Charlson comorbidity index, neutrophil-to-lymphocyte ratio and undertreatment with renin-angiotensin-aldosterone system inhibitors predict in-hospital mortality of hospitalized COVID-19 patients during the omicron dominant period
PurposeTo investigate the clinical predictors of in-hospital mortality in hospitalized patients with Coronavirus disease 2019 (COVID-19) infection during the Omicron period.MethodsAll consecutive hospitalized laboratory‐confirmed COVID-19 patients between January and May 2022 were retrospectively an...
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2022.958418/full |
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| author | Andrea Sonaglioni Michele Lombardo Adriana Albini Douglas M. Noonan Douglas M. Noonan Margherita Re Roberto Cassandro Davide Elia Antonella Caminati Gian Luigi Nicolosi Sergio Harari Sergio Harari |
| author_facet | Andrea Sonaglioni Michele Lombardo Adriana Albini Douglas M. Noonan Douglas M. Noonan Margherita Re Roberto Cassandro Davide Elia Antonella Caminati Gian Luigi Nicolosi Sergio Harari Sergio Harari |
| author_sort | Andrea Sonaglioni |
| collection | DOAJ |
| description | PurposeTo investigate the clinical predictors of in-hospital mortality in hospitalized patients with Coronavirus disease 2019 (COVID-19) infection during the Omicron period.MethodsAll consecutive hospitalized laboratory‐confirmed COVID-19 patients between January and May 2022 were retrospectively analyzed. All patients underwent accurate physical, laboratory, radiographic and echocardiographic examination. Primary endpoint was in-hospital mortality.Results74 consecutive COVID-19 patients (80.0 ± 12.6 yrs, 45.9% males) were included. Patients who died during hospitalization (27%) and those who were discharged alive (73%) were separately analyzed. Compared to patients discharged alive, those who died were significantly older, with higher comorbidity burden and greater prevalence of laboratory, radiographic and echographic signs of pulmonary and systemic congestion. Charlson comorbidity index (CCI) (OR 1.76, 95%CI 1.07-2.92), neutrophil-to-lymphocyte ratio (NLR) (OR 1.24, 95%CI 1.10-1.39) and absence of angiotensin-converting enzyme inhibitors (ACEI)/angiotensin II receptor blockers (ARBs) therapy (OR 0.01, 95%CI 0.00-0.22) independently predicted the primary endpoint. CCI ≥7 and NLR ≥9 were the best cut-off values for predicting mortality. The mortality risk for patients with CCI ≥7, NLR ≥9 and not in ACEI/ARBs therapy was high (86%); for patients with CCI <7, NLR ≥9, with (16.6%) or without (25%) ACEI/ARBs therapy was intermediate; for patients with CCI <7, NLR <9 and in ACEI/ARBs therapy was of 0%.ConclusionsHigh comorbidity burden, high levels of NLR and the undertreatment with ACEI/ARBs were the main prognostic indicators of in-hospital mortality. The risk stratification of COVID-19 patients at hospital admission would help the clinicians to take care of the high-risk patients and reduce the mortality. |
| first_indexed | 2024-04-14T02:36:43Z |
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| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-04-14T02:36:43Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Immunology |
| spelling | doaj.art-85ff5941e78246458934a5995af03fa42022-12-22T02:17:23ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-08-011310.3389/fimmu.2022.958418958418Charlson comorbidity index, neutrophil-to-lymphocyte ratio and undertreatment with renin-angiotensin-aldosterone system inhibitors predict in-hospital mortality of hospitalized COVID-19 patients during the omicron dominant periodAndrea Sonaglioni0Michele Lombardo1Adriana Albini2Douglas M. Noonan3Douglas M. Noonan4Margherita Re5Roberto Cassandro6Davide Elia7Antonella Caminati8Gian Luigi Nicolosi9Sergio Harari10Sergio Harari11Division of Cardiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, ItalyDivision of Cardiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, ItalyEuropean Institute of Oncology (IEO) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, ItalyImmunology and General Pathology Laboratory, Department of Biotechnology and Life Sciences, University of Insubria, Varese, ItalyUnit of Molecular Pathology, Immunology and Biochemistry, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, ItalyDivision of Internal Medicine, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, ItalyDivision of Pneumology, Semi Intensive Care Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, ItalyDivision of Pneumology, Semi Intensive Care Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, ItalyDivision of Pneumology, Semi Intensive Care Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, ItalyDivision