scholarly journals Novel Systemic Inflammation Markers to Predict COVID-19 Prognosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Amirali Karimi ◽  
Parnian Shobeiri ◽  
Arutha Kulasinghe ◽  
Nima Rezaei

Coronavirus disease 2019 (COVID-19) has resulted in a global pandemic, challenging both the medical and scientific community for the development of novel vaccines and a greater understanding of the effects of the SARS-CoV-2 virus. COVID-19 has been associated with a pronounced and out-of-control inflammatory response. Studies have sought to understand the effects of inflammatory response markers to prognosticate the disease. Herein, we aimed to review the evidence of 11 groups of systemic inflammatory markers for risk-stratifying patients and prognosticating outcomes related to COVID-19. Numerous studies have demonstrated the effectiveness of neutrophil to lymphocyte ratio (NLR) in prognosticating patient outcomes, including but not limited to severe disease, hospitalization, intensive care unit (ICU) admission, intubation, and death. A few markers outperformed NLR in predicting outcomes, including 1) systemic immune-inflammation index (SII), 2) prognostic nutritional index (PNI), 3) C-reactive protein (CRP) to albumin ratio (CAR) and high-sensitivity CAR (hsCAR), and 4) CRP to prealbumin ratio (CPAR) and high-sensitivity CPAR (hsCPAR). However, there are a limited number of studies comparing NLR with these markers, and such conclusions require larger validation studies. Overall, the evidence suggests that most of the studied markers are able to predict COVID-19 prognosis, however NLR seems to be the most robust marker.

Cancers ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 514 ◽  
Author(s):  
Ichikawa ◽  
Mizuno ◽  
Hayasaki ◽  
Kishiwada ◽  
Fujii ◽  
...  

Background: In many malignancies, including pancreatic ductal adenocarcinoma (PDAC), host-related inflammatory/immunonutritional markers, such as the prognostic nutritional index (PNI), modified Glasgow prognostic score (mGPS), and C-reactive protein (CRP)/albumin ratio are reported to be prognostic factors. However, the prognostic influence of these factors before and after chemoradiotherapy (CRT) has not been studied in PDAC patients. Methods: Of 261 consecutive PDAC patients who were scheduled for CRT with gemcitabine or S1 plus gemcitabine between February 2005 and December 2015, participants in this study were 176 who completed CRT and had full data available on inflammatory/immunonutritional markers as well as on anatomical and biological factors for the investigation of prognostic/predictive factors. Results: In multivariate analysis, the significant prognostic factors were RECIST classification, cT category, performance status, post-CRT carcinoembryonic antigen, post-CRT C-reactive protein/albumin ratio, post-CRT mGPS, and post-CRT PNI. Post-CRT PNI (cut-off value, 39) was the strongest host-related prognostic factor according to the p-value. In the patients who underwent resection after CRT, median survival time (MST) was significantly shorter in the 12 patients with low PNI (<39) than in the 97 with high PNI (≥39), at 15.5 months versus 27.2 months, respectively (p = 0.0016). In the patients who did not undergo resection, MST was only 8.9 months in those with low PNI and 12.3 months in those with high PNI (p < 0.0001), and thus was similar to that of the resected patients with low PNI. Conclusions: Post-CRT PNI was the strongest prognostic/predictive indicator among the independent biological and conditional prognostic factors in PDAC patients who underwent CRT.


2021 ◽  
Vol 105 (1-3) ◽  
pp. 278-283
Author(s):  
Masahide Ikeguchi ◽  
Takehiko Hanaki ◽  
Kyo-ichi Kihara ◽  
Kanenori Endo ◽  
Kazunori Suzuki ◽  
...  

Emergent surgery is necessary in patients with strangulation ileus. However, such procedures are associated with high morbidity and mortality. A retrospective analysis was performed to determine whether the preoperative C-reactive protein/albumin ratio (CAR); neutrophil/lymphocyte ratio (NLR); and prognostic nutritional index (PNI) are good indicators of mortality or morbidity in patients undergoing emergent operations for treatment of strangulation ileus. Emergent surgery was performed for 1698 patients at Tottori Prefectural Central Hospital from 2012 and 2015. Among them, 45 patients (2.7%) were preoperatively diagnosed with strangulation ileus. We evaluated the clinical importance of the preoperative CAR, NLR, and PNI in these patients. We excluded pediatric patients from this study. Postoperative complications developed in 14 of 45 (31.1%) patients. The mean postoperative hospital stay among the 14 patients with postoperative complications was significantly longer than that of the 31 patients without postoperative complications (44.0 versus 11.3 days, respectively; P = 0.006). Three patients died of postoperative complications. The overall operative mortality and morbidity rates were 6.7% and 31.1%, respectively. We found strong correlations of postoperative complications with older age, a longer operation time, and an abnormal preoperative CAR, NLR, and PNI. Not only inflammation, but also a patients' nutritional and immune status appear to be strongly correlated with mortality or morbidity after emergent operations for strangulation ileus. Patients with a high CAR and NLR and low PNI preoperatively must be closely monitored for the occurrence of postoperative complications such as surgical site infections or pulmonary complications.


Sari Pediatri ◽  
2016 ◽  
Vol 16 (4) ◽  
pp. 278
Author(s):  
Sofni Sarmen ◽  
Mayetti Mayetti ◽  
Hafni Bachtiar

Latar belakang. Sepsis merupakan salah satu penyebab morbiditas dan mortalitas pada anak. Diagnosissepsis ditegakkan berdasarkan gejala Systemic Inflammatory Response Syndrome (SIRS) dan penemuan bakteripada kultur darah. Kultur bakteri darah memiliki sensitifitas yang rendah dan membutuhkan waktu yanglama sehingga sering menyebabkan terjadinya overdiagnosis dan overtreatment. C-reactive protein adalahreaktan fase akut yang kadarnya meningkat pada keadaan infeksi. High sensitivity C-reactive protein (hs-CRP) adalah metode yang lebih sensitif untuk mengukur kadar CRP dalam jumlah kecil.Tujuan. Mengetahui peran hs-CRP sebagai parameter diagnostik dan prediktor luaran sepsis pada anakyang menderita SIRS.Metode. Penelitian uji diagnostik dengan desain potong lintang terhadap 85 anak dengan gejala SIRS berusia1 bulan sampai dengan 15 tahun dan dirawat di bangsal anak RS.Dr.M.Djamil Padang sejak Juni sampaiNovember 2012. Pemeriksaan hs-CRP dilakukan dengan metode enzyme-linked immunosorbent assay (ELISA).Data dianalisis dengan SPSS serta dilakukan uji diagnostik. Baku emas sepsis adalah biakan darah.Hasil. Cut off point hs-CRP untuk menentukan sepsis adalah 15,55 ng/ml, (sensitivitas 90,9% dan spesivisitas53,8%). Kadar rata-rata hs-CRP meningkat sesuai dengan beratnya penyakit.Kesimpulan. High sensitivity C-reactive protein dapat dijadikan sebagai parameter diagnostik sepsis padapasien SIRS dengan cut off point 15,55 ng/ml, serta dapat dipakai sebagai prediktor luaran sepsis.


2019 ◽  
Vol 13 (10) ◽  
pp. 811-820 ◽  
Author(s):  
Wei Wang ◽  
Dong Ren ◽  
Chun-Song Wang ◽  
Tai Li ◽  
Heng-Chen Yao ◽  
...  

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