scholarly journals Prognostic Value of Immune-Inflammatory Index in PSI IV-V Patients with COVID-19

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Rui Han ◽  
Honghui Su ◽  
Gangwen Guo ◽  
Qiao Wang ◽  
Jiahui Ma ◽  
...  
Keyword(s):  
Characteristic Curve ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Neutrophil To Lymphocyte Ratio ◽  
Pneumonia Severity ◽  
Lymphocyte Ratio ◽  
Inflammatory Index ◽  
Risk Of Mortality ◽  
The Relationship ◽  
Initial Research

Objective. Respiratory failure is the leading cause of mortality in COVID-19 patients, characterized by a generalized disbalance of inflammation. The aim of this study was to investigate the relationship between immune-inflammatory index and mortality in PSI IV-V patients with COVID-19. Methods. We retrospectively reviewed the medical records of COVID-19 patients from Feb. to Apr. 2020 in the Zhongfa Xincheng Branch of Tongji Hospital, Wuhan, China. Patients who presented high severity of COVID-19-related pneumonia were enrolled for further analysis according to the Pneumonia Severity Index (PSI) tool. Results. A total of 101 patients diagnosed with COVID-19 were identified at initial research. The survival analysis revealed that mortality of the PSI IV-V cohort was significantly higher than the PSI I-III group ( p = 0.0003 ). The overall mortality in PSI IV-V patients was 32.1% (9/28). The fatal cases of the PSI IV-V group had a higher level of procalcitonin ( p = 0.022 ) and neutrophil-to-lymphocyte ratio ( p = 0.033 ) compared with the survivors. Procalcitonin was the most sensitive predictor of mortality for the severe COVID-19 population with area under receiver operating characteristic curve of 0.78, higher than the neutrophil-to-lymphocyte ratio (0.75) and total lymphocyte (0.68) and neutrophil (0.67) counts. Conclusion. Procalcitonin and neutrophil-to-lymphocyte ratio may potentially be effective predictors for mortality in PSI IV-V patients with COVID-19. Increased procalcitonin and neutrophil-to-lymphocyte ratio were associated with greater risk of mortality.

The value of neutrophil-to-lymphocyte ratio as a marker of renal damage in patients with H-type hypertension

2021 ◽  
Author(s):  
Zhen-Ni Chen ◽  
Yi-Ran Huang ◽  
Xing Chen ◽  
Kun Liu ◽  
Si-Jin Li ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Renal Damage ◽  
Operating Characteristic ◽  
Estimated Glomerular Filtration Rate ◽  
Characteristic Curve ◽  
Linear Regression Analysis ◽  
Significant Negative Correlation ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
The Relationship

Aim: To explore the relationship between the neutrophil-to-lymphocyte ratio (NLR) and renal damage in patients with H-type hypertension. Materials & methods: A total of 618 patients between 2017 and 2019 were analyzed retrospectively. Results: NLR was significantly correlated with renal damage in hypertension patients. Appropriate cut-off value for NLR (2.247) was determined by receiver operating characteristic curve; linear regression analysis showed that NLR and estimated glomerular filtration rate, blood urea nitrogen/creatinine has a significant negative correlation in H-type hypertension group (p < 0.05); logistic regression analysis showed that the risk of renal damage increased by 10% for each 1 umol/l increase of homocysteine, and 51% for each 1.0 increase of NLR in H-type hypertension patients. Conclusion: NLR worth popularizing in prediction of renal damage in patients with H-type hypertension.

scholarly journals Prognosis of patients hospitalized with a diagnosis of COVID-19 pneumonia in a tertiary hospital in Turkey

2021 ◽  
Vol 41 (6) ◽  
pp. 327-335
Author(s):  
Tayfun Birtay ◽  
Suzan Bahadir ◽  
Ebru Kabacaoglu ◽  
Ozgur Yetiz ◽  
Mehmet Fatih Demirci ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Disease Index ◽  
Morbidity And Mortality ◽  
Smoking History ◽  
Pneumonia Severity ◽  
Laboratory Parameters ◽  
The Relationship ◽  
D Dimer

