronavirus disease 2019 cases.
Material and methods: 883 patients were followed in 758 wards and 125 intensive care units. Data of the patients included in the study were compared with those admitted to the service and intensive care unit, and with those who survived and developed mortality.
Results: According to the receiver operating characteristic analysis to distinguish the patients followed in the intensive care unit from the patients hospitalized in the ward that was determined that lymphocyte-C-reactive protein ratio, C-reactive protein ratio, CRP-albumin ratio, and neutrophil-lymphocyte ratio were moderate (70%–80%). D-dimer was good (80%–90%) predicting follow-up in intensive care unit. Increase in age, increase in lactate dehydrogenase and interleukin-6 levels, and uptake in tomography were determined as independent risk factors that increase intensive care unit admission. 243 (27.5%) of the patients were mortal. The mean age of the patients with a mortal course was 70±14 years, and mortality increased with increasing age. In the receiver operating characteristic analysis of patients with a mortal course that was determined that lymphocyte-C-reactive protein ratio, neutrophil-lymphocyte ratio, and D-dimer had a good (80–90%) ability to distinguish patients with a mortal course. Age, fever, and increases in lactate dehydrogenase and interleukin-6 levels were determined to be independent risk factors increasing mortality.
Conclusions: Low lymphocyte-C-reactive protein ratio and high D-Dimer, neutrophil-lymphocyte ratio, and CRP-albumin ratio can be used in clinical monitoring to reduce morbidity and mortality rates due to COVID-19.
Keywords
Resumen
Introducción: Si bien la prevención de la enfermedad y su propagación es el objetivo principal en la lucha contra la pandemia, también son importantes los estudios sobre el correcto manejo de los pacientes con la enfermedad y la previsibilidad del pronóstico. El objetivo de este estudio fue determinar si la proporción de linfocitos y proteína C reactiva, junto con otros marcadores inflamatorios, sería útil para predecir el ingreso a la unidad de cuidados intensivos y la mortalidad en casos de enfermedad por coronavirus en 2019.
Material y métodos: Se siguieron 883 pacientes en 758 salas y 125 unidades de cuidados intensivos. Los datos de los pacientes incluidos en el estudio se compararon con los ingresados en el servicio y unidad de cuidados intensivos, y con los que sobrevivieron y desarrollaron mortalidad.
Resultados: Según el análisis de las características operativas del receptor para distinguir los pacientes seguidos en la unidad de cuidados intensivos de los pacientes hospitalizados en el servicio, se encontró que la relación linfocitos a proteína C reactiva, proteína C reactiva a albúmina y neutrófilos a la proporción de linfocitos fue moderada y el dímero D fue bueno para predecir el seguimiento en la unidad de cuidados intensivos. Se encontró que el aumento de la edad, el aumento de los niveles de lactato deshidrogenasa e interleucina-6 y la captación en la tomografía eran factores de riesgo independientes para el ingreso a la unidad de cuidados intensivos. 243 (27,5%) de los pacientes fallecieron. En el análisis de las características operativas del receptor de pacientes con un desenlace fatal, se encontró que la proporción de linfocitos a proteína C reactiva, la proporción de neutrófilos a linfocitos y el dímero D tenían una buena capacidad para discriminar a los pacientes con un desenlace fatal. Se encontró que la edad, la fiebre y los niveles elevados de lactato deshidrogenasa e interleucina-6 eran factores de riesgo independientes para una mayor mortalidad.
Conclusiones: Una proporción baja de linfocitos a proteína C reactiva y una proporción alta de dímero D, neutrófilos a linfocitos y PCR a albúmina se pueden utilizar en el seguimiento clínico para reducir las tasas de morbilidad y mortalidad debido a COVID-19.
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References
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Submitted date:
06/30/2023
Reviewed date:
07/26/2023
Accepted date:
08/23/2023
Publication date:
08/26/2023
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