Systemic Inflammatory Biomarkers and Chest CT Findings as Predictors of Acute Limb Ischemia Risk, Intensive Care Unit Admission, and Mortality in COVID-19 Patients

Background: Numerous tools, including inflammatory biomarkers and lung injury severity scores, have been evaluated as predictors of thromboembolic events and the requirement for intensive therapy in COVID-19 patients. This study aims to verify the predictive role of inflammatory biomarkers [monocyte...

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Main Authors: Emil Marian Arbănași, Ioana Halmaciu, Réka Kaller, Adrian Vasile Mureșan, Eliza Mihaela Arbănași, Bogdan Andrei Suciu, Cătălin Mircea Coșarcă, Ioana Iulia Cojocaru, Razvan Marian Melinte, Eliza Russu
Format: Article
Language:English
Published: MDPI AG 2022-09-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/12/10/2379
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author Emil Marian Arbănași
Ioana Halmaciu
Réka Kaller
Adrian Vasile Mureșan
Eliza Mihaela Arbănași
Bogdan Andrei Suciu
Cătălin Mircea Coșarcă
Ioana Iulia Cojocaru
Razvan Marian Melinte
Eliza Russu
author_facet Emil Marian Arbănași
Ioana Halmaciu
Réka Kaller
Adrian Vasile Mureșan
Eliza Mihaela Arbănași
Bogdan Andrei Suciu
Cătălin Mircea Coșarcă
Ioana Iulia Cojocaru
Razvan Marian Melinte
Eliza Russu
author_sort Emil Marian Arbănași
collection DOAJ
description Background: Numerous tools, including inflammatory biomarkers and lung injury severity scores, have been evaluated as predictors of thromboembolic events and the requirement for intensive therapy in COVID-19 patients. This study aims to verify the predictive role of inflammatory biomarkers [monocyte to lymphocyte ratio (MLR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic inflammatory index (SII), Systemic Inflammation Response Index (SIRI), and Aggregate Index of Systemic Inflammation (AISI)] and the CT Severity Score in acute limb ischemia (ALI) risk, intensive unit care (ICU) admission, and mortality in COVID-19 patients.; Methods: The present study was designed as an observational, analytical, retrospective cohort study and included all patients older than 18 years of age with a diagnosis of COVID-19 infection, confirmed through real time-polymerase chain reaction (RT-PCR), and admitted to the County Emergency Clinical Hospital of Targu-Mureș, Romania, and Modular Intensive Care Unit of UMFST “George Emil Palade” of Targu Mures, Romania between January 2020 and December 2021. Results: Non-Survivors and “ALI” patients were associated with higher incidence of cardiovascular disease [atrial fibrillation (AF) <i>p</i> = 0.0006 and <i>p</i> = 0.0001; peripheral arterial disease (PAD) <i>p</i> = 0.006 and <i>p</i> < 0.0001], and higher pulmonary parenchyma involvement (<i>p</i> < 0.0001). Multivariate analysis showed a high baseline value for MLR, NLR, PLR, SII, SIRI, AISI, and the CT Severity Score independent predictor of adverse outcomes for all recruited patients (all <i>p</i> < 0.0001). Moreover, the presence of AF and PAD was an independent predictor of ALI risk and mortality. Conclusions: According to our findings, higher MLR, NLR, PLR, SII, SIRI, AISI, and CT Severity Score values at admission strongly predict ALI risk, ICU admission, and mortality. Moreover, patients with AF and PAD had highly predicted ALI risk and mortality but no ICU admission.