BACKGROUND: SARS-CoV2/COVID-19 emerged in China and caused a global pandemic in 2020. The mortality rate has been reported to be between 0% and 14.6% in all patients. In this study, we determined the clinical and laboratory parameters of COVID-19 related morbidity and mortality in our hospital. OBJECTIVES: Investigate the relationship between demographic, clinical, and laboratory parameters on COVID-19-related morbidity and mortality. DESIGN: Retrospective observational study. SETTINGS: Tertiary care hospital. PATIENTS AND METHODS: Patients diagnosed with COVID-19 pneumonia from March until the end of December were included in the study. MAIN OUTCOME MEASURES: The relationship between demographic, clinical, and laboratory parameters and the morbidity and mortality rates of patients diagnosed with COVID-19. SAMPLE SIZE: 124 patients RESULTS: The mortality rate was 9.6% (12/124). Coronary artery disease ( P <.0001) diabetes mellitus ( P =.04) fever (>38.3°C) at presentation ( P =.04) hypertension ( P <.0001), and positive smoking history ( P <.0001) were significantly associated with mortality. Patients who died were older, had a higher comorbid disease index, pneumonia severity index, fasting blood glucose, baseline serum creatinine, D-dimer, and had lower baseline haemoglobin, SaO 2 , percentage of lymphocyte counts and diastolic blood pressure. Patients admitted to the ICU were older, had a higher comorbidity disease index, pneumonia severity index, C-reactive protein, WBC, D-dimer, creatinine, number of antibiotics used, longer O 2 support duration, lower hemoglobin, lymphocyte (%), and baseline SaO 2 (%). CONCLUSIONS: Our results were consistent with much of the reported data. We suggest that the frequency, dosage, and duration of steroid treatment should be limited. LIMITATIONS: Low patient number, uncertain reason of mortality, no standard treatment regimen, limited treatment options, like ECMO. CONFLICT OF INTEREST: None.

scholarly journals Prognostic value of serial neutrophil-to-lymphocyte ratio measurements in hospitalized community-acquired pneumonia

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250067
Author(s):  
Heock Lee ◽  
Insu Kim ◽  
Bo Hyoung Kang ◽  
Soo-Jung Um
Keyword(s):  
Treatment Response ◽  
Early Treatment ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Community Acquired Pneumonia ◽  
Neutrophil To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Icu Admission ◽  
Incremental Change ◽  
Early Treatment Response

Introduction Several serum inflammatory markers are associated with poor clinical outcomes in community-acquired pneumonia (CAP). However, the prognosis and early treatment response in hospitalized CAP patients based on serial neutrophil-to-lymphocyte ratio (NLR) measurement has never been investigated. Methods We performed a retrospective observational study for 175 consecutive patients hospitalized with CAP between February 2016 and February 2018. NLR, C-reactive protein (CRP) and procalcitonin levels were measured on admission day (D1) and on hospital day 4 (D4). The Pneumonia Severity Index (PSI) was also assessed on admission. The primary endpoint was all-cause death within 30 days after admission. The secondary endpoint was early treatment response such as intensive care unit (ICU) admission during hospitalization and clinical unstability on day 4. Results The 30-day mortality rate was 9.7%. In multivariate analysis, NLR D4 (OR: 1.11; 95% CI: 1.04–1.18; P = 0.003) and its incremental change (NLR D4/D1 >1) (OR: 7.10; 95% CI: 2.19–23.06; P = 0.001) were significant predictors of 30-day mortality. NLR D4 and its incremental change were significant predictors of ICU admission and clinical unstability on day 4 in multivariate analyses. Adding of incremental NLR change significantly improved the prognostic ability of the PSI. The additive value of incremental NLR change for the prognostic ability of the PSI was larger than that of incremental CRP change. Conclusion Serial NLR measurement represents useful laboratory tool to predict the prognosis and early treatment response of hospitalized CAP patients.

