Prognostic Performance of Inflammatory Biomarkers Based on Complete Blood Counts in COVID-19 Patients

• Published in: Viruses 2023-09, Vol.15 (9), p.1920
• Main Authors: Gambichler, Thilo, Schuleit, Nadine, Susok, Laura, Becker, Jürgen C, Scheel, Christina H, Torres-Reyes, Christian, Overheu, Oliver, Reinacher-Schick, Anke, Schmidt, Wolfgang
• Format: Article
• Language: English
• Subjects: Age; Biological markers; Biomarkers; Blood platelets; Brief Report; C-reactive protein; Comorbidity; COVID-19; Dehydrogenases; Diabetes; Eosinopenia; eosinophils; Ferritin; Health aspects; Health care; Hypoxia; Inflammation; Laboratories; lactate dehydrogenase; Leukocytes (eosinophilic); Leukocytes (neutrophilic); Lung diseases; Lymphocytes; Medical research; Medicine, Experimental; Neutrophils; Patients; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Statistical analysis; systemic immune-inflammation
• ISSN: 1999-4915; 1999-4915
• DOI: 10.3390/v15091920

With the end of the pandemic, COVID-19 has entered an endemic phase with expected seasonal spikes. Consequently, the implementation of easily accessible prognostic biomarkers for patients with COVID-19 remains an important area of research. In this monocentric study at a German tertiary care hospital, we determined the prognostic performance of different clinical and blood-based parameters in 412 COVID-19 patients. We evaluated the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), and absolute eosinopenia (AEP, 0/µL) of COVID-19 patients (n = 412). The Siddiqui and Mehra staging proposal, the WHO clinical progression scale, and COVID-19-associated death were used as COVID-19 outcome measures. With respect to Siddiqi and Mehra staging, patient age of older than 75 years, high C-reactive protein (CRP), absolute eosinopenia (AEP), cardiovascular comorbidities, and high ferritin were significant independent predictors for severe COVID-19. When outcome was determined according to the WHO clinical progression scale, patient age of older than 75 years, high CRP, high LDH, AEP, high neutrophil-to-lymphocyte ratio (NLR), and the presence of pulmonal comorbidities were significant independent predictors for severe COVID-19. Finally, COVID-19-associated death was predicted independently by patient age of older than 75 years, high LDH, high NLR, and AEP. Eosinopenia (< 40/µL) was observed in 74.5% of patients, and AEP in almost 45%. In conclusion, the present real-world data indicate that the NLR is superior to more complex systemic immune-inflammation biomarkers (e.g., SII and PIV) in COVID-19 prognostication. A decreased eosinophil count emerged as a potential hallmark of COVID-19 infection, whereas AEP turned out to be an accessible independent biomarker for COVID-19 severity and mortality.