Prognostic clinical characteristics and systemic immune inflammatory biomarkers in 520 inpatients with herpes zoster: a retrospective analysis based on tertiary care hospitals.

Abstract

Herpes zoster (HZ) is a very common disease associated with a considerable individual and public health burden. To evaluate prognostic clinical and laboratory parameters, including systemic immune inflammatory biomarkers (SIIB) in inpatients with HZ. We investigated clinical and laboratory data of 520 inpatients with HZ. Complete blood count was determined at baseline. SIIB was assessed based on neutrophil-to-lymphocyte ratio (NLR), pan-immune-inflammation value (PIV), and absolute eosinopenia (AEP). Both uni- and multivariable statistics were performed. NRL and PIV were significantly (p < 0.0001) higher in HZ patients vs. healthy controls and. The presence of absolute eosinopenia (OR: 3.9, 95 % CI: 1.9 to 8.3) was a strong predictor of herpes zoster ophthalmicus (HZO). Ramsay-Hunt syndrome (OR: 4.3, 95 % CI: 1.8 to 10.3), bacterial superinfection (OR: 2.3, 95 % CI: 1.3 to 4.1), and age < 65 (OR: 0.51, 95 % CI: 0.33 to 0.78) were associated with length of hospitalisation. The presence of immunosuppression predicted herpes encephalitis (OR: 22.4, 95 % CI: 2.3 to 221) as well as treatment outcome in the intensive care unit (OR: 8.9, 95 % CI: 1.3 to 61.8). Postherpetic neuralgia was associated with absence of intravenous antiviral therapy (OR: 55.2 [16.5 to 184.9]). We identified several clinical and laboratory-based independent predictors that may aid prognostication of HZ patients. The increase in SIIB reflects the possible role of systemic inflammatory alterations in HZ. However, the only effective SIIB studied was AEP which was independently associated with HZO. The use of intravenous antiviral therapy decreases the risk of postherpetic neuralgia.