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Biomedicines
Volume 9
Issue 11
10.3390/biomedicines9111656
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Article

Dynamic Changes of the Neutrophil-to-Lymphocyte Ratio, Systemic Inflammation Index, and Derived Neutrophil-to-Lymphocyte Ratio Independently Predict Invasive Mechanical Ventilation Need and Death in Critically Ill COVID-19 Patients

by
Emanuel Moisa
1,2,*,†,
Dan Corneci
1,3,†,
Silvius Negoita
1,2,†,
Cristina Raluca Filimon
3,
Andreea Serbu
3,
Mihai Ionut Negutu
2 and
Ioana Marina Grintescu
1,4
1
Department of Anaesthesia and Intensive Care Medicine, Faculty of Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
2
Clinic of Anaesthesia and Intensive Care Medicine, Elias Emergency University Hospital, 011461 Bucharest, Romania
3
Clinic of Anaesthesia and Intensive Care Medicine, Dr. Carol Davila Central Military Emergency University Hospital, 010825 Bucharest, Romania
4
Clinic of Anaesthesia and Intensive Care Medicine, Clinical Emergency Hospital of Bucharest, 014461 Bucharest, Romania
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Biomedicines 2021, 9(11), 1656; https://doi.org/10.3390/biomedicines9111656
Submission received: 20 October 2021 / Revised: 5 November 2021 / Accepted: 8 November 2021 / Published: 10 November 2021
(This article belongs to the Special Issue Bacterial and Viral Infection and Sepsis: From Pathogenesis to Therapeutic Strategies)
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Abstract

Background: Hematological indices can predict disease severity, progression, and death in patients with coronavirus disease-19 (COVID-19). Objectives: To study the predictive value of the dynamic changes (first 48 h after ICU admission) of the following ratios: neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR), monocyte-to-lymphocyte (MLR), systemic inflammation index (SII), and derived neutrophil-to-lymphocyte (dNLR) for invasive mechanical ventilation (IMV) need and death in critically ill COVID-19 patients. Methods: Observational, retrospective, and multicentric analysis on 272 patients with severe or critical COVID-19 from two tertiary centers. Hematological indices were adjusted for confounders through multivariate analysis using Cox regression. Results: Patients comprised 186 males and 86 females with no difference across groups (p > 0.05). ΔNLR > 2 had the best independent predictive value for IMV need (HR = 5.05 (95% CI, 3.06–8.33, p < 0.0001)), followed by ΔSII > 340 (HR = 3.56, 95% CI 2.21–5.74, p < 0.0001) and ΔdNLR > 1 (HR = 2.61, 95% CI 1.7–4.01, p < 0.0001). Death was also best predicted by an NLR > 11 (HR = 2.25, 95% CI: 1.31–3.86, p = 0.003) followed by dNLR > 6.93 (HR = 1.89, 95% CI: 1.2–2.98, p = 0.005) and SII > 3700 (HR = 1.68, 95% CI: 1.13–2.49, p = 0.01). Conclusions: Dynamic changes of NLR, SII, and dNLR independently predict IMV need and death in critically ill COVID-19 patients.
Keywords: COVID-19; NLR; systemic inflammation index; dNLR; PLR; MLR; sepsis; mechanical ventilation; ICU COVID-19; NLR; systemic inflammation index; dNLR; PLR; MLR; sepsis; mechanical ventilation; ICU

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MDPI and ACS Style

Moisa, E.; Corneci, D.; Negoita, S.; Filimon, C.R.; Serbu, A.; Negutu, M.I.; Grintescu, I.M. Dynamic Changes of the Neutrophil-to-Lymphocyte Ratio, Systemic Inflammation Index, and Derived Neutrophil-to-Lymphocyte Ratio Independently Predict Invasive Mechanical Ventilation Need and Death in Critically Ill COVID-19 Patients. Biomedicines 2021, 9, 1656. https://doi.org/10.3390/biomedicines9111656

AMA Style

Moisa E, Corneci D, Negoita S, Filimon CR, Serbu A, Negutu MI, Grintescu IM. Dynamic Changes of the Neutrophil-to-Lymphocyte Ratio, Systemic Inflammation Index, and Derived Neutrophil-to-Lymphocyte Ratio Independently Predict Invasive Mechanical Ventilation Need and Death in Critically Ill COVID-19 Patients. Biomedicines. 2021; 9(11):1656. https://doi.org/10.3390/biomedicines9111656

Chicago/Turabian Style

Moisa, Emanuel, Dan Corneci, Silvius Negoita, Cristina Raluca Filimon, Andreea Serbu, Mihai Ionut Negutu, and Ioana Marina Grintescu. 2021. "Dynamic Changes of the Neutrophil-to-Lymphocyte Ratio, Systemic Inflammation Index, and Derived Neutrophil-to-Lymphocyte Ratio Independently Predict Invasive Mechanical Ventilation Need and Death in Critically Ill COVID-19 Patients" Biomedicines 9, no. 11: 1656. https://doi.org/10.3390/biomedicines9111656

APA Style

Moisa, E., Corneci, D., Negoita, S., Filimon, C. R., Serbu, A., Negutu, M. I., & Grintescu, I. M. (2021). Dynamic Changes of the Neutrophil-to-Lymphocyte Ratio, Systemic Inflammation Index, and Derived Neutrophil-to-Lymphocyte Ratio Independently Predict Invasive Mechanical Ventilation Need and Death in Critically Ill COVID-19 Patients. Biomedicines, 9(11), 1656. https://doi.org/10.3390/biomedicines9111656

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