scholarly journals Predicting value of neutrophil–lymphocyte ratio and CURB-65 score for early clinical stability of adult community-acquired pneumonia

2019 ◽  
Vol 17 ◽  
pp. 205873921983510
Author(s):  
Xuegui Ju ◽  
Shaoqiang Tao ◽  
Hui Zhou ◽  
Qianglin Zeng
Keyword(s):  
Pneumonia Severity Index ◽  
Area Under The Curve ◽  
Severity Index ◽  
Community Acquired Pneumonia ◽  
Pneumonia Severity ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Clinical Instability ◽  
Combined Test ◽  
Clinical Stability

Early clinical stability has been proven to be vital for the treatment of community-acquired pneumonia (CAP). This research retrospectively analyzed the predictive implication of neutrophil–lymphocyte ratio (NLR) and confusion, urea >7 mmol/L, respiratory rate ⩾30 breaths/min, low blood pressure, and age ⩾65 years (CURB-65) score to predict early clinical stability of the adult CAP. Clinical data, CURB-65 scores, pneumonia severity index (PSI) scores, NLR on admission (within 24 h) of 230 patients between January 2012 and June 2015 were obtained from the Affiliated Hospital of Chengdu University. Instable patients had significantly higher CURB-65, PSI, white blood cell (WBC), neutrophil, and NLR than the stable patients ( P < 0.05); NLR was positively correlated with CURB-65 (r = 0.270, P < 0.001) and PSI (r = 0.316, P < 0.001). NLR and CURB-65 were screened as risk factors through the discriminant analysis. The area under the curve (AUC) was 0.662 (95% confidence interval (CI): (0.569, 0.756), P = 0.002) for NLR, 0.670 (95% CI (0.569, 0.772) P = 0.001) for CURB-65. The enhanced predictive power was observed for combining NLR-CURB-65 with the AUC of 0.704 (95% CI (0.606, 0.802), P < 0.001). The risk of early clinical instability rose significantly in patients with NLR (odds ratio (OR) = 3.440, 95% CI (1.741, 6.798) with the cut-off value of NLR = 6.161) and higher CURB-65 (OR = 3.797, 95% CI (1.801, 8.005), with the CURB-65 cut-off value of 1.5). Both NLR and CURB-65 are qualitatively accurate for predicting early clinical stability of CAP, an accuracy-enhanced predicting power was observed in the NLR-CURB-65 combined test, further large-sample studies are required to validate the conclusion.

scholarly journals Early and late mortality of patients with community acquired pneumonia

2012 ◽  
Vol 153 (23) ◽  
pp. 884-890
Author(s):  
György Losonczy
Keyword(s):  
Independent Risk Factor ◽  
Troponin I ◽  
Pneumonia Severity Index ◽  
Early Death ◽  
Severity Index ◽  
Community Acquired Pneumonia ◽  
Atherosclerotic Plaques ◽  
Pneumonia Severity ◽  
Risk Of Mortality ◽  
Pro Inflammatory Cytokines

Community acquired pneumonia is the most frequent infective cause of severe sepsis and death. The risk of mortality in community acquired pneumonia is predictable by the ”pneumonia severity index” and various biomarkers (e.g., procalcitonin, troponin-I). Quantitative testing of pneumococcal load (DNA) in blood has also become possible recently. Early death due to acute myocardial infarction is more frequent among patients with previous community acquired pneumonia. The 1-year and the 5–6 year survival is shorter among these patients. Pro-inflammatory cytokines synthesized during community acquired pneumonia accelerate chronic inflammation ongoing in atherosclerotic plaques. The pro-thrombotic condition present in atherosclerosis is also potentiated by community acquired pneumonia. These pathophysiological mechanisms may explain the epidemiologic fact that community acquired pneumonia is an independent risk factor of cardiovascular mortality. Orv. Hetil., 2012, 153, 884–890.

