| Autor: |
Halmaciu I; Department of Radiology, Mureș County Emergency Hospital, 540136 Targu-Mures, Romania.; Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu-Mures, Romania., Arbănași EM; Clinic of Vascular Surgery, Mureș County Emergency Hospital, 540136 Targu-Mures, Romania., Kaller R; Clinic of Vascular Surgery, Mureș County Emergency Hospital, 540136 Targu-Mures, Romania., Mureșan AV; Clinic of Vascular Surgery, Mureș County Emergency Hospital, 540136 Targu-Mures, Romania.; Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu-Mures, Romania., Arbănași EM; Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu-Mures, Romania., Bacalbasa N; Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania., Suciu BA; Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu-Mures, Romania.; First Clinic of Surgery, Mureș County Emergency Hospital, 540136 Targu-Mures, Romania., Cojocaru II; First Clinic of Surgery, Mureș County Emergency Hospital, 540136 Targu-Mures, Romania., Runcan AI; Department of Radiology, Mureș County Emergency Hospital, 540136 Targu-Mures, Romania., Grosu F; Department of Histology, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania., Vunvulea V; Department of Radiology, Mureș County Emergency Hospital, 540136 Targu-Mures, Romania., Russu E; Clinic of Vascular Surgery, Mureș County Emergency Hospital, 540136 Targu-Mures, Romania.; Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu-Mures, Romania. |
| Abstrakt: |
Background: Numerous tools, including inflammatory biomarkers and lung injury severity scores, have been evaluated as predictors of disease progression and the requirement for intensive therapy in COVID-19 patients. This study aims to verify the predictive role of inflammatory biomarkers [monocyte to lymphocyte ratio (MLR), neutrophil to lymphocyte ratio (NLR), systemic inflammatory index (SII), Systemic Inflammation Response Index (SIRI), Aggregate Index of Systemic Inflammation (AISI), and interleukin-6 (IL-6)] and the total system score (TSS) in the need for invasive mechanical ventilation (IMV) and mortality in COVID-19 patients. Methods: The present study was designed as an observational, analytical, retrospective cohort study and included all patients over 18 years of age with a diagnosis of COVID-19 pneumonia, confirmed through real time-polymerase chain reaction (RT-PCR) and radiological chest CT findings admitted to County Emergency Clinical Hospital of Targu-Mureș, Romania, and Modular Intensive Care Unit of UMFST “George Emil Palade” of Targu Mures, Romania between January 2021 and December 2021. Results: Non-Survivors patients were associated with higher age (p = 0.01), higher incidence of cardiac disease [atrial fibrillation (AF) p = 0.0008; chronic heart failure (CHF) p = 0.01], chronic kidney disease (CKD; p = 0.02), unvaccinated status (p = 0.001), and higher pulmonary parenchyma involvement (p < 0.0001). Multivariate analysis showed a high baseline value for MLR, NLR, SII, SIRI, AISI, IL-6, and TSS independent predictor of adverse outcomes for all recruited patients. Moreover, the presence of AF, CHF, CKD, and dyslipidemia were independent predictors of mortality. Furthermore, AF and dyslipidemia were independent predictors of IMV need. Conclusions: According to our findings, higher MLR, NLR, SII, SIRI, AISI, IL-6, and TSS values at admission strongly predict IMV requirement and mortality. Moreover, patients above 70 with AF, dyslipidemia, and unvaccinated status highly predicted IMV need and fatality. Likewise, CHF and CKD were independent predictors of increased mortality. |
