The Value of Early and Follow-Up Elevated Scores Based on Peripheral Complete Blood Cell Count for Predicting Adverse Outcomes in COVID-19 Patients
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. CBC-Derived Scores in Relation to ICU Admission
3.2. CBC-Derived Scores in Relation to Short-Term Mortality
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Total Cases N = 607 | No ICU Admission N = 513 | ICU Admission N = 94 | p Value | 30 Day Survivors N = 456 | 30 Day Non-Survivors N = 132 | p Value |
---|---|---|---|---|---|---|---|
Age groups (N, %) | 0.949 a | 0.002 a | |||||
51–60 y | 51 (8.4) | 43 (8.4) | 8 (8.5) | 48 (10.5) | 5 (3.8) | ||
61–70 y | 141 (23.2) | 118 (23.0) | 23 (24.5) | 115 (25.2) | 21 (15.9) | ||
>70 y | 415 (68.4) | 352 (68.6) | 63 (67.0) | 293 (64.3) | 106 (80.3) | ||
Males (N, %) | 294 (48.4) | 247 (48.1) | 47 (50.0) | 0.822 a | 216 (47.4) | 74 (5.1) | 0.093 a |
NEWS2 * | 6 [4–8] | 5 [4–8] | 7 [5–9] | <0.001 b | 5 [4–7] | 4.5 [4–6] | 0.870 b |
CCI * | 4 [2–5] | 4 [2–5] | 4 [2–5] | 0.087 b | 3 [2–5] | 5 [4–7] | <0.001 b |
SaO2 > 90% (N, %) | 459 (75.7) | 422 (82.2) | 38 (40.4) | <0.001 a | 364 (80.0) | 94 (71.2) | 0.042 |
#SaO2 > 90% (N, %) | 599 (98.3) | 433 (84.4) | 28 (28.9) | 0.012 a | 411 (90.1) | 50 (37.9) | 0.070 |
HR (bpm) * | 81 [74–94] | 85 [75–100] | 88 [80–100] | 0.016 b | 84 [75–97] | 84 [68–96] | 0.015 b |
SBP (mmHg) * | 130 [120–144] | 131 [120–150] | 130 [116–148] | 0.503 b | 130 [120–146] | 122 [106–140] | 0.015 b |
Hb (g/dL) * | 13.1 [11.9–14.3] | 13.0 [11.3- 14.1] | 13.1 [11.4–14.3] | 0.689 b | 13.2 [12.0–14.5] | 12.5 [11.9–14.3] | 0.773 b |
WBCs (*103/mmc) * | 7.4 [6.0–10.3] | 7.7 [5.5–10.7] | 10.0 [7.0–14.3] | <0.001 b | 7.3 [5.8–10.1] | 11.1 [7.3–14.5] | <0.001 b |
#WBCs (*103/mmc) * | 9.4 [6.6–13.1] | 9.0 [6.6–12.2] | 12.5 [8.7–17.7] | <0.001 b | 9.6 [6.5–12.0] | 11.1 [8.8–12.7] | 0.003 b |
Ly (*103/mmc) * | 1.1 [0.7–1.6] | 1.1 [0.8–1.6] | 0.9 [0.5–1.4] | 0.001 b | 1.3 [1.0–1.7] | 1.0 [0.7–1.8] | 0.923 b |
#Ly (*103/mmc) * | 1.3 [0.9–1.9] | 1.5 [1.0–2.0] | 1.0 [0.5–1.5] | <0.001 b | 1.6 [1.2–2.1] | 0.9 [0.7–2.1] | <0.001 b |
RDW (%) * | 13.8 [13.1–15.4] | 13.8 [13.0–15.0] | 14.4 [13.4–15.9] | 0.242 b | 13.6 [12.9–15.1] | 15.3 [13.8–15.9] | <0.001 b |
MPV * | 10.7 [9.9–11.3] | 10.6 [10.0–11.3] | 10.8 [10.3–11.7] | 0.176 b | 10.8 [9.8–11.4] | 10.7 [10.0–11.9] | 0.052 b |
