Systemic Inflammatory Index Is a Novel Predictor of Intubation Requirement and Mortality after SARS-CoV-2 Infection (original) (raw)
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Assessment of Systemic Immune Inflammation Index to Predict SARS-CoV-2 Infection
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY, 2021
Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and has become a major health problem worldwide. Inflammation plays a vital role in the pathophysiology of COVID-19. Systemic Immune Inflammation Index (SII) is an index obtained from calculating the platelets counts, neutrophils, and lymphocytes, which can indicate the inflammation status and immunity. This study aimed to determine the potential of SII as a predictor of SARS-CoV-2 infection in suspected COVID-19 subjects. A retrospective study was carried out by obtaining medical record data in June 2020 at Sleman General Hospital. An unpaired T-test or the Mann-Whitney test was used to determine the statistical difference. A Receiver Operating Characteristic (ROC) curve was generated and used to get the cut-off values. Bivariate analysis was performed using Chi-Square. There were 84 subjects consisting of 46 (54.8%) males and 38 (45.2%) females with a...
Clinical Hemorheology and Microcirculation
BACKGROUND: Severe COVID-19 disease is associated with multiple organ involvement,then failure and often fatal outcomes.In addition,inflammatory mechanisms and cytokine storms,documented in many COVID-19 patients,are responsible for the progression of the disease and high mortality rates.Inflammatory parameters,such as procalcitonin(PCT) and C-reactive protein(CRP), are widely used in clinical practice. OBJECTIVE: To evaluate the predictive power of non-conventional inflammatory markers regarding mortality risk. METHODS: In our prospective study 52 patients were followed for 5 days after admission to an intensive care unit immediately with severe SARS-CoV-2 infection.We compared leukocyte-,platelet antisedimentation rate (LAR, PAR),neutrophil lymphocyte ratio(NLR), CRP, PCT levels. RESULTS: In non-surviving(NSU) patients LAR remained largely constant from D1 to D4 with a statistically significant drop(p < 0.05) only seen on D5.The NSU group showed statistically significant(p <...
Indian Journal of Respiratory Care
We report the first time-course of illness severity scores and a spectrum of biochemical and inflammatory markers and their association with survival in invasively ventilated coronavirus disease 2019 (COVID-19) acute respiratory failure (C-ARF) from India. In resource-limited settings, routine and economical biomarkers such as absolute lymphocyte count, platelet count, blood urea nitrogen, and serum creatinine can be used to monitor the severity of COVID-19 infection and triage-scarce healthcare. introduction Coronavirus disease of 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) portrays a spectrum of clinical infliction, severe of which is multiorgan dysfunction syndrome (MODS) often progressing to mortality. 35-50% of these patients have been reported to have a fatal outcome. 1 It is difficult to ascertain the timing of the tipping point in C-ARF as these patients display hyperinflammation 2 from an early stage. Alterations in biochemical parameters commensurate with the severity of infection. Studies have evaluated outcomes of C-ARF using biochemical values at baseline. In order to recognize the presence and extent of severity of inflammation in the tissues,
Inflammation Research
Objective To investigate whether a simplified inflammation-based risk scoring system comprising three readily available biomarkers (albumin, C-reactive protein, and leukocytes) may predict major adverse outcomes in patients with COVID-19. Methods Upon admission to the emergency room, the inflammation-based risk scoring system was applied and patients were classified as having mild, moderate, or severe inflammation. In-hospital occurrence of thrombosis, need for mechanical ventilation, and death were recorded. Results One-hundred patients (55 ± 13 years; 71% men) were included and classified as having mild (29%), moderate (12%), or severe (59%) inflammation. The need for mechanical ventilation differed among patients in each group (16%, 50%, and 71%, respectively; P < 0.0001), yielding a 4.1-fold increased risk of requiring mechanical ventilation in patients with moderate inflammation and 5.4 for those with severe inflammation. On the contrary, there were no differences for the occurrence of thrombosis (10%, 8%, and 22%, respectively; P = 0.142) or death (21%, 42%, and 39%, respectively; P = 0.106). In the multivariate analysis, only severe inflammation (hazard ratio [HR] = 4.1), D-dimer > 574 ng/mL (HR = 3.0), and troponin I ≥ 6.7 ng/mL (HR = 2.4) at hospital admission were independent predictors of the need for mechanical ventilation. Conclusion The inflammation-based risk scoring system predicts the need for mechanical ventilation in patients with severe COVID-19.
