Objective Respiratory failure is the leading cause of mortality in COVID-19 patients, characterized by a generalized disbalance of inflammation. The aim of this study was to investigate the relationship between immune-inflammatory index and mortality in PSI IV-V patients with COVID-19. Methods We retrospectively reviewed the medical records of COVID-19 patients from Feb. to Apr. 2020 in the Zhongfa Xincheng Branch of Tongji Hospital, Wuhan, China. Patients who presented high severity of COVID-19-related pneumonia were enrolled for further analysis according to the Pneumonia Severity Index (PSI) tool. Results A total of 101 patients diagnosed with COVID-19 were identified at initial research. The survival analysis revealed that mortality of the PSI IV-V cohort was significantly higher than the PSI I-III group ( p = 0.0003). The overall mortality in PSI IV-V patients was 32.1% (9/28). The fatal cases of the PSI IV-V group had a higher level of procalcitonin ( p = 0.022) and neutrophil-to-lymphocyte ratio ( p = 0.033) compared with the survivors. Procalcitonin was the most sensitive predictor of mortality for the severe COVID-19 population with area under receiver operating characteristic curve of 0.78, higher than the neutrophil-to-lymphocyte ratio (0.75) and total lymphocyte (0.68) and neutrophil (0.67) counts. Conclusion Procalcitonin and neutrophil-to-lymphocyte ratio may potentially be effective predictors for mortality in PSI IV-V patients with COVID-19. Increased procalcitonin and neutrophil-to-lymphocyte ratio were associated with greater risk of mortality.
【초록키워드】 Inflammation, Respiratory failure, Mortality, severe COVID-19, Pneumonia, severity, neutrophil, risk, procalcitonin, Neutrophil-to-lymphocyte ratio, lymphocyte, Cohort, survival, Survivors, Research, Patient, predictor, respiratory, characteristic, COVID-19 patients, Analysis, survival analysis, COVID-19 patient, receiver operating characteristic, medical records, medical record, index, overall mortality, receiver operating characteristic curve, Tongji Hospital, branch, Pneumonia Severity Index, objective, effective, Wuhan, China, initial, Result, greater, enrolled, characterized, significantly higher, Increased, PSI, diagnosed with COVID-19, patients with COVID-19, 【제목키워드】 index, value, PSI, with COVID-19,