Role of hemogram-derived ratios in predicting intensive care unit admission in COVID-19 patients: a multicenter study

Abstract

Purpose: As hyperinflammation is recognized as a driver of severe COVID-19 disease, checking markers of inflammation is gaining more attention. Our study aimed to evaluate the utility of cost-effective hemogram-derived ratios in predicting intensive care unit (ICU) admission in COVID-19 patients.

Methods: This multicenter retrospective study included hospitalized COVID-19 patients from four dedicated COVID-19 hospitals in Sylhet, Bangladesh. Data on demographics, clinical characteristics, laboratory parameters and survival outcomes were analyzed. Logistic regression analysis was used to identify the significance of each hemogram-derived ratio in predicting ICU admission.

Results: Of 442 included patients, 98 (22.17%) required ICU admission. At the time of admission, patients requiring ICU had a higher neutrophil count and lower lymphocyte and platelet counts than patients not requiring ICU. Peripheral capillary oxygen saturation at admission was significantly lower in those who subsequently required ICU admission. Neutrophil-to-lymphocyte ratio, derived neutrophil-to-lymphocyte ratio, neutrophil-to-platelet ratio, and systemic immune-inflammation index were significant predictors of ICU admission.

Conclusion: Hemogram-derived ratios can be an effective tool in facilitating the early categorization of at-risk patients, enabling timely measures to be taken early in the disease course.

Keywords: COVID-19; ICU admission; hemogram-derived ratios.

Figure 1

ROC curve for the different hemogram-derived ratios and their respective area under the curves (AUC).

Figure 2

Ranking of comrbidities for total and ICU patients.