Association between Inflammatory Markers and the Outcome of Critically Ill COVID-19 Patients
Scholars journal of applied medical sciences, 2022
Original Research Article Background: Coronavirus disease (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2). It had emerged from Wuhan, China and has rapidly spread around the world. In critically ill patients, the mortality rates are significantly high. This study analyzed the various inflammatory markers and their association with patient mortality, thus helping to identify critically ill patients with a high possibility of worsening prognosis. Materials and Methods: In this multicenter, prospective study, 85 patients were included and were followed until either of two outcomes was achieved: patients were successfully discharged or patients expired at the ICU. Correlation between the patient outcome and inflammatory markers were analyzed. Cutoff values for patients with worse prognosis were speculated through ROC curve. Results: Significantly, mortality was associated with CRP (P<0.001), d-dimer (P<0.001)., LDH (P=0.001), IL-6(P<0.001), serum ferritin(P=0.001), procalcitonin (P<0.001)along with neutropenia (P<0.001) and lymphocytosis (P<0.001). Conclusion: With the following inflammatory markers such as CRP, d-dimer, LDH, IL-6, procalcitonin and serum ferritin, patients who have a worse prognosis can be identified among the critically ill patients at the ICU. Hence, close monitoring and early management of such patients can help improve their prognosis.
Inflammation Profiling of Critically Ill Coronavirus Disease 2019 Patients
Critical Care Explorations, 2020
; on behalf of the Lawson COVID-19 Study Team Objectives: Coronavirus disease 2019 is caused by severe acute respiratory syndrome-coronavirus-2 infection to which there is no community immunity. Patients admitted to ICUs have high mortality, with only supportive therapies available. Our aim was to profile plasma inflammatory analytes to help understand the host response to coronavirus disease 2019. Design: Daily blood inflammation profiling with immunoassays. Setting: Tertiary care ICU and academic laboratory. Subjects: All patients admitted to the ICU suspected of being infected with severe acute respiratory syndrome-coronavirus-2, using standardized hospital screening methodologies, had daily blood samples collected until either testing was confirmed negative on ICU day 3 (coronavirus disease 2019 negative), or until ICU day 7 if the patient was positive (coronavirus disease 2019 positive). Interventions: None. Measurements and Main Results: Age-and sex-matched healthy controls and ICU patients that were either coronavirus disease 2019 positive or coronavirus disease 2019 negative were enrolled. Cohorts were well-balanced with the exception that coronavirus disease 2019 positive patients were more likely than coronavirus disease 2019 negative patients to suffer bilateral pneumonia. Mortality rate for coronavirus disease 2019 positive ICU patients was 40%. We measured 57 inflammatory analytes and then analyzed with both conventional statistics and machine learning. Twenty inflammatory analytes were different between coronavirus disease 2019 positive patients and healthy controls (p < 0.01). Compared with coronavirus disease 2019 negative patients, coronavirus disease 2019 positive patients had 17 elevated inflammatory analytes on one or more of their ICU days 1-3 (p < 0.01), with feature classification identifying the top six analytes between cohorts as tumor necrosis factor, granzyme B, heat shock protein 70, interleukin-18, interferon-gammainducible protein 10, and elastase 2. While tumor necrosis factor, granzyme B, heat shock protein 70, and interleukin-18 were elevated for all seven ICU days, interferon-gamma-inducible protein 10 transiently elevated on ICU days 2 and 3 and elastase 2 increased over ICU days 2-7. Inflammation profiling predicted coronavirus disease 2019 status with 98% accuracy, whereas elevated heat shock protein 70 was strongly associated with mortality. Conclusions: While many inflammatory analytes were elevated in coronavirus disease 2019 positive ICU patients, relative to healthy controls, the top six analytes distinguishing coronavirus disease 2019 positive ICU patients from coronavirus disease 2019 negative ICU patients were tumor necrosis factor, granzyme B, heat shock protein 70, interleukin-18, interferon-gamma-inducible protein 10, and elastase 2.
