Evaluation of Inflammation-Based Prognostic Risk Scores in Predicting in-Hospital Mortality Risk in Hospitalized COVID-19 Patients: A Cross-Sectional Retrospective Study

ORIGINAL ARTICLE Infect Dis Clin Microbiol 2022; 5(1): 4-12 Evaluation of Inflammation-Based Prognostic Risk Scores In Predicting in-Hospital Mortality Risk in Hospitalized COVID-19 Patients: A Cross-Sectional Retrospective Study Casit Olgun Celik? ®, Nurtag Ozer? ©, Orcun Giftci3 ©, Serife Torun* ©, Meri Yavuz-Colak5 ©, ibrahim Haldun Miderrisoglu3 ® 1 Department of Cardiology, Baskent University Konya Training and Research Hospital, Konya, Turkey 2 Department of Cardiology, Private Natomed Hospital, Ankara, Turkey 3 Department of Cardiology, Baskent University School of Medicine, Ankara Hospital, Ankara, Turkey 4 Department of Chest Diseases, Baskent University Konya Training and Research Hospital, Konya, Turkey 5 Department of Biostatistics, Baskent University School of Medicine, Ankara, Turkey ABSTRACT Objective: Systemic inflammatory parameters are predictors of poor prognosis in COVID-19 patients. This study evaluated whether the prognostic nutritional index, which was also related to nutrition risk and other inflammation-based prognostic scores, was predictive of in-hospital mortality in COVID-19 patients. Materials and Methods: This was a retrospective cross-sectional single-center study. Based Corresponding Author: on the exclusion criteria, 151 patients over 18 years old diagnosed with COVID-19 and hosCasit Olgun Gelik pitalized in the intensive care unit between March 2020 and December 2020 were eligible for this study. Multivariable logistic regression analysis was performed to evaluate the predictive value of the Glasgow Prognostic Score (GPS), Prognostic Index (PI), Prognostic E-mail: drolgunclkO9@gmail.com Nutritional Index (PNI), and Systemic Inflammatory Index (SII). Received: August 29, 2022 Results: In the univariate analyses, age, diabetes mellitus (DM), chronic kidney disease, ante eee 2022 acute kidney injury, hypothyroidism, hospitalization stay, lactate dehydrogenase (LDH), aspubleness nated ;20e partate aminotrans ferase (AST), D-dimer, ferritin, C-reactive protein (CRP), albumin, heSuggested citation: moglobin level, platelet count, urea, creatinine level, PNI, GPS were significantly associated Celik CO, Ozer N, Ciftci O, Torun with mortality. However, in the multivariable logistic regression analysis of the inflammaS, Yavuz-Colak M, Miderrisoglu tion-based prognostic scores, only PNI was statistically significant in predicting in-hospital IH. Evaluation of inflammationmortality (OR=0.83; [95% Cl=0.71-0.97]; p=0.019). based prognostic risk scores in zi i 7 ? : predicting in-hospital mortality Conclusion: PNI is a more useful and powerful tool among these inflammation-based progrisk in hospitalized COVID-19 nostic risk scores in predicting in-hospital mortality in COVID-19 patients. patients: A cross-sectional Keywords: COVID-19, inflammation-based prognostic scores, mortality, prognostic nutriretrospective study. Infect Dis ; : Clin Microbiol. 2023;1:4-12. tional index DOI: 10.36519/idcm.2023.171 This work is licensed under a Creative Commons Attribution-Non Commercial 4.0 International License. 4 INTRODUCTION n acute respiratory syndrome (COVID-19), caused by a novel coronavirus (SARSCoV-2), has spread from China worldwide and caused a pandemic that brought severe medical, social, and economic problems. The COVID-19 infection results in various clinical presentations ranging from an asymptomatic course and mild flu-like clinics to severe pneumonia and hyperinflammatory response, potentially requiring intensive care and even causing death. In severe cases, COVID-19 is a systemic disease with hyper-inflammation, cytokine storm, and elevated cardiac enzymes (1-3). Recently, several studies have tried explaining the pathways and incomplete links between the humoral and cellular immune systems and COVID-19 4-7). There are several risk factors associated with mortality in COVID-19 patients, notably age, hypertension, diabetes mellitus (DM), cardiovascular disease, D-dimer, neutrophil count, lymphocyte count, neutrophil/lymphocyte ratio (NLR), C-reactive protein (CRP), and others (8, 9). It is also known that rapid risk classification and early medical intervention reduce mortality in COVID-19. Furthermore, several studies have investigated the prognostic factors in COVID-19, such as C-reactive protein, alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin, creatinine, creatine kinase, D-dimer, procalcitonin, ferritin, lactate dehydrogenase (LDH), neutrophil count, lymphocyte count, NLR, monocyte to lymphocyte ratio (MLR), platelet to lymphocyte ratio (PLR), and other inflammatory parameters (10-14). Thus, systemic inflammatory response markers are reasonably used in the clinical follow-up of COVID-19 patients. However, few studies have used inflammation-based HIGHLIGHTS e Parameters obtained from blood tests at the admission of COVID-19 patients may be significant in determining the disease severity and prognosis. ¢ PNI was a strong predictor of in-hospital mortality