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Article

The Systemic Inflammation Index on Admission Predicts In-Hospital Mortality in COVID-19 Patients

1
Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
2
Unit of Respiratory Diseases, University Hospital Sassari (AOU), 07100 Sassari, Italy
3
Pneumology Unit, Santissima Trinità Hospital, 09121 Cagliari, Italy
4
Mater Olbia Hospital, 07026 Olbia, Italy
5
Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy
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Operative Unit of Hematology, Center for Stem Cell Transplantation, San Francesco Hospital, 08100 Nuoro, Italy
7
Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, University of Milan, 20122 Milan, Italy
8
Department of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide 5042, Australia
*
Author to whom correspondence should be addressed.
Academic Editor: Jean Jacques Vanden Eynde
Molecules 2020, 25(23), 5725; https://doi.org/10.3390/molecules25235725
Received: 18 November 2020 / Revised: 30 November 2020 / Accepted: 1 December 2020 / Published: 4 December 2020
(This article belongs to the Special Issue Anti-inflammatory and Anti-allergy Agents in Medicinal Chemistry-III)
Background. The rapid onset of a systemic pro-inflammatory state followed by acute respiratory distress syndrome is the leading cause of mortality in patients with COVID-19. We performed a retrospective observational study to explore the capacity of different complete blood cell count (CBC)-derived inflammation indexes to predict in-hospital mortality in this group. Methods. The neutrophil to lymphocyte ratio (NLR), derived NLR (dNLR), platelet to lymphocyte ratio (PLR), mean platelet volume to platelet ratio (MPR), neutrophil to lymphocyte × platelet ratio (NLPR), monocyte to lymphocyte ratio (MLR), systemic inflammation response index (SIRI), systemic inflammation index (SII), and the aggregate index of systemic inflammation (AISI) were calculated on hospital admission in 119 patients with laboratory confirmed COVID-19. Results. Non-survivors had significantly higher AISI, dNLR, NLPR, NLR, SII, and SIRI values when compared to survivors. Similarly, Kaplan–Meier survival curves showed significantly lower survival in patients with higher AISI, dNLR, MLR, NLPR, NLR, SII, and SIRI. However, after adjusting for confounders, only the SII remained significantly associated with survival (HR = 1.0001; 95% CI, 1.0000–1.0001, p = 0.029) in multivariate Cox regression analysis. Conclusions. The SII on admission independently predicts in-hospital mortality in COVID-19 patients and may assist with early risk stratification in this group. View Full-Text
Keywords: CBC; coronavirus; COVID-19; inflammation; SII CBC; coronavirus; COVID-19; inflammation; SII
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MDPI and ACS Style

Fois, A.G.; Paliogiannis, P.; Scano, V.; Cau, S.; Babudieri, S.; Perra, R.; Ruzzittu, G.; Zinellu, E.; Pirina, P.; Carru, C.; Arru, L.B.; Fancellu, A.; Mondoni, M.; Mangoni, A.A.; Zinellu, A. The Systemic Inflammation Index on Admission Predicts In-Hospital Mortality in COVID-19 Patients. Molecules 2020, 25, 5725. https://doi.org/10.3390/molecules25235725

AMA Style

Fois AG, Paliogiannis P, Scano V, Cau S, Babudieri S, Perra R, Ruzzittu G, Zinellu E, Pirina P, Carru C, Arru LB, Fancellu A, Mondoni M, Mangoni AA, Zinellu A. The Systemic Inflammation Index on Admission Predicts In-Hospital Mortality in COVID-19 Patients. Molecules. 2020; 25(23):5725. https://doi.org/10.3390/molecules25235725

Chicago/Turabian Style

Fois, Alessandro G., Panagiotis Paliogiannis, Valentina Scano, Stefania Cau, Sergio Babudieri, Roberto Perra, Giulia Ruzzittu, Elisabetta Zinellu, Pietro Pirina, Ciriaco Carru, Luigi B. Arru, Alessandro Fancellu, Michele Mondoni, Arduino A. Mangoni, and Angelo Zinellu. 2020. "The Systemic Inflammation Index on Admission Predicts In-Hospital Mortality in COVID-19 Patients" Molecules 25, no. 23: 5725. https://doi.org/10.3390/molecules25235725

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