Predicting Severe COVID-19 Outcomes in the Elderly: The Role of Systemic Immune Inflammation, Liver Function Tests, and Neutrophil-to-Lymphocyte Ratio.
Adrian Vasile Bota, Felicia Marc, Mavrea Adelina, Laura Nicolescu, Adelina Georgiana Tudora, Coralia Cotoraci
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引用次数: 0
Abstract
Background: Patients aged 80 years and above are at increased risk for severe COVID-19 outcomes. This study aimed to evaluate the prognostic utility of the derived neutrophil-to-lymphocyte ratio (dNLR), aspartate-aminotransferase-to-lymphocyte ratio index (ALRI), aspartate-aminotransferase-to-platelet ratio index (APRI), and systemic immune inflammation index (SII) in predicting severe disease, intensive care unit (ICU) admission, and mortality among COVID-19 patients aged 80 years and older. Methods: In this retrospective cohort study, 138 elderly patients (≥80 years) and 215 younger controls (<65 years) with confirmed COVID-19 were included. Laboratory data at admission were collected, and the dNLR, ALRI, APRI, and SII scores were calculated. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive performance of these indices. Results: The SII had the highest area under the ROC curve (AUC) for predicting severe disease in elderly patients (AUC = 0.857, 95% CI: 0.795-0.919, p < 0.001), with an optimal cutoff value of 920 × 10⁹/L (sensitivity 86%, specificity 78%). Elevated SII was significantly associated with increased risk of ICU admission (hazard ratio (HR): 2.9, 95% CI: 1.8-4.6, p < 0.001) and mortality (HR: 3.2, 95% CI: 1.9-5.2, p < 0.001). Similarly, dNLR showed good predictive value (AUC = 0.792, 95% CI: 0.722-0.862, p < 0.001). Conclusions: SII and dNLR are valuable prognostic biomarkers for predicting severe outcomes in COVID-19 patients aged 80 years and above. Early identification using these indices can assist clinicians in risk stratification and management decisions to improve patient outcomes.
期刊介绍:
Healthcare (ISSN 2227-9032) is an international, peer-reviewed, open access journal (free for readers), which publishes original theoretical and empirical work in the interdisciplinary area of all aspects of medicine and health care research. Healthcare publishes Original Research Articles, Reviews, Case Reports, Research Notes and Short Communications. We encourage researchers to publish their experimental and theoretical results in as much detail as possible. For theoretical papers, full details of proofs must be provided so that the results can be checked; for experimental papers, full experimental details must be provided so that the results can be reproduced. Additionally, electronic files or software regarding the full details of the calculations, experimental procedure, etc., can be deposited along with the publication as “Supplementary Material”.