Perbandingan Expanded Curb-65 Terhadap Curb-65 dan Psi Dalam Memprediksi Luaran Pasien Cap

2019 ◽  
Vol 4 (3) ◽  
pp. 608
Author(s):  
Suyastri Suyastri ◽  
Irvan Medison ◽  
Deddy Herman ◽  
Russilawati Russilawati
Keyword(s):  
Logistic Regression ◽  
Multivariate Analysis ◽  
Prospective Study ◽  
Pneumonia Severity Index ◽  
Severity Index ◽  
Accurate Method ◽  
P Value ◽  
Pneumonia Severity ◽  
Advantages And Disadvantages ◽  
Care Decision

<p><em>Tingkat keparahan CAP adalah poin penting pengambilan keputusan perawatan pasien. Beberapa metode telah digunakan untuk menilai tingkat keparahan pneumonia seperti Pneumonia Severity Index (PSI), CURB-65, SMART-COP dan Expanded CURB-65. Metode tersebut memiliki kelebihan dan kekurangan. Expanded CURB 65 diusulkan menjadi metode yang lebih akurat untuk mengevaluasi keparahan pneumonia dan memprediksi kematian pasien CAP. Tujuan penelitian ini memprediksi keakuratan Expanded CURB  65 dibandingkan CURB 65 dan PSI. Penelitian kohort prospektif pada pasien CAP yang dirawat di RSUP Dr. M.Djamil Padang dari April sampai Oktober 2019. Tingkat keparahan CAP pada pasien dinilai menggunakan PSI, CURB 65, Expanded CURB 65, kemudian hasilnya dievaluasi berdasarkan keparahan. Data dianalisis menggunakan regresi logistik dengan CI 95% dan nilai p &lt;0,05 dianggap signifikan. Hasil penelitian pada 90 pasien sebagian besar laki-laki usia 53 tahun dengan komorbiditas terbanyak keganasan. Uji Pearson Chi aquare menunjukkan tidak ada hubungan antara tingkat keparahan berdasarkan CURB 65 dan luaran pengobatan (CI 95%, nilai p = 0,104). Sementara, PSI dan Expanded CURB 65 memiliki hubungan yang signifikan antara tingkat keparahan dan luaran (CI 95%, p=0,081 dan CI 95%, p= 0,046, masing-masing). Analisis multivariat menemukan Expanded CURB 65 lebih akurat dalam memprediksi luaran pasien CAP rawat inap (kappa =0,108 dan AUC=0,422).</em></p><p><em><br /></em></p><p><em><em>Severity of CAP is very important for site care decision inpatients. Several methods have been used to assess the severity of pneumonia such as Pneumonia Severity Index (PSI), CURB-65, SMART-COP and Expanded CURB-65. Those methods have advantages and disadvantages. Expanded CURB 65 is proposed to be more accurate method for evaluating pneumonia severity and predicting mortality in CAP. The aim of this study was to investigate the accuracy of Expanded CURB 65 compare to CURB 65 and PSI. Cohort prospective study was conducted for CAP patients who were hospitalized at RSUP Dr. M.Djamil Padang from April to October 2019. Patients was assesed for severity using PSI, CURB 65, Expanded CURB 65, then we evaluated it’s outcome. The data were analyzed by logistic regression with CI 95% and p value &lt;0,05 considered as statistically significant. We found 90 patients that predominantly males with an average age of 53 years, and the most common comorbidity is malignancy. There was no relationship between pneumonia severity by CURB 65 and outcome (CI 95%, p=0.104). PSI and Expanded CURB 65 had significant relationship between severity and outcome (CI 95%, p=0.081and CI 95%, p=0.046, respectively). Multivariate analysis showed the expanded CURB 65 was more accurate for predicting the outcome of CAP inpatients (kappa=0.108 and AUC= 0.422).</em></em></p>

scholarly journals Predictive value of the neutrophil to lymphocyte ratio for disease deterioration and serious adverse outcomes in patients with COVID-19: a prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhi-Yong Zeng ◽  
Shao-Dan Feng ◽  
Gong-Ping Chen ◽  
Jiang-Nan Wu
Keyword(s):  
Cohort Study ◽  
Hospital Admission ◽  
Clinical Outcomes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Characteristic Curve ◽  
Adverse Outcomes ◽  
Neutrophil To Lymphocyte Ratio ◽  
Predictive Values ◽  
Lymphocyte Ratio

