Abstract
Introduction and aim: Interleukin-6 to lymphocyte (IL-6/Lym) ratio has been identified as a potential prognostic tool in patients with SARS-CoV2 related pneumonia. The aim of our study was to compare the prognostic power of IL-6/Lym ratio with other biomarkers in patients initially admitted in a non intensive unit and suffering for respiratory failure associated with SARS-CoV2 related pneumonia.
Materials and methods: IL-6/Lym ratio, IL-6, D-Dimer, D-Dimer/fibrinogen ratio, fibrinogen, C-reactive protein (CRP), lymphocytes count and neutrophil/lymphocyte (N/L) ratio collected at hospital admission were tested as prognosticators of negative outcome, defined as combined endpoint in-hospital mortality and/or Intensive Care Unit (ICU) admission requiring oro-tracheal intubation (OTI).
Results: Study population encompassed two hundreds and twenty-three patients (46% females) with mean age ± DS 69.4 ± 13.3 years. Eighty-nine patients (39.9%) suffered for severe respiratory failure and required non invasive ventilation, helmets and/or high flow nasal cannula. Fourty-one patients (18.3%) died during hospital stay and/or required OTI. In these patients mean values of IL-6/Lym ratio, IL-6, CRP and N/L were significantly higher and lymphocytes count was significantly lower compared with patients discharged alive and/or not requiring OTI, while no difference was found in mean values of D-Dimer, D-Dimer/Fibrinogen ratio and fibrinogen. AUC (0.797, 95% CI: 0.738-0.848) of IL-6/Lym ratio was the highest compared with those of all the other analyzed biomarkers and the difference was significant with the exception of IL-6. At multivariate logistic regression IL-6/Lym ratio > 66.5 resulted the only independent biomarker associated with mortality and/or OTI (OR 5.65; 95% 1.63-19.54).
Conclusion: IL-6/Lym ratio seems to be an optimal prognosticator in SARS-CoV2 related pneumonia. Its routinary use in COVID-19 patients could be warranted.
Keywords: COVID-19; Cytokine storm; Interleukin-6; Lymphocytes; Prognosis; SARS-CoV2.
【저자키워드】 COVID-19, Cytokine storm, SARS-CoV2, Lymphocytes, Prognosis, interleukin-6, 【초록키워드】 Cytokine storm, SARS-CoV2, Biomarker, Lymphocytes, Respiratory failure, Mortality, Prognosis, Pneumonia, IL-6, severe respiratory failure, neutrophil, intensive care unit, interleukin-6, intubation, C-reactive protein, CRP, D-dimer, nasal, cytokine, outcome, invasive ventilation, ICU, lymphocyte, Hospital mortality, interleukin, Patient, fibrinogen, age, Hospital admission, prognostic, Admission, Intensive, in-hospital mortality, COVID-19 patient, AUC, High flow nasal cannula, Hospital stay, nasal cannula, Endpoint, 95% CI, study population, no difference, multivariate logistic regression, mean value, dimer, multivariate, material, significantly lower, females, independent, defined, highest, tested, analyzed, collected, died, required, suffered, significantly higher, discharged, N/L, 【제목키워드】 SARS-CoV2,