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. 2022 Dec 10;12(12):3118.
doi: 10.3390/diagnostics12123118.

Has COVID-19 Modified the Weight of Known Systemic Inflammation Indexes and the New Ones (MCVL and IIC) in the Assessment as Predictive Factors of Complications and Mortality in Acute Pancreatitis?

Patricia Mihaela Radulescu  1 , Dragos Virgil Davitoiu  2 , Vlad Dumitru Baleanu  2 , Vlad Padureanu  3 , Dumitru Sandu Ramboiu  4 , Marin Valeriu Surlin  4 , Tudor Constantin Bratiloveanu  4 , Eugen Florin Georgescu  4 , Costin Teodor Streba  5 , Razvan Mercut  6 , Elena Irina Caluianu  4 , Emil Tiberius Trasca  4 , Dumitru Radulescu  4
Affiliations

Has COVID-19 Modified the Weight of Known Systemic Inflammation Indexes and the New Ones (MCVL and IIC) in the Assessment as Predictive Factors of Complications and Mortality in Acute Pancreatitis?

Patricia Mihaela Radulescu et al. Diagnostics (Basel). .

Abstract

We aimed at evaluating the prognostic capacity of the inflammatory indices derived from routine complete blood cell counts in two groups of patients with acute pancreatitis from two different time periods, before and during the COVID-19 pandemic, when a high incidence of complications with surgical risk and mortality was found. Two new markers were introduced: the mean corpuscular volume to lymphocyte ratio (MCVL) and the cumulative inflammatory index (IIC), which were calculated at a baseline in the two groups of patients. Of the already established markers, none of them managed to effectively predict the complications with surgical risk and mortality, with a decrease of less than 50% in specificity in the peri-COVID group. The MCVL had the best prediction of complications with surgical risk in both the pre-COVID and peri-COVID groups, validated it as an independent factor by multivariate analysis. The IIC had the best prediction of mortality in both periods and was proven to be an independent factor by multivariate analysis. As the IIC predicted death best, we tested the occurrence of death and found that patients with PA who had an IIC > 12.12 presented a risk of death 4.08 times higher in the pre-COVID group and 3.33 times higher in the peri-COVID group. The new MCVL and IIC independent markers had a superior sensitivity and specificity in predicting surgical risk complications and, respectively, mortality in the group of patients with acute pancreatitis during the COVID-19 pandemic, which makes them widely applicable in populations with modified immune and inflammatory status. Conclusions: In patients with acute pancreatitis, MCVL has a significant predictive value regarding complications with surgical risk (abscess, necrosis, and pseudocyst), and the IIC has a significant predictive value for mortality.

Keywords: IIC; MCVL; NLR; abscess; acute pancreatitis; average crepuscular volume−lymphocyte ratio; cumulative inflammatory index; necrosis; neutrophil-lymphocyte ratio; pseudocyst.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flow chart of patient inclusion.
Figure 2
Figure 2
Receiver operating characteristic (ROC) curve for logistic regression models of inflammatory markers in relation to complications in the pre-COVID group.
Figure 3
Figure 3
Receiver operating characteristic (ROC) curve for logistic regression models of inflammatory markers related to complications in the peri-COVID group.
Figure 4
Figure 4
Receiver operating characteristic (ROC) curve for logistic regression models of inflammatory markers related to death in the pre-COVID group.
Figure 5
Figure 5
Receiver operating characteristic (ROC) curve for logistic regression models of inflammatory markers related to death in the peri-COVID group.
Figure 6
Figure 6
Correlation between mortality and IIC in the pre-COVID andperi-COVID group. X2—chi-square value.
See this image and copyright information in PMC

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