The Role of Inflammatory Parameters in the Prognosis of Patients with COVID-19

Abstract

Background: The prognostic significance of inflammatory parameters in patients with Coronavirus disease-2019 (COVID-19) has been investigated. Materials and Methods: Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio, C-reactive protein (CRP) albumin ratio (CAR), systemic inflammation index (SII), CRP-lymphocyte ratio (CRP/L), neutrophil to lymphocyte, platelet ratio (NLPR), red cell volume distribution width index (RDW-SD), and procalcitonin were evaluated in relation to admission to intensive care unit (ICU) and mortality in 419 patients with moderate-to-severe COVID-19. Results: NLR, CAR, CRP/L, NLPR, RDW-SD and procalcitonin levels were higher both in those who needed ICU compared to those who did not (p=0.001, 0.005, 0.002, 0.001, 0.001 and 0.001; respectively), and in those who died compared to the survival group (p=0.001, 0.024, 0.009, 0.001, 0.001 and 0.001; respectively). SII was higher only in those who needed ICU (p=0.001). NLR (0.610, p=0.002), CAR (0.602, p=0.005), SII (0.573, p=0.043), CRP/L (0.593, p=0.010), and NLPR (0.618, p=0.001) were statistically significant for admission to ICU; and NLR (0.637, p=0.006), CAR (0.613, p=0.024), CRP/L (0.605, p=0.035) and NLPR (0.660, p=0.001) were statistically significant for mortality in the evaluation of area under curve in ROC analysis. RDW-SD was an independent risk factor for both ICU admission [odds ratio (OR): 1.194, p=0.024] and mortality (OR: 1.263, p=0.002), and procalcitonin was an independent risk factor for ICU admission (OR: 1.492, p=0.034) in multivariate analysis. Conclusion: NLR, CAR, CRP/L, NLPR, RDW-SD and procalcitonin were determined as prognostic parameters in terms of both the need for ICU and mortality in patients with COVID-19. SII was a prognostic parameter only for the need for ICU.