Neutrophil-platelet ratio as a predictor of acute kidney injury in severe COVID-19.
Humans
COVID-19
/ complications
Acute Kidney Injury
/ blood
Male
Female
Retrospective Studies
Neutrophils
Middle Aged
Aged
Platelet Count
Predictive Value of Tests
SARS-CoV-2
Risk Factors
ROC Curve
Blood Platelets
Severity of Illness Index
Leukocyte Count
Intensive Care Units
/ statistics & numerical data
Adult
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
11 Oct 2024
11 Oct 2024
Historique:
medline:
28
10
2024
pubmed:
28
10
2024
entrez:
28
10
2024
Statut:
ppublish
Résumé
Acute kidney injury (AKI) is one of the most seen complications of coronavirus-2019 (COVID-19) infection. Patients with AKI caused by COVID-19 likely have higher neutrophil counts and lower platelet and lymphocyte levels. Therefore, the predictive value of many inflammation indexes calculated from the total blood count has been investigated to predict the AKI in COVID-19. According to our clinical experience, we thought that neutrophilia and thrombocytopenia may be more common in the development of AKI. For this reason, this study aimed to evaluate the predictive value of the neutrophil-to-platelet ratio (NPR) for AKI in severe COVID-19 patients. This retrospective study included 334 severe COVID-19 patients followed up in the intensive care unit (ICU). Predictive factors for AKI were analyzed. ROC curve analysis was performed to determine the inflammation indexes' cutoff values for the AKI prediction. Multivariate analyses were performed to determine correlations between the inflammation indexes and AKI. In this study, AKI was determined at the rate of 43% (n:145). Independent risk factors affecting AKI were determined to be age (HR = 1.047, 95% confidence interval [CI]: 1.021-1.072, P < .001), the need for invasive mechanical ventilation (HR = 3.003, 95% CI: 1.645-5.481, P = .001) and the need for vasopressor (HR = 8.111, 95% CI: 3.786-17.375, P < .001). The optimal cutoff values predicting AKI were determined to be 3.9 for the NPR (AUC = 0.679, 95% CI: 0.622-0.737, P < .001) with 71.7% sensitivity and 61.9% specificity, 16.1 for the neutrophil-to-lymphocyte ratio (NLR) (AUC = 0.634, 95% CI: 0.575-0.694, P < .001) with 65.5% sensitivity and 56.1% specificity, and 3872.5 × 109L for the systemic inflammatory index (SII) (AUC = 0.566, 95% CI: 0.504-0.629, P = .038) with 60% sensitivity and 55.6% specificity. In the regression model, only NPR values above the cutoff were related to AKI (HR = 3.817, 95% CI: 1.782-8.177, P = .001). The NPR has more predictive value than the NLPR, NLR, and SII in developing AKI in severe COVID-19 patients in the ICU. NPR is a new helpful index that can help clinicians predict early AKI in critical COVID-19.
Identifiants
pubmed: 39465828
doi: 10.1097/MD.0000000000040053
pii: 00005792-202410110-00046
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e40053Informations de copyright
Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no funding and conflicts of interest to disclose.
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