Abstract Background Early identification of patients who are at high risk of poor clinical outcomes is of great importance in saving the lives of patients with novel coronavirus disease 2019 (COVID-19) in the context of limited medical resources. Objective To evaluate the value of the neutrophil to lymphocyte ratio (NLR), calculated at hospital admission and in isolation, for the prediction of the subsequent presence of disease progression and serious clinical outcomes (e.g., shock, death). Methods We designed a prospective cohort study of 352 hospitalized patients with COVID-19 between January 9 and February 26, 2020, in Yichang City, Hubei Province. Patients with an NLR equal to or higher than the cutoff value derived from the receiver operating characteristic curve method were classified as the exposed group. The primary outcome was disease deterioration, defined as an increase of the clinical disease severity classification during hospitalization (e.g., moderate to severe/critical; severe to critical). The secondary outcomes were shock and death during the treatment. Results During the follow-up period, 51 (14.5%) patients’ conditions deteriorated, 15 patients (4.3%) had complicated septic shock, and 15 patients (4.3%) died. The NLR was higher in patients with deterioration than in those without deterioration (median: 5.33 vs. 2.14, P < 0.001), and higher in patients with serious clinical outcomes than in those without serious clinical outcomes (shock vs. no shock: 6.19 vs. 2.25, P < 0.001; death vs. survival: 7.19 vs. 2.25, P < 0.001). The NLR measured at hospital admission had high value in predicting subsequent disease deterioration, shock and death (all the areas under the curve > 0.80). The sensitivity of an NLR ≥ 2.6937 for predicting subsequent disease deterioration, shock and death was 82.0% (95% confidence interval, 69.0 to 91.0), 93.3% (68.0 to 100), and 92.9% (66.0 to 100), and the corresponding negative predictive values were 95.7% (93.0 to 99.2), 99.5% (98.6 to 100) and 99.5% (98.6 to 100), respectively. Conclusions The NLR measured at admission and in isolation can be used to effectively predict the subsequent presence of disease deterioration and serious clinical outcomes in patients with COVID-19.

scholarly journals Neutrophil-to-Lymphocyte Ratio Is a Useful Marker for Predicting Histological Types of Early Gastric Cancer

2021 ◽  
Vol 10 (4) ◽  
pp. 791
Author(s):  
Sho Yasui ◽  
Tomoaki Takata ◽  
Yu Kamitani ◽  
Yukari Mae ◽  
Hiroki Kurumi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Gastric Cancer ◽  
Inflammatory Response ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Histological Assessment ◽  
Lymphocyte Ratio ◽  
Undifferentiated Adenocarcinoma ◽  
Grade Of Malignancy ◽  
The Relationship

Background: The indications for endoscopic submucosal dissection (ESD) for gastric cancer are based on preoperative histological assessment; however, examination of tissue biopsy is not always reliable as only a limited portion of the lesion can be obtained. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are markers of inflammatory response and are potentially associated with the grade of malignancy in gastric cancer. We aimed to investigate the association between NLR and PLR and the histology of gastric cancer. Methods: This study included 218 patients who underwent ESD for gastric cancer. The relationship between NLR/PLR and histological diagnosis was investigated. Results: Patients with adenocarcinomas showed significantly higher NLR and PLR than those with adenomas (p < 0.001 and p < 0.05, respectively). Further, patients with undifferentiated adenocarcinoma showed a significantly higher NLR (p < 0.05) than those with differentiated adenocarcinoma. Conclusion: This study suggests that NLR could be a useful marker for assessing early gastric cancer.

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