Background The vast impact of COVID-19 call for the identification of clinical parameter that can help predict a torpid evolution. Among these, endothelial injury has been proposed as one of the main pathophysiological mechanisms underlying the disease, promoting a hyperinflammatory and prothrombotic state leading to worse clinical outcomes. Leukocytes and platelets play a key role in inflammation and thrombogenesis, hence the objective of the current study was to study whether neutrophil-to-lymphocyte ratio (NLR), platelets-to-lymphocyte ratio (PLR), the systemic immune-inflammation index (SII) as well as the new parameter neutrophil-to-platelet ratio (NPR), could help identify patients who at risk of admission at Intensive Care Units. Methods A retrospective observational study was performed at HM Hospitales including electronic health records from 2245 patients admitted due to COVID-19 from March 1 to June 10, 2020. Patients were divided into two groups, admitted at ICU or not. Results Patients who were admitted at the ICU had significantly higher values in all hemogram-derived ratios at the moment of hospital admission compared to those who did not need ICU admission. Specifically, we found significant differences in NLR (6.9 [4–11.7] vs 4.1 [2.6–7.6], p < 0.0001), PLR (2 [1.4–3.3] vs 1.9 [1.3–2.9], p = 0.023), NPR (3 [2.1–4.2] vs 2.3 [1.6–3.2], p < 0.0001) and SII (13 [6.5–25.7] vs 9 [4.9–17.5], p < 0.0001) compared to those who did not require ICU admission. After multivariable logistic regression models, NPR was the hemogram-derived ratio with the highest predictive value of ICU admission, (OR 1.11 (95% CI: 0.98–1.22, p = 0.055). Conclusions Simple, hemogram-derived ratios obtained from early hemogram at hospital admission, especially the novelty NPR, have shown to be useful predictors of risk of ICU admission in patients hospitalized due to COVID-19. Supplementary Information The online version contains supplementary material available at 10.1186/s12873-021-00480-w.
【저자키워드】 COVID-19, Neutrophil-to-lymphocyte ratio, ICU admission, Hemogram, Hemogram-derived ratio, Neutrophil-to-platelet ratio, 【초록키워드】 Evolution, Inflammation, neutrophil, risk, Platelets, observational study, clinical outcomes, ICU, Electronic health record, Predictive value, Neutrophil-to-lymphocyte ratio, lymphocyte, intensive care units, Patient, ICU admission, Hemogram, Platelet, Hospital admission, endothelial injury, predictor, Admission, predict, leukocytes, NLR, retrospective, Electronic health records, Predictive, not need, significant difference, two groups, supplementary material, significant differences, moment, multivariable logistic regression, multivariable logistic regression models, help, pathophysiological mechanism, prothrombotic state, clinical parameter, systemic immune-inflammation index, thrombogenesis, parameter, simple, Hyperinflammatory, SII, Result, highest, shown, identify, the disease, was performed, significantly higher, patients hospitalized, torpid, 【제목키워드】 Prognostic marker,