MPR * | 0.3 [0.2–0.4] | 0.3 [0.2–0.4] | 0.2 [0.1–0.4] | 0.191 b | 0.3 [0.2–0.4] | 0.4 [0.3–0.5] | 0.002 b |
NLR * | 4.6 [2.8–7.2] | 5.2 [3.0–9.3] | 9.6 [4.8–18.6] | <0.001 b | 4.4 [2.8–6.7] | 7.1 [5.4–10.2] | 0.078 b |
PLR * | 181.5 [126.6–304.8] | 208.8 [137.9–333.1] | 267.9 [155.9–452.8] | 0.004 b | 169.6 [125.9–306.5] | 174.7 [131.1–305.6] | 0.230 b |
MLR * | 0.5 [0.4–0.8] | 0.5 [0.4–0.8] | 0.6 [0.4–1.1] | 0.012 b | 0.5 [0.4–0.8] | 0.9 [0.5–1.1] | 0.066 b |
#NLR * | 3.8 [2.5–6.4] | 4.2 [2.5–7.4] | 15.9 [7.3–30.5] | <0.001 b | 3.9 [2.6–5.2] | 6.5 [2.8–13.1] | <0.001 b |
#PLR * | 201.8 [129.2–294.2] | 199.0 [135.0–292.2] | 343.1 [160.4–530.3] | <0.001 b | 198.7 [128.5–283.8] | 219.8 [134.2–292.2] | 0.928 b |
#MLR * | 0.4 [0.3–0.7] | 0.4 [0.3–0.7] | 0.7 [0.4–1.3] | <0.001 b | 0.4 [0.3–0.6] | 0.9 [0.3–1.4] | <0.001 b |
SII * | 1075.7 [501.5–1912.0] | 1164.4 [585.1–2297.0] | 2031.8 [930.0–4579.0] | <0.001 b | 1110.5 [465.4–1973.0] | 1628.8 [862.0–2812.8] | 0.642 b |
#SII * | 1202.8 [712.1–2044.2] | 1170.2 [654.7–2211.1] | 3915.5 [1202.5–7348.2] | <0.001 b | 1347.0 [699.5–1826.2] | 1689.9 [548.2–2689.6] | 0.022 b |
NMR * | 9.2 [6.5–13.6] | 9.0 [6.5–13.1] | 10.9 [7.6–16.4] | <0.001 b | 8.3 [6.4–11.8] | 11.9 [8.5–13.4] | 0.527 b |
NPR * | 2.2 [1.7–3.3] | 2.4 [1.7–3.7] | 3.5 [2.5–5.1] | <0.001 b | 2.2 [1.7–3.2] | 3.5 [1.9–5.6] | <0.001 b |
ESR (mm/h) * | 44 [10–66] | 36 [11–60] | 51 [7–72] | 0.416 b | 31 [11–65] | 52 [17–74] | 0.474 b |
PT (seconds) * | 12.9 [12.0–14.6] | 13.1 [12.0–15.0] | 13.2 [12.1–15.0] | 0.381 b | 12.7 [12.0–14.6] | 12.9 [11.7–15.5] | 0.288 b |
Fibrinogen (mg/dL) * | 430 [358–488] | 444 [363–533] | 468 [381–573] | 0.032 b | 417 [354–473] | 425 [363–538] | 0.202 b |
#Fibrinogen (mg/dL) * | 381 [315–464] | 381 [319–450] | 366 [283–483] | 0.212 | 381 [319–454] | 373 [267–463] | 0.045 |
Lactate (mg/dL) * | 22.6 [14.1–29.4] | 22.8 [14.4–28.5] | 28.9 [18.7–35.4] | 0.032 b | 26.0 [21.3–30.2] | 27.8 [23.8–31.2] | 0.212 b |
CRP (mg/dL) * | 5.0 [1.5–9.9] | 5.8 [1.9–13.4] | 12.3 [4.4–20.4] | <0.001 b | 3.8 [1.7–8.0] | 8.6 [1.5–10.5] | 0.464 b |
#CRP (mg/dL) * | 1.4 [0.4–5.4] | 1.6 [0.4–5.3] | 4.2 [1.4–8.4] | <0.001 b | 0.9 [0.3–3.7] | 6.4 [1.1–9.4] | <0.001 b |
CLR | 6.0 [1.6–17.3] | 3.9 [1.1–11.6] | 8.1 [2.4–23.2] | <0.001 b | 3.5 [1.2–7.0] | 5.4 [2.0–11.1] | 0.565 b |
