Leukocyte ratios are useful early predictors for adverse outcomes of COVID-19 infection
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista do Instituto de Medicina Tropical de São Paulo |
Texto Completo: | https://www.revistas.usp.br/rimtsp/article/view/204625 |
Resumo: | Leukocyte biomarkers, including the neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte-(MLR), platelet-to-lymphocyte (PLR) ratios and systemic immune-inflammation index (SII) have been associated with severity and mortality of patients with COVID-19. The purpose of this study was to evaluate the association of baseline leukocyte biomarkers calculated in the emergency department (ED) with the disease severity and mortality. This was a retrospective cohort study that evaluated 1,535 (mean age 57+18 years) patients with SARS-CoV-2 infection in the ED of a single reference center. Outcomes were severity, defined as intensive care unit (ICU) admission requirement, and in-hospital mortality. All leukocyte biomarkers were calculated in the ED before the hospital admission. Their ability to predict the severity and mortality was measured using receiver operating characteristic (ROC) curves. Severity and mortality were observed in 30.9% and 12.6% of the patients, respectively, and were significantly correlated with NLR, MLR, PLR and SII, but only NLR was independently associated with both outcomes on multivariate analysis. Analysis of ROC curves revealed that NLR (0.78 for severity and 0.80 for mortality) and SII (0.77 for severity and 0.75 for mortality) had the best ability to predict mortality, when compared to other ratios. The highest AUC was observed for NLR, employing cut-off points of 5.4 for severity and 5.5 for mortality. Leukocyte biomarkers, particularly NLR, are capable of predicting the severity and mortality of patients with SARS-CoV-2 infection and could be important adjunct tools to identify patients in the ED that are more prone to develop adverse outcomes. |
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Leukocyte ratios are useful early predictors for adverse outcomes of COVID-19 infectionLeukocyte biomarkersCOVID-19PrognosisOutcomeCritical careEmergency departmentLeukocyte biomarkers, including the neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte-(MLR), platelet-to-lymphocyte (PLR) ratios and systemic immune-inflammation index (SII) have been associated with severity and mortality of patients with COVID-19. The purpose of this study was to evaluate the association of baseline leukocyte biomarkers calculated in the emergency department (ED) with the disease severity and mortality. This was a retrospective cohort study that evaluated 1,535 (mean age 57+18 years) patients with SARS-CoV-2 infection in the ED of a single reference center. Outcomes were severity, defined as intensive care unit (ICU) admission requirement, and in-hospital mortality. All leukocyte biomarkers were calculated in the ED before the hospital admission. Their ability to predict the severity and mortality was measured using receiver operating characteristic (ROC) curves. Severity and mortality were observed in 30.9% and 12.6% of the patients, respectively, and were significantly correlated with NLR, MLR, PLR and SII, but only NLR was independently associated with both outcomes on multivariate analysis. Analysis of ROC curves revealed that NLR (0.78 for severity and 0.80 for mortality) and SII (0.77 for severity and 0.75 for mortality) had the best ability to predict mortality, when compared to other ratios. The highest AUC was observed for NLR, employing cut-off points of 5.4 for severity and 5.5 for mortality. Leukocyte biomarkers, particularly NLR, are capable of predicting the severity and mortality of patients with SARS-CoV-2 infection and could be important adjunct tools to identify patients in the ED that are more prone to develop adverse outcomes.Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo2022-11-18info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rimtsp/article/view/20462510.1590/S1678-9946202264073Revista do Instituto de Medicina Tropical de São Paulo; Vol. 64 (2022); e73Revista do Instituto de Medicina Tropical de São Paulo; Vol. 64 (2022); e73Revista do Instituto de Medicina Tropical de São Paulo; v. 64 (2022); e731678-99460036-4665reponame:Revista do Instituto de Medicina Tropical de São Pauloinstname:Instituto de Medicina Tropical (IMT)instacron:IMTenghttps://www.revistas.usp.br/rimtsp/article/view/204625/188261Copyright (c) 2022 João Pedro Farias, Pedro Paulo Costa e Silva, Liana Codes, Diana Vinhaes, Ana Paula Amorim, Ricardo Cruz D’Oliveira, Alberto Queiroz Farias, Paulo Lisboa Bittencourthttps://creativecommons.org/licenses/by-nc/4.0info:eu-repo/semantics/openAccess Farias, João Pedro Silva, Pedro Paulo Costa eCodes, Liana Vinhaes, Diana Amorim, Ana Paula D’Oliveira, Ricardo Cruz Farias, Alberto Queiroz Bittencourt, Paulo Lisboa 2022-11-18T18:32:29Zoai:revistas.usp.br:article/204625Revistahttp://www.revistas.usp.br/rimtsp/indexPUBhttps://www.revistas.usp.br/rimtsp/oai||revimtsp@usp.br1678-99460036-4665opendoar:2022-12-13T16:54:11.201900Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT)true |
