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Can the Systemic Inflammatory Index be a Prognostic Indicator in COVID-19 Patients Presenting to the Emergency Department?

Year 2024, Volume: 6 Issue: 4, 155 - 162, 29.10.2024
https://doi.org/10.46310/tjim.1552501

Abstract

Background: This study aimed to evaluate whether the systemic immune-inflammatory index (SII) can be used as a prognostic indicator in COVID-19 patients presenting to the emergency department. Given the high mortality and morbidity associated with COVID-19, identifying reliable prognostic markers is crucial for optimizing patient management.
Methods: This retrospective observational study included 639 COVID-19 patients admitted to our emergency department between February 1, 2022, and February 1, 2023. Patients’ SII was calculated using complete blood count parameters (neutrophil, lymphocyte, and platelet counts). Data on patient outcomes, including intensive care unit (ICU) admission and in-hospital mortality, were analyzed using statistical methods such as receiver operating characteristic (ROC) curve analysis to assess the predictive power of SII, neutrophil-to-lymphocyte ratio (NLR), and neutrophil-to-platelet ratio (NPL).
Results: Among the 639 patients, 136 died during hospitalization. Significant differences in SII, NLR, and NPL were observed between patients admitted to the ICU and those with less severe outcomes. The highest AUC (area under the curve) value was observed for NLR, with a cut-off value of >4.87, predicting mortality with a sensitivity of 72.79% and specificity of 77.73%. SII also demonstrated significant prognostic value with a cut-off of >806.03, predicting mortality with a sensitivity of 75.74% and specificity of 66%.
Conclusion: SII, NLR, and NPL are effective prognostic indicators in COVID-19 patients, particularly in predicting the need for intensive care and mortality risk. These findings suggest incorporating these markers into routine clinical practice could improve risk stratification and patient outcomes. However, further large-scale studies are needed to validate these results and refine the use of these markers in clinical settings.

References

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Year 2024, Volume: 6 Issue: 4, 155 - 162, 29.10.2024
https://doi.org/10.46310/tjim.1552501

Abstract

References

  • Guo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, Tan KS, Wang DY, Yan Y. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res. 2020 Mar 13;7(1):11. Mil Med Res. 2020 Mar 13;7(1):11. doi: 10.1186/s40779-020-00240-0.
  • Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020 Mar 19;91(1):157-60. doi: 10.23750/abm.v91i1.9397.
  • Sohrabi C, Alsafi Z, O'Neill N, Khan M, Kerwan A, Al-Jabir A, Iosifidis C, Agha R. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg. 2020 Apr:76:71-6. doi: 10.1016/j.ijsu.2020.02.034.
  • Velavan TP, Meyer CG. The COVID-19 epidemic. Trop Med Int Health. 2020 Mar;25(3):278-80. doi: 10.1111/tmi.13383.
  • Lanham D, Roe J, Chauhan A, Evans R, Hillman T, Logan S, Heightman M. COVID-19 emergency department discharges: an outcome study. Clin Med (Lond). 2021 Mar;21(2):e126-e131. doi: 10.7861/clinmed.2020-0817.
  • Zhang Y, Chen B, Wang L, Wang R, Yang X. Systemic immune-inflammation index is a promising noninvasive marker to predict survival of lung cancer: A meta-analysis. Medicine (Baltimore). 2019 Jan;98(3):e13788. doi: 10.1097/MD.0000000000013788.
  • 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 Dec 4;25(23):5725. doi: 10.3390/molecules25235725.
  • Nergiz S, Ozturk O. Relationship between systemic immune inflammation index and prognosis in patients with COVID-19. Dicle Tıp Dergisi. 2022;49(4):612-8. doi: 10.5798/dicletip.1220894.
  • Aydın C, Alpsoy Ş, Yıldırım İ, Gültekin A, Arar C, Engin M, Amaç B. Predictive values of inflammation indexes in predicting mortality in patients with COVID 19 hospitalized in general intensive care unit. OTJHS. 2022 Mar 1;7(1):32-9. doi: 10.26453/otjhs.984345.
  • Günaydin EB, Ay S. Evaluation of the prognostic role of the systemic immune inflammation index in postmenopausal osteoporosis. J PMR Sci. 2022;25(3):369-76. doi: 10.31609/jpmrs.2022-91431.
  • Yang AP, Liu JP, Tao WQ, Li HM. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol. 2020 Jul;84:106504. doi: 10.1016/j.intimp.2020.106504.
  • Xia W, Tan Y, Hu S, Li C, Jiang T. Predictive value of systemic immune-inflammation index and neutrophil-to-lymphocyte ratio in patients with severe COVID-19. Clin Appl Thromb Hemost. 2022 Jan-Dec;28:10760296221111391. doi: 10.1177/10760296221111391.
  • Mangoni AA, Zinellu A. Systemic inflammation index, disease severity, and mortality in patients with COVID-19: a systematic review and meta-analysis. Front Immunol. 2023 Jun 21;14:1212998. doi: 10.3389/fimmu.2023.1212998.
  • Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020 May;46(5):846-8. doi: 10.1007/s00134-020-05991-x. Erratum in: Intensive Care Med. 2020 Jun;46(6):1294-7. doi: 10.1007/s00134-020-06028-z.
  • Mangalesh S, Dudani S, Malik A. The systemic immune-inflammation index in predicting sepsis mortality. Postgrad Med. 2023 May;135(4):345-51. doi: 10.1080/00325481.2022.2140535.
  • Pricop M, Ancusa O, Talpos S, Urechescu H, Bumbu BA. The predictive value of systemic immune-inflammation index and symptom severity score for sepsis and systemic inflammatory response syndrome in odontogenic infections. J Pers Med. 2022 Dec 7;12(12):2026. doi: 10.3390/jpm12122026.
  • Liu J, Liu Y, Xiang P, Pu L, Xiong H, Li C, Zhang M, Tan J, Xu Y, Song R, Song M, Wang L, Zhang W, Han B, Yang L, Wang X, Zhou G, Zhang T, Li B, Wang Y, Chen Z, Wang X. Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage. J Transl Med. 2020 May 20;18(1):206. doi: 10.1186/s12967-020-02374-0.
  • Qu R, Ling Y, Zhang YH, Wei LY, Chen X, Li XM, Liu XY, Liu HM, Guo Z, Ren H, Wang Q. Platelet-to-lymphocyte ratio is associated with prognosis in patients with coronavirus disease-19. J Med Virol. 2020 Sep;92(9):1533-41. doi: 10.1002/jmv.25767.
There are 18 citations in total.

Details

Primary Language English
Subjects Infectious Diseases
Journal Section Original Articles
Authors

Mehmet Göktuğ Efgan 0000-0002-0794-1239

Osman Sezer Çınaroğlu 0000-0002-3860-2053

Publication Date October 29, 2024
Submission Date September 18, 2024
Acceptance Date October 15, 2024
Published in Issue Year 2024 Volume: 6 Issue: 4

Cite

EndNote Efgan MG, Çınaroğlu OS (October 1, 2024) Can the Systemic Inflammatory Index be a Prognostic Indicator in COVID-19 Patients Presenting to the Emergency Department?. Turkish Journal of Internal Medicine 6 4 155–162.

e-ISSN: 2687-4245 

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