Background: Timely assessment of COVID-19 severity is crucial for the rapid provision of appropriate treatments. Definitive criteria for the early identification of severe COVID-19 cases that require intensive care unit admission are lacking. Methods: This was a single-center, retrospective case-control study of 95 consecutive adults admitted to the intensive care unit (cases) or a medical ward (controls) for laboratory-confirmed COVID-19. Clinical data were collected and changes in laboratory test results were calculated between presentation at the emergency department and admission. Univariate and multivariable logistic regression was performed to calculate odds ratios for intensive care unit admission according to changes in laboratory variables. Results: Of the 95 adults with COVID-19, 25 were admitted to intensive care and 70 to a medical ward after a median 6 h stay in the emergency department. During this interval, neutrophil counts increased in cases and decreased in controls (median, 934 vs. -295 × 106/L; P = 0.006), while lymphocyte counts decreased in cases and increased in controls (median, -184 vs. 109 × 106/L; P < 0.001). In cases, the neutrophil-to-lymphocyte ratio increased 6-fold and the urea-to-creatinine ratio increased 20-fold during the emergency department stay, but these ratios did not change in controls (P < 0.001 for both comparisons). By multivariable logistic regression, short-term increases in the neutrophil-to-lymphocyte ratio (OR = 1.43; 95% CI, 1.16-1.76) and urea-to-creatinine ratio (OR = 1.72; 95% CI, 1.20-2.66) were independent predictors of intensive care unit admission. Conclusion: Short-time changes in neutrophil-to-lymphocyte ratio and urea-to-creatinine ratio emerged as stand-alone parameters able to identify patients with aggressive disease at an early stage.
Background: Timely assessment of COVID-19 severity is crucial for the rapid provision of appropriate treatments. Definitive criteria for the early identification of severe COVID-19 cases that require intensive care unit admission are lacking. Methods: This was a single-center, retrospective case-control study of 95 consecutive adults admitted to the intensive care unit (cases) or a medical ward (controls) for laboratory-confirmed COVID-19. Clinical data were collected and changes in laboratory test results were calculated between presentation at the emergency department and admission. Univariate and multivariable logistic regression was performed to calculate odds ratios for intensive care unit admission according to changes in laboratory variables. Results: Of the 95 adults with COVID-19, 25 were admitted to intensive care and 70 to a medical ward after a median 6 h stay in the emergency department. During this interval, neutrophil counts increased in cases and decreased in controls (median, 934 vs. -295 × 106/L; P = 0.006), while lymphocyte counts decreased in cases and increased in controls (median, -184 vs. 109 × 106/L; P < 0.001). In cases, the neutrophil-to-lymphocyte ratio increased 6-fold and the urea-to-creatinine ratio increased 20-fold during the emergency department stay, but these ratios did not change in controls (P < 0.001 for both comparisons). By multivariable logistic regression, short-term increases in the neutrophil-to-lymphocyte ratio (OR = 1.43; 95% CI, 1.16-1.76) and urea-to-creatinine ratio (OR = 1.72; 95% CI, 1.20-2.66) were independent predictors of intensive care unit admission. Conclusion: Short-time changes in neutrophil-to-lymphocyte ratio and urea-to-creatinine ratio emerged as stand-alone parameters able to identify patients with aggressive disease at an early stage.
Authors: Ryan W Haines; Parjam Zolfaghari; Yize Wan; Rupert M Pearse; Zudin Puthucheary; John R Prowle Journal: Intensive Care Med Date: 2019-09-17 Impact factor: 17.440
Authors: M Sorbello; K El-Boghdadly; I Di Giacinto; R Cataldo; C Esposito; S Falcetta; G Merli; G Cortese; R M Corso; F Bressan; S Pintaudi; R Greif; A Donati; F Petrini Journal: Anaesthesia Date: 2020-03-30 Impact factor: 6.955
Authors: Puja Mehta; Daniel F McAuley; Michael Brown; Emilie Sanchez; Rachel S Tattersall; Jessica J Manson Journal: Lancet Date: 2020-03-16 Impact factor: 79.321
Authors: Diana Tejada; Regina Juanbeltz; María Rivero; Ramón San Miguel; Ferrán Capdevila; Juan José Beloqui; Maite Sarobe Journal: PLoS One Date: 2022-04-28 Impact factor: 3.752
Authors: Antonio G Solimando; Carmen Palumbo; Mary Victoria Pragnell; Max Bittrich; Antonella Argentiero; Markus Krebs Journal: Int J Mol Sci Date: 2022-10-04 Impact factor: 6.208
Authors: Marie Laure Chabi; Ophélie Dana; Titouan Kennel; Alexia Gence-Breney; Hélène Salvator; Marie Christine Ballester; Marc Vasse; Anne Laure Brun; François Mellot; Philippe A Grenier Journal: Diagnostics (Basel) Date: 2021-05-14