#CLR | 1.4 [0.3–5.2] | 1.2 [0.3–4.1] | 6.2 [1.2–14.6] | <0.001 b | 0.4 [0.1–3.2] | 6.0 [0.5–15.1] | <0.001 b |
Creatinine (mg/dL) * | 0.89 [0.73–1.19] | 0.89 [0.76–1.20] | 1.04 [0.81–1.49] | <0.001 b | 0.8 [0.7–1.2] | 1.3 [0.9–2.3] | <0.001 b |
TGP (U/L) * | 31 [18–52] | 32 [20–52] | 38 [23–58] | 0.079 b | 28 [19–47] | 38 [31–63] | 0.415 b |
LDH (U/L) * | 240 [200–314] | 266 [204–396] | 489 [317–685] | <0.001 b | 242 [200–295] | 219 [193–323] | 0.124 b |
#LDH (U/L) * | 197 [168–254] | 202 [163–272] | 463 [255–628] | <0.001 b | 200 [160–246] | 330 [186–442] | <0.001 b |
Presepsin (ng/mL) * | 331 [192–597] | 336 [186–577] | 727 [387–1844] | <0.001 b | 306 [156–433] | 667 [407–1117] | <0.001 b |
Ferritin (ng/dL) * | 449 [192–881] | 495 [195–1059] | 757 [376–1519] | <0.001 b | 295 [174–783] | 448 [212–799] | 0.980 b |
Hospitalization (days) | 15 [12–18] | 15 [12–19] | 14 [10–18] | 0.133 b | 15 [13–18] | 16 [14–19] | 0.001 |
Duration of illness (days) | 19 [16–22] | 15 [8–19] | 14 [9–20] | 0.566 b | 19 [17–23] | 18 [15–20] | <0.001 b |
Variable | ICU Admission | Short-Term Mortality | ||||||
---|---|---|---|---|---|---|---|---|
Univariate | Multivariate | Univariate | Multivariate | |||||
OR (95%CI) | p Value | OR (95%CI) | p Value | OR (95%CI) | p Value | OR (95%CI) | p Value | |
NLR # | 1.08 (1.05–1.11) | <0.001 | 1.14 (1.06–1.22) | <0.001 | 1.15 (1.11–1.19) | <0.001 | 1.30 (1.09–1.57) | 0.005 |
Deltastrain | 1.50 (1.23–1.83) | <0.001 | 2.34 (1.12–4.90) | 0.024 | - | - | - | - |
SaO2 (<90%) | 1.15 (1.09–1.24) | <0.001 | 2.74 (0.70–10.73) | 0.149 | 2.55 (1.89–3.42) | <0.001 | 1.80 (0.30–10.90) | 0.520 |
NEWS2 | 1.20 (1.11–1.28) | <0.001 | 1.06 (0.84–1.36) | 0.616 | - | - | - | - |
CCI | - | - | - | - | 1.35 (1.24–1.46) | <0.001 | 1.49 (1.04–2.13) | 0.030 |
SII | 1.00 (1.00–1.00) | <0.001 | 1.00 (1.00–1.00) | 0.005 | - | - | - | - |
SII # | - | - | - | - | 1.00 (1.00–1.00) | <0.001 | 1.00 (1.00–1.00) | 0.056 |
Fibrinogen | 1.00 (1.00–1.00) | 0.012 | 1.00 (1.00–1.01) | 0.151 | - | - | - | - |
Fibrinogen # | - | - | - | - | 1.00 (1.00–1.00) | 0.056 | 1.00 (0.99–1.01) | 0.962 |
CRP # | 1.07 (1.03–1.10) | <0.001 | 0.91 (0.79–1.04) | 0.165 | 1.14 (1.09–1.19) | <0.001 | 1.04 (0.92–1.19) | 0.517 |