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spelling doaj.art-f004a32e93a14d5e877cef3eb76919d82023-11-23T23:44:13ZengMDPI AGDiagnostics2075-44182022-09-011210237910.3390/diagnostics12102379Systemic Inflammatory Biomarkers and Chest CT Findings as Predictors of Acute Limb Ischemia Risk, Intensive Care Unit Admission, and Mortality in COVID-19 PatientsEmil Marian Arbănași0Ioana Halmaciu1Réka Kaller2Adrian Vasile Mureșan3Eliza Mihaela Arbănași4Bogdan Andrei Suciu5Cătălin Mircea Coșarcă6Ioana Iulia Cojocaru7Razvan Marian Melinte8Eliza Russu9Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, RomaniaDepartment of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, RomaniaClinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, RomaniaClinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, RomaniaFaculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, RomaniaDepartment of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, RomaniaClinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, RomaniaFirst Clinic of Surgery, Mures County Emergency Hospital, 540136 Targu Mures, RomaniaDepartment of Orthopedics, Regina Maria Health Network, 540098 Targu Mures, RomaniaClinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, RomaniaBackground: Numerous tools, including inflammatory biomarkers and lung injury severity scores, have been evaluated as predictors of thromboembolic events and the requirement for intensive therapy in COVID-19 patients. This study aims to verify the predictive role of inflammatory biomarkers [monocyte to lymphocyte ratio (MLR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic inflammatory index (SII), Systemic Inflammation Response Index (SIRI), and Aggregate Index of Systemic Inflammation (AISI)] and the CT Severity Score in acute limb ischemia (ALI) risk, intensive unit care (ICU) admission, and mortality in COVID-19 patients.; Methods: The present study was designed as an observational, analytical, retrospective cohort study and included all patients older than 18 years of age with a diagnosis of COVID-19 infection, confirmed through real time-polymerase chain reaction (RT-PCR), and admitted to the County Emergency Clinical Hospital of Targu-Mureș, Romania, and Modular Intensive Care Unit of UMFST “George Emil Palade” of Targu Mures, Romania between January 2020 and December 2021. Results: Non-Survivors and “ALI” patients were associated with higher incidence of cardiovascular disease [atrial fibrillation (AF) <i>p</i> = 0.0006 and <i>p</i> = 0.0001; peripheral arterial disease (PAD) <i>p</i> = 0.006 and <i>p</i> < 0.0001], and higher pulmonary parenchyma involvement (<i>p</i> < 0.0001). Multivariate analysis showed a high baseline value for MLR, NLR, PLR, SII, SIRI, AISI, and the CT Severity Score independent predictor of adverse outcomes for all recruited patients (all <i>p</i> < 0.0001). Moreover, the presence of AF and PAD was an independent predictor of ALI risk and mortality. Conclusions: According to our findings, higher MLR, NLR, PLR, SII, SIRI, AISI, and CT Severity Score values at admission strongly predict ALI risk, ICU admission, and mortality. Moreover, patients with AF and PAD had highly predicted ALI risk and mortality but no ICU admission.https://www.mdpi.com/2075-4418/12/10/2379acute limb ischemiaCOVID-19MLRNLRPLRSII
spellingShingle Emil Marian Arbănași
Ioana Halmaciu
Réka Kaller
Adrian Vasile Mureșan
Eliza Mihaela Arbănași
Bogdan Andrei Suciu
Cătălin Mircea Coșarcă
Ioana Iulia Cojocaru
Razvan Marian Melinte
Eliza Russu
Systemic Inflammatory Biomarkers and Chest CT Findings as Predictors of Acute Limb Ischemia Risk, Intensive Care Unit Admission, and Mortality in COVID-19 Patients
Diagnostics
acute limb ischemia
COVID-19
MLR
NLR
PLR
SII
title Systemic Inflammatory Biomarkers and Chest CT Findings as Predictors of Acute Limb Ischemia Risk, Intensive Care Unit Admission, and Mortality in COVID-19 Patients
title_full Systemic Inflammatory Biomarkers and Chest CT Findings as Predictors of Acute Limb Ischemia Risk, Intensive Care Unit Admission, and Mortality in COVID-19 Patients
title_fullStr Systemic Inflammatory Biomarkers and Chest CT Findings as Predictors of Acute Limb Ischemia Risk, Intensive Care Unit Admission, and Mortality in COVID-19 Patients
title_full_unstemmed Systemic Inflammatory Biomarkers and Chest CT Findings as Predictors of Acute Limb Ischemia Risk, Intensive Care Unit Admission, and Mortality in COVID-19 Patients
title_short Systemic Inflammatory Biomarkers and Chest CT Findings as Predictors of Acute Limb Ischemia Risk, Intensive Care Unit Admission, and Mortality in COVID-19 Patients
title_sort systemic inflammatory biomarkers and chest ct findings as predictors of acute limb ischemia risk intensive care unit admission and mortality in covid 19 patients
topic acute limb ischemia
COVID-19
MLR
NLR
PLR
SII
url https://www.mdpi.com/2075-4418/12/10/2379
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