dc.title.none.fl_str_mv |
Leukocyte ratios are useful early predictors for adverse outcomes of COVID-19 infection |
title |
Leukocyte ratios are useful early predictors for adverse outcomes of COVID-19 infection |
spellingShingle |
Leukocyte ratios are useful early predictors for adverse outcomes of COVID-19 infection Farias, João Pedro Leukocyte biomarkers COVID-19 Prognosis Outcome Critical care Emergency department |
title_short |
Leukocyte ratios are useful early predictors for adverse outcomes of COVID-19 infection |
title_full |
Leukocyte ratios are useful early predictors for adverse outcomes of COVID-19 infection |
title_fullStr |
Leukocyte ratios are useful early predictors for adverse outcomes of COVID-19 infection |
title_full_unstemmed |
Leukocyte ratios are useful early predictors for adverse outcomes of COVID-19 infection |
title_sort |
Leukocyte ratios are useful early predictors for adverse outcomes of COVID-19 infection |
author |
Farias, João Pedro |
author_facet |
Farias, João Pedro Silva, Pedro Paulo Costa e Codes, Liana Vinhaes, Diana Amorim, Ana Paula D’Oliveira, Ricardo Cruz Farias, Alberto Queiroz Bittencourt, Paulo Lisboa |
author_role |
author |
author2 |
Silva, Pedro Paulo Costa e Codes, Liana Vinhaes, Diana Amorim, Ana Paula D’Oliveira, Ricardo Cruz Farias, Alberto Queiroz Bittencourt, Paulo Lisboa |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Farias, João Pedro Silva, Pedro Paulo Costa e Codes, Liana Vinhaes, Diana Amorim, Ana Paula D’Oliveira, Ricardo Cruz Farias, Alberto Queiroz Bittencourt, Paulo Lisboa |
dc.subject.por.fl_str_mv |
Leukocyte biomarkers COVID-19 Prognosis Outcome Critical care Emergency department |
topic |
Leukocyte biomarkers COVID-19 Prognosis Outcome Critical care Emergency department |
description |
Leukocyte biomarkers, including the neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte-(MLR), platelet-to-lymphocyte (PLR) ratios and systemic immune-inflammation index (SII) have been associated with severity and mortality of patients with COVID-19. The purpose of this study was to evaluate the association of baseline leukocyte biomarkers calculated in the emergency department (ED) with the disease severity and mortality. This was a retrospective cohort study that evaluated 1,535 (mean age 57+18 years) patients with SARS-CoV-2 infection in the ED of a single reference center. Outcomes were severity, defined as intensive care unit (ICU) admission requirement, and in-hospital mortality. All leukocyte biomarkers were calculated in the ED before the hospital admission. Their ability to predict the severity and mortality was measured using receiver operating characteristic (ROC) curves. Severity and mortality were observed in 30.9% and 12.6% of the patients, respectively, and were significantly correlated with NLR, MLR, PLR and SII, but only NLR was independently associated with both outcomes on multivariate analysis. Analysis of ROC curves revealed that NLR (0.78 for severity and 0.80 for mortality) and SII (0.77 for severity and 0.75 for mortality) had the best ability to predict mortality, when compared to other ratios. The highest AUC was observed for NLR, employing cut-off points of 5.4 for severity and 5.5 for mortality. Leukocyte biomarkers, particularly NLR, are capable of predicting the severity and mortality of patients with SARS-CoV-2 infection and could be important adjunct tools to identify patients in the ED that are more prone to develop adverse outcomes. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-11-18 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/204625 10.1590/S1678-9946202264073 |
url |
https://www.revistas.usp.br/rimtsp/article/view/204625 |
identifier_str_mv |
10.1590/S1678-9946202264073 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/204625/188261 |
dc.rights.driver.fl_str_mv |
https://creativecommons.org/licenses/by-nc/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
https://creativecommons.org/licenses/by-nc/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
dc.source.none.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo; Vol. 64 (2022); e73 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 64 (2022); e73 Revista do Instituto de Medicina Tropical de São Paulo; v. 64 (2022); e73 1678-9946 0036-4665 reponame:Revista do Instituto de Medicina Tropical de São Paulo instname:Instituto de Medicina Tropical (IMT) instacron:IMT |
instname_str |
Instituto de Medicina Tropical (IMT) |
instacron_str |
IMT |
institution |
IMT |
reponame_str |
Revista do Instituto de Medicina Tropical de São Paulo |
collection |
Revista do Instituto de Medicina Tropical de São Paulo |
repository.name.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT) |
repository.mail.fl_str_mv |
||revimtsp@usp.br |
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