LDH # | 1.00 (1.00–1.00) | <0.001 | 1.00 (1.00–1.01) | 0.127 | 1.01 (1.01–1.01) | <0.001 | 1.01 (1.00–1.01) | 0.013 |
Presepsin | 0.02 (1.00–1.00) | <0.001 | 1.00 (1.00–1.00) | <0.001 | 1.00 (1.00–1.00) | <0.001 | 1.00 (1.00–1.00) | 0.004 |
OD | 1.31 (0.70–2.45) | 0.040 | 0.82 (0.11–6.45) | 0.851 | 1.45 (0.93–2.24) | 0.098 | 2.50 (0.47–13.20) | 0.281 |
Duration of illness | - | - | - | - | 0.94 (0.92–0.96) | <0.001 | 1.14 (1.02–1.26) | 0.017 |
Variable | ICU Admission | Short-Term Mortality | ||||||
---|---|---|---|---|---|---|---|---|
Univariate | Multivariate | Univariate | Multivariate | |||||
OR (95%CI) | p Value | OR (95%CI) | p Value | OR (95%CI) | p Value | OR (95%CI) | p Value | |
MLR # | 1.08 (1.05–1.11) | <0.001 | 2.46 (1.27–4.79) | 0.008 | 2.05 (1.43–2.93) | <0.001 | 2.23 (1.07–4.65) | 0.032 |
Delta strain | 1.50 (1.23–1.83) | <0.001 | 2.48 (1.25–4.92) | 0.010 | - | - | - | - |
SaO2 (<90%) | 1.15 (1.09–1.24) | <0.001 | 5.62 (1.51–20.91) | 0.010 | 2.55 (1.89–3.42) | <0.001 | 1.58 (0.31–8.07) | 0.586 |
NEWS2 | 1.20 (1.11–1.28) | <0.001 | 1.07 (0.85–1.35) | 0.549 | - | - | - | - |
CCI | - | - | - | - | 1.35 (1.24–1.46) | <0.001 | 1.47 (1.05–2.05) | 0.024 |
SII | 1.00 (1.00–1.00) | <0.001 | 1.00 (1.00–1.00) | 0.004 | - | - | - | - |
SII # | 1.00 (1.00–1.00) | <0.001 | 1.00 (1.00–1.00) | 0.183 | ||||
Fibrinogen | 1.00 (1.00–1.00) | 0.012 | 1.00 (1.00–1.01) | 0.173 | - | - | - | - |
Fibrinogen # | - | - | - | - | 1.00 (1.00–1.00) | 0.056 | 1.00 (0.99–1.01) | 0.940 |
CRP # | 1.07 (1.03–1.10) | <0.001 | 0.92 (0.80–1.06) | 0.229 | 1.14 (1.09–1.19) | <0.001 | 1.05 (0.93–1.19) | 0.404 |
LDH # | 1.00 (1.00–1.00) | <0.001 | 1.00 (1.00–1.00) | 0.057 | 1.01 (1.01–1.01) | <0.001 | 1.01 (1.00–1.01) | 0.002 |
Presepsin | 0.02 (1.00–1.00) | <0.001 | 1.00 (1.00–1.00) | <0.001 | 1.00 (1.00–1.00) | <0.001 | 1.00 (1.00–1.00) | 0.002 |
OD | 1.31 (0.70–2.45) | 0.040 | 1.41 (0.19–10.28) | 0.735 | 1.45 (0.93–2.24) | 0.098 | 2.21 (0.45–11.00) | 0.331 |
Duration of illness | - | - | - | - | 0.94 (0.92–0.96) | <0.001 | 1.11 (1.01–1.22) | 0.036 |
Variable | ICU Admission | Short-Term Mortality | ||||
---|---|---|---|---|---|---|
OR (95%CI) Model 1 | OR (95%CI) Model 2 | OR (95%CI) Model 3 | OR (95%CI) Model 1 | OR (95%CI) Model 2 | OR (95%CI) Model 3 | |
NLR # | 1.14 (1.06–1.22) | 1.12 (1.04–1.20) | 1.30 (1.09–1.57) | 1.28 (1.06–1.54) | ||