PLOS ONE, 2021
Several reports highlighted the central role of inflammation in the pathogenesis of corona virus disease-19 (COVID-19) disease. Also, the hyper-inflammatory response that is triggered by severe acute respiratory syndrom-Covid-2 (SARS-CoV-2) infection was believed to play an essential role in disease severity and adverse clinical course. For that reason, the classical inflammatory markers were proposed as a possible indicator for COVID-19 severity. However, an extensive analysis of the predictive value of inflammatory biomarkers in large patients’ cohorts is still limited and critically needed. In this study we investigated the predictive value of the classical inflammatory biomarkers in a patient cohort consists of 541 COVID-19 patients admitted to Al Kuwait Hospital, Dubai, UAE. A detailed analysis of the association between the essential inflammatory markers and clinical characteristics as well as clinical outcome of the patients were made. In addition, the correlation between tho...
Cureus
Background: The World Health Organization declared coronavirus disease 2019 (COVID-19) responsible for a catastrophic global pandemic. The complexity of COVID-19 is centred on the unpredictable course of the disease, which can rapidly develop from patients being asymptomatic to having life-threatening symptoms. The unpredictable disease severity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been a major problem facing the healthcare system during the pandemic. Identifying the laboratory biomarkers would help predict SARS-CoV-2 pathogenicity. This study focused on the previous literature regarding three laboratory biomarker profiles: haematological, inflammatory, and biochemical biomarkers. Methods: A retrospective study of COVID-19 patients was conducted between May 2020 and September 2020 to determine the predictors of hospitalization (severity) in COVID-19 patients. Patients were divided into two groups: those admitted to an intensive care unit (ICU, severe) and those admitted to a non-ICU (stable).
Multi-inflammatory Index as a Novel Mortality Predictor in Critically Ill COVID-19 Patients
Journal of Intensive Care Medicine, 2022
AimSystemic inflammation has a crucial role in the pathogenesis and mortality of Coronavirus disease 2019 (COVID-19). Multi-inflammatory index (MII) is a novel index related with systemic inflammation. In this study, we investigated the relationship between MII and in-hospital mortality in COVID-19 patients admitted to the intensive care unit (ICU).MethodsWe retrospectively analyzed the medical records of COVID-19 patients followed-up in the ICU of our institution between 01.04.2020 and 01.10.2021. Patients were classified into two groups according to mortality status as survivors and non-survivors. Various inflammatory parameters of the groups were compared and their efficacy in predicting mortality was investigated.ResultsOut of 348 study patients, 86 cases (24.7%) were in the survived group and 262 cases (75.3%) were in the dead group. The median age of the mortal group was significantly higher than that of the survived group (65.5 vs 76, P < .001). Multiple logistic regression analysis revealed that among all the included inflammatory parameters, MII showed the best efficacy for predicting mortality (OR: 0.999; 95% CI: 0.9991-0.9998; P = .003).ConclusionMII, a new combination of Neutrophil to lymphocyte ratio (NLR) and C-reactive protein (CRP), is a simple and practical biomarker that can help us in the prediction of mortality in COVID-19 patients followed-up in the ICU.
Türk Yoğun Bakim Derneği Dergisi, 2021
Objective: Laboratory parameters may predict the severity and mortality of coronavirus disease-2019 (COVID-19). We investigated the relationship of laboratory findings obtained at admission and 72 nd hour and mortality and morbidity of patients with pneumonia who were treated in two intensive care units. Materials and Methods: Chart data of 75 patients (March-May 2020) were retrospectively analysed. Patient characteristics and laboratory parameters were compared according to the presence of COVID-19 and mortality. Patients with COVID-19 were compared according to mortality and gender. Results: The mean patient age was 74.7±11.3 years. COVID-19 positivity was not associated with marked differences in laboratory values. Lung disease, bedridden status, worse renal function scores, and high C-reactive protein level was more often observed in non-survivors (p<0.05). A decline in D-dimer level was more apparent in survivors; the increase in ferritin and neutrophillymphocyte ratio was more apparent in non-survivors (not significant). Among patients with COVID-19, women had higher mean platelet volume than men (p=0.033). The rise in ferritin level was more pronounced in men, whereas the rise in neutrophil-lymphocyte ratio and platelet-lymphocyte ratio was higher in women. Conclusion: In this geriatric cohort, chronic lung disease and bedridden status were the main determinants of mortality. Moreover, different patterns of inflammatory markers may help predict the severity of COVID-19.