Elevated Monocyte to Lymphocyte Ratio and Increased Mortality among Patients with Chronic Kidney Disease Hospitalized for COVID-19
Chronic kidney disease (CKD) constitutes a major health problem and one of the leading causes of death worldwide. Patients with CKD have impaired immune functions that predispose them to an increased risk of infections, as well as virus-associated cancers and a diminished vaccine response. In this s...
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| Language: | English |
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MDPI AG
2021-03-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/11/3/224 |
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| author | Ramsés Dávila-Collado Oscar Jarquín-Durán Andrés Solís-Vallejo Mai Anh Nguyen J. Luis Espinoza |
| author_facet | Ramsés Dávila-Collado Oscar Jarquín-Durán Andrés Solís-Vallejo Mai Anh Nguyen J. Luis Espinoza |
| author_sort | Ramsés Dávila-Collado |
| collection | DOAJ |
| description | Chronic kidney disease (CKD) constitutes a major health problem and one of the leading causes of death worldwide. Patients with CKD have impaired immune functions that predispose them to an increased risk of infections, as well as virus-associated cancers and a diminished vaccine response. In this study, we aimed to identify clinical and laboratory parameters associated with in-hospital mortality in patients evaluated in the department of emergency (ER) and admitted with the diagnosis of severe acute respiratory syndrome (SARS) caused by coronavirus disease 2019 (COVID-19) at the Baptist Hospital of Nicaragua (BHN). There were 37 patients with CKD, mean age 58.3 ± 14.1 years, admitted to BHN due to COVID-19, and among them, 24 (65.7%) were males (<i>p</i> = 0.016). During hospitalization, 23 patients with CKD (62.1%) died of complications associated with COVID-19 disease, which was a higher proportion (odds ratio (OR) 5.6, confidence interval (CI) 2.1–15.7, <i>p</i> = 0.001) compared to a group of 70 patients (64.8% males, mean age 57.5 ± 13.7 years) without CKD admitted during the same period in whom 28.5% died of COVID-19. In the entire cohort, the majority of patients presented with bilateral pneumonia, and the most common symptoms at admission were dyspnea, cough, and fever. Serum levels of D-dimer, ferritin and procalcitonin were significantly higher in patients with CKD compared with those without CKD. Multivariate analysis revealed that CKD, age (>60 years), and hypoxia measured in the ER were factors associated with increased in-hospital mortality. Among patients with CKD but not in those without CKD (OR 36.8, CI 1.5–88.3, <i>p</i> = 0.026), an increased monocytes-to-lymphocyte ratio (MLR) was associated with higher mortality and remained statistically significant after adjusting for confounders. The MLR measured in the ER may be useful for predicting in-hospital mortality in patients with CKD and COVID-19 and could contribute to early risk stratification in this group. |
| first_indexed | 2024-03-10T13:02:15Z |
| format | Article |
| id | doaj.art-a84c98d673c94aed9edff6a7d4dc1f68 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-10T13:02:15Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
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| series | Journal of Personalized Medicine |
| spelling | doaj.art-a84c98d673c94aed9edff6a7d4dc1f682023-11-21T11:27:21ZengMDPI AGJournal of Personalized Medicine2075-44262021-03-0111322410.3390/jpm11030224Elevated Monocyte to Lymphocyte Ratio and Increased Mortality among Patients with Chronic Kidney Disease Hospitalized for COVID-19Ramsés Dávila-Collado0Oscar Jarquín-Durán1Andrés Solís-Vallejo2Mai Anh Nguyen3J. Luis Espinoza4Department of Emergency Medicine, Baptist Hospital of Nicaragua, Managua 11001, NicaraguaDepartment of Emergency Medicine, Baptist Hospital of Nicaragua, Managua 11001, NicaraguaDepartment of Emergency Medicine, Baptist Hospital of Nicaragua, Managua 11001, NicaraguaDepartment of Hematology and Respirology, Kanazawa University, Kanazawa 920-0942, JapanFaculty of Health Sciences, Kanazawa University, Kanazawa 920-0942, JapanChronic kidney disease (CKD) constitutes a major health problem and one of the leading causes of death worldwide. Patients with CKD have impaired immune functions that predispose them to an increased risk of infections, as well as virus-associated cancers and a diminished vaccine response. In this study, we aimed to identify clinical and laboratory parameters associated with in-hospital mortality in patients evaluated in the department of emergency (ER) and admitted with the diagnosis of severe acute respiratory syndrome (SARS) caused by coronavirus disease 2019 (COVID-19) at the Baptist Hospital of Nicaragua (BHN). There were 37 patients with CKD, mean age 58.3 ± 14.1 years, admitted to BHN due to COVID-19, and among them, 24 (65.7%) were males (<i>p</i> = 0.016). During hospitalization, 23 patients with CKD (62.1%) died of complications associated with COVID-19 disease, which was a higher proportion (odds ratio (OR) 5.6, confidence interval (CI) 2.1–15.7, <i>p</i> = 0.001) compared to a group of 70 patients (64.8% males, mean age 57.5 ± 13.7 years) without CKD admitted during the same period in whom 28.5% died of COVID-19. In the entire cohort, the majority of patients presented with bilateral pneumonia, and the most common symptoms at admission were dyspnea, cough, and fever. Serum levels of D-dimer, ferritin and procalcitonin were significantly higher in patients with CKD compared with those without CKD. Multivariate analysis revealed that CKD, age (>60 years), and hypoxia measured in the ER were factors associated with increased in-hospital mortality. Among patients with CKD but not in those without CKD (OR 36.8, CI 1.5–88.3, <i>p</i> = 0.026), an increased monocytes-to-lymphocyte ratio (MLR) was associated with higher mortality and remained statistically significant after adjusting for confounders. The MLR measured in the ER may be useful for predicting in-hospital mortality in patients with CKD and COVID-19 and could contribute to early risk stratification in this group.https://www.mdpi.com/2075-4426/11/3/224COVID-19chronic kidney diseasemonocytes-to-lymphocyte ratioinfection complications |
| spellingShingle | Ramsés Dávila-Collado Oscar Jarquín-Durán Andrés Solís-Vallejo Mai Anh Nguyen J. Luis Espinoza Elevated Monocyte to Lymphocyte Ratio and Increased Mortality among Patients with Chronic Kidney Disease Hospitalized for COVID-19 Journal of Personalized Medicine COVID-19 chronic kidney disease monocytes-to-lymphocyte ratio infection complications |
| title | Elevated Monocyte to Lymphocyte Ratio and Increased Mortality among Patients with Chronic Kidney Disease Hospitalized for COVID-19 |
| title_full | Elevated Monocyte to Lymphocyte Ratio and Increased Mortality among Patients with Chronic Kidney Disease Hospitalized for COVID-19 |
| title_fullStr | Elevated Monocyte to Lymphocyte Ratio and Increased Mortality among Patients with Chronic Kidney Disease Hospitalized for COVID-19 |
| title_full_unstemmed | Elevated Monocyte to Lymphocyte Ratio and Increased Mortality among Patients with Chronic Kidney Disease Hospitalized for COVID-19 |
| title_short | Elevated Monocyte to Lymphocyte Ratio and Increased Mortality among Patients with Chronic Kidney Disease Hospitalized for COVID-19 |
| title_sort | elevated monocyte to lymphocyte ratio and increased mortality among patients with chronic kidney disease hospitalized for covid 19 |
| topic | COVID-19 chronic kidney disease monocytes-to-lymphocyte ratio infection complications |
| url | https://www.mdpi.com/2075-4426/11/3/224 |
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