MLR # | - | 2.46 (1.27–4.79) | 1.92 (0.79–4.71) * | 2.23 (1.07–4.65) | 1.84 (0.68–4.95) * | |
Delta strain | 2.34 (1.12–4.90) | 2.48 (1.25–4.92) | 2.37 (1.13–4.97) | |||
SaO2 (<90%) | - | 5.62 (1.51–20.91) | 1.29 (1.21–1.70) * | - | - | - |
CCI | 1.49 (1.04–2.13) | 1.47 (1.05–2.05) | 1.50 (1.04–2.16) | |||
SII | 1.00 (1.00–1.00) | 1.00 (1.00–1.00) | 1.00 (1.00–1.00) | |||
SII # | 1.00 (1.00–1.00) * | - | 1.00 (1.00–1.00) * | |||
Fibrinogen | - | - | 1.01 (1.00–1.01) * | |||
Fibrinogen # | - | - | - | |||
CRP # | - | - | - | - | - | - |
LDH # | - | 1.00 (1.00–1.00) * | - | 1.01 (1.00–1.01) | 1.01 (1.00–1.01) | 1.01 (1.00–1.01) |
Presepsin | 1.00 (1.00–1.00) | 1.00 (1.00–1.00) | 1.00 (1.00–1.00) | 1.00 (1.00–1.00) | 1.00 (1.00–1.00) | 1.00 (1.00–1.00) |
OD | - | - | - | - | - | - |
Duration of illness | 1.30 (1.09–1.57) | 1.11 (1.01–1.22) | 1.14 (1.02–1.26) | |||
ROC analysis | AUC (95%CI) | AUC (95%CI) | AUC (95%CI) | AUC (95%CI) | AUC (95%CI) | AUC (95%CI) |
0.937 (0.880–0.994) | 0.912 (0.838–0.986) | 0.939 (0.882–0.997) | 0.948 (0.911–0.984) | 0.931 (0.888–0.975) | 0.950 (0.914–0.986) |
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Chelariu, A.-C.; Coman, A.E.; Lionte, C.; Gorciac, V.; Sorodoc, V.; Haliga, R.E.; Petris, O.R.; Bologa, C.; Puha, G.; Stoica, A.; et al. The Value of Early and Follow-Up Elevated Scores Based on Peripheral Complete Blood Cell Count for Predicting Adverse Outcomes in COVID-19 Patients. J. Pers. Med. 2022, 12, 2037. https://doi.org/10.3390/jpm12122037
Chelariu A-C, Coman AE, Lionte C, Gorciac V, Sorodoc V, Haliga RE, Petris OR, Bologa C, Puha G, Stoica A, et al. The Value of Early and Follow-Up Elevated Scores Based on Peripheral Complete Blood Cell Count for Predicting Adverse Outcomes in COVID-19 Patients. Journal of Personalized Medicine. 2022; 12(12):2037. https://doi.org/10.3390/jpm12122037
Chicago/Turabian StyleChelariu, Andrei-Costin, Adorata Elena Coman, Catalina Lionte, Victoria Gorciac, Victorita Sorodoc, Raluca Ecaterina Haliga, Ovidiu Rusalim Petris, Cristina Bologa, Gabriela Puha, Alexandra Stoica, and et al. 2022. "The Value of Early and Follow-Up Elevated Scores Based on Peripheral Complete Blood Cell Count for Predicting Adverse Outcomes in COVID-19 Patients" Journal of Personalized Medicine 12, no. 12: 2037. https://doi.org/10.3390/jpm12122037