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Predictors of COVID-19 Severity in Patients With Autoimmune Diseases
TAKE-HOME MESSAGE
- This retrospective study conducted in China evaluated the predictors of COVID-19 severity in patients with autoimmune diseases during the later stages of the pandemic. The results showed a higher neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune–inflammation index in patients with severe COVID-19 compared with those with non-severe COVID-19, indicating that these markers can be used as predictors of severe COVID-19.
- The authors mention the gap of knowledge in identifying the risk factors for adverse COVID-19 progression among Chinese patients with autoimmune diseases. This study allows us to elucidate some markers of inflammation that may portend more severe COVID-19 in this patient population.
abstract
This abstract is available on the publisher's site.
Access this abstract now Full Text Available for ClinicalKey SubscribersBACKGROUND
Early identification of risk factors for adverse COVID-19 progression in patients with autoimmune diseases is crucial for patient management, but data on the Chinese population are scarce.
OBJECTIVES
The purpose of this study was to identify predictors of severe COVID-19 in patients using blood cell ratios, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and other inflammatory markers.
METHODS
A retrospective study of 855 patients (746 females; median age 49 years) with autoimmune diseases and concurrent COVID-19 was conducted from December 2022 to February 2023 at the Rheumatology and Immunology Department of the First Affiliated Hospital of Nanchang University. Disease severity was assessed according to the 8th edition of the National Health Commission of the People's Republic of China's COVID-19 Diagnosis and Treatment Guidelines. The clinical classification criteria group mild and moderate cases as nonsevere cases and severe and critical cases as severe cases. A multivariate logistic regression model was established to evaluate the relationships between COVID-19 severity and demographic characteristics, comorbidities, medication use, and laboratory findings.
RESULTS
The PLR, NLR, and SII were significantly greater in the severe COVID-19 group than in the nonsevere group (all P < 0.05). In addition to classical independent clinical risk factors, increases in the PLR (OR: 1.004, 95 % CI: 1.001∼1.007, p = 0.001), NLR (OR: 1.180, 95 % CI: 1.041∼1.337, p = 0.010), and SII (OR: 0.999, 95 % CI: 0.998∼1.000, p = 0.005) were identified as risk factors for severe COVID-19 in patients with autoimmune diseases. After adjusting for clinical risk factors, the PLR (AUC: 0.592 vs. 0.865; P < 0.05), NLR (AUC: 0.670 vs. 0.866; P < 0.05), and SII (AUC: 0.616 vs. 0.864; P < 0.05) demonstrated higher predictive values.
CONCLUSION
Early prediction of severe COVID-19 in patients with autoimmune diseases can be achieved using the NLR, PLR, and SII.
Additional Info
Predictors of COVID-19 severity in autoimmune disease patients: A retrospective study during full epidemic decontrol in China
Heart Lung 2024 Nov 01;68(xx)272-278, LM Chen, JB Li, R WuFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.