Abstract:
Background: In COVID-19 patients, lymphocyte-CRP ratio (LCR) is a promising biomarker for predicting adverse clinical outcomes. How well LCR performs compared to conventional inflammatory markers for prognosticating COVID-19 patients remains unclear, which hinders the clinical translation of this novel biomarker. Methods: In a cohort of COVID-19 inpatients, we characterised the clinical applicability of LCR by comparing its prognostic value against conventional inflammatory markers for predicting inpatient mortality and a composite of mortality, invasive/non-invasive ventilation and intensive care unit admissions. Results: Of the 413 COVID-19 patients, 100 (24%) patients suffered inpatient mortality. On Receiver Operating Characteristics analysis, LCR performed similarly to CRP for predicting mortality (AUC 0.74 vs. 0.71, p = 0.049) and the composite endpoint (AUC 0.76 vs. 0.76, p = 0.812). LCR outperformed lymphocyte counts (AUC 0.74 vs. 0.66, p = 0.002), platelet counts (AUC 0.74 vs. 0.61, p = 0.003) and white cell counts (AUC 0.74 vs. 0.54, p < 0.001) for predicting mortality. On Kaplan-Meier analysis, patients with a low LCR (below a 58 cut-off) had worse inpatient survival than patients with other LCR values (p < 0.001). Conclusion: LCR appears comparable to CRP, but outperformed other inflammatory markers, for prognosticating COVID-19 patients. Further studies are required to improve the diagnostic value of LCR to facilitate clinical translation.
摘要:
背景:在COVID-19患者中,淋巴细胞-CRP比值(LCR)是预测不良临床结局的一个有前景的生物标志物.与预测COVID-19患者的常规炎症标志物相比,LCR表现如何尚不清楚,这阻碍了这种新型生物标志物的临床转化。方法:在一组COVID-19住院患者中,我们通过比较LCR对预测住院患者死亡率和复合死亡率的预后价值,来表征LCR的临床适用性。有创/无创通气和重症监护病房入院。结果:在413例COVID-19患者中,100名(24%)患者住院死亡。关于接收机工作特性分析,LCR与CRP相似,用于预测死亡率(AUC0.74vs.0.71,p=0.049)和复合终点(AUC0.76vs.0.76,p=0.812)。LCR优于淋巴细胞计数(AUC0.74vs.0.66,p=0.002),血小板计数(AUC0.74vs.0.61,p=0.003)和白细胞计数(AUC0.74vs.0.54,p<0.001)用于预测死亡率。关于Kaplan-Meier分析,LCR较低(低于58截止值)的患者的住院生存率低于其他LCR值(p<0.001).结论:LCR与CRP相当,但优于其他炎症标志物,用于预测COVID-19患者。需要进一步的研究来提高LCR的诊断价值,以促进临床转化。