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

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.

Keywords

• COVID-19 Prognosis
• Systemic Immune-Inflammatory Index
• Inflammatory Markers

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