of Cardiology, Policlinico San Giorgio, Pordenone, ItalyDivision of Pneumology, Semi Intensive Care Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, ItalyDepartment of Clinical Sciences and Community Health, Università Di Milano, Milan, ItalyPurposeTo investigate the clinical predictors of in-hospital mortality in hospitalized patients with Coronavirus disease 2019 (COVID-19) infection during the Omicron period.MethodsAll consecutive hospitalized laboratory‐confirmed COVID-19 patients between January and May 2022 were retrospectively analyzed. All patients underwent accurate physical, laboratory, radiographic and echocardiographic examination. Primary endpoint was in-hospital mortality.Results74 consecutive COVID-19 patients (80.0 ± 12.6 yrs, 45.9% males) were included. Patients who died during hospitalization (27%) and those who were discharged alive (73%) were separately analyzed. Compared to patients discharged alive, those who died were significantly older, with higher comorbidity burden and greater prevalence of laboratory, radiographic and echographic signs of pulmonary and systemic congestion. Charlson comorbidity index (CCI) (OR 1.76, 95%CI 1.07-2.92), neutrophil-to-lymphocyte ratio (NLR) (OR 1.24, 95%CI 1.10-1.39) and absence of angiotensin-converting enzyme inhibitors (ACEI)/angiotensin II receptor blockers (ARBs) therapy (OR 0.01, 95%CI 0.00-0.22) independently predicted the primary endpoint. CCI ≥7 and NLR ≥9 were the best cut-off values for predicting mortality. The mortality risk for patients with CCI ≥7, NLR ≥9 and not in ACEI/ARBs therapy was high (86%); for patients with CCI <7, NLR ≥9, with (16.6%) or without (25%) ACEI/ARBs therapy was intermediate; for patients with CCI <7, NLR <9 and in ACEI/ARBs therapy was of 0%.ConclusionsHigh comorbidity burden, high levels of NLR and the undertreatment with ACEI/ARBs were the main prognostic indicators of in-hospital mortality. The risk stratification of COVID-19 patients at hospital admission would help the clinicians to take care of the high-risk patients and reduce the mortality.https://www.frontiersin.org/articles/10.3389/fimmu.2022.958418/fullCOVID-19Charlson comobidity indexneutrophil-to-lymphocyte ratioangiotensin-converting enzyme inhibitors/angiotensin II receptor blockersmortality |
| spellingShingle | Andrea Sonaglioni Michele Lombardo Adriana Albini Douglas M. Noonan Douglas M. Noonan Margherita Re Roberto Cassandro Davide Elia Antonella Caminati Gian Luigi Nicolosi Sergio Harari Sergio Harari Charlson comorbidity index, neutrophil-to-lymphocyte ratio and undertreatment with renin-angiotensin-aldosterone system inhibitors predict in-hospital mortality of hospitalized COVID-19 patients during the omicron dominant period Frontiers in Immunology COVID-19 Charlson comobidity index neutrophil-to-lymphocyte ratio angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers mortality |
| title | Charlson comorbidity index, neutrophil-to-lymphocyte ratio and undertreatment with renin-angiotensin-aldosterone system inhibitors predict in-hospital mortality of hospitalized COVID-19 patients during the omicron dominant period |
| title_full | Charlson comorbidity index, neutrophil-to-lymphocyte ratio and undertreatment with renin-angiotensin-aldosterone system inhibitors predict in-hospital mortality of hospitalized COVID-19 patients during the omicron dominant period |
| title_fullStr | Charlson comorbidity index, neutrophil-to-lymphocyte ratio and undertreatment with renin-angiotensin-aldosterone system inhibitors predict in-hospital mortality of hospitalized COVID-19 patients during the omicron dominant period |
| title_full_unstemmed | Charlson comorbidity index, neutrophil-to-lymphocyte ratio and undertreatment with renin-angiotensin-aldosterone system inhibitors predict in-hospital mortality of hospitalized COVID-19 patients during the omicron dominant period |
| title_short | Charlson comorbidity index, neutrophil-to-lymphocyte ratio and undertreatment with renin-angiotensin-aldosterone system inhibitors predict in-hospital mortality of hospitalized COVID-19 patients during the omicron dominant period |
| title_sort | charlson comorbidity index neutrophil to lymphocyte ratio and undertreatment with renin angiotensin aldosterone system inhibitors predict in hospital mortality of hospitalized covid 19 patients during the omicron dominant period |
| topic | COVID-19 Charlson comobidity index neutrophil-to-lymphocyte ratio angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers mortality |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2022.958418/full |
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