ABSTRACT

The estimation of disease severity based on early biomarkers may facilitate treatment and reduce mortality in patients with COVID-19. The present retrospective, observational study evaluates the role of different inflammatory indices in predicting mortality in COVID-19 patients.

The prognostic value for the prediction of 30-day mortality of inflammatory parameters [C-reactive protein (CRP), ferritin, procalcitonin (PCT)] and [neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), derived NLR (dNLR), systemic inflammation index (SII), C-reactive protein-to-lymphocyte ratio (CRP/L), C-reactive protein-to-albumin ratio, and neutrophi-lto-lymphocyte and platelet ratio (N/LP)] were evaluated upon the initial admission of 305 COVID-19 patients to the intensive care unit.

In this study, APACHE score, ferritin, PCT and CRP/L were significantly higher in the non-survivors than in survivors. No significant differences were found in the other inflammatory indices. High ferritin (p<0.001) and high APACHE scores (p<0.001) were identified as predictors of in-hospital mortality in a ROC curve analysis. Only a high ferritin level was identified as an independent risk factor for mortality in a multivariate regression analysis (p=0.002).

Inflammatory indices were not identified as predictors of mortality in critically ill COVID-19 patients admitted to the intensive care unit in the present study; and only high ferritin levels among the parameters related to inflammation were identified as an independent risk factor for mortality.