Prognostic marker for mortality of COVID-19 patients in the intensive care unit: the delta neutrophil index


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DOI:

https://doi.org/10.51271/KMJ-0057

Keywords:

Covid-19, intensive care unit, delta neutrophil index, mortality, prognostic biomarker

Abstract

 

Aim: The Delta Neutrophil Index (DNI) shows the ratio of immature granulocytes in the circulation and increases in conditions of infection and inflammation. The aim of this study was to investigate the suitability of using DNI as a prognostic marker of mortality in COVID-19 patients in the Intensive Care Unit (ICU).

Material and Method: This retrospective study included 316 patients followed up in the ICU with a diagnosis of COVID-19. A record was made for each patient of demographic data, laboratory values, clinical results and mortality status. All the data of the patients were evaluated and compared between the two groups of surviving and non-surviving patients.

Results: Mortality developed in 181 (57.27%) patients. The Glasgow Coma Scale score was lower and the APACHE II and SOFA scores were higher in the mortality group than in the surviving group (p<0.001 for all). The creatinine, procalcitonin, white blood cell, neutrophil count, neutrophil-lymphocyte ratio, lactate, interleukin -6 and C-reactive protein values were statistically significantly higher in the mortality group. In the comparison of DNI between the groups, a statistically significant difference was only determined on day 3 (p=0.026). For the DNI examined on day 3, the AUC value was 0.574 and the cutoff value was 1.35% for the prediction of mortality.

Conclusion: DNI, which is low cost and simple to use, can be considered safe for use in the prediction of mortality of ICU patients diagnosed with COVID-19. The monitoring of increasing or decreasing trends by keeping regular records can be considered important for the clinical course.

References

Debuc B, Smadja DM. Is COVID-19 a new hematologic disease? Stem Cell Rev Rep 2021; 17: 4-8.

Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020; 323: 1239–42.

WHO coronavirus (COVID-19) dashboard. Geneva: World Health Organization, 2021 (https: //covid19.who.int.).

Sabaka P, Koščálová A, Straka I, et al. Role of interleukin 6 as a predictive factor for a severe course of COVID-19: retrospective data analysis of patients from a long-term care facility during COVID-19 outbreak. BMC Infect Dis 2021; 21: 308.

Copaescu A, James F, Mouhtouris E, et al. The role of immunological and clinical biomarkers to predict clinical COVID-19 severity and response to therapy-a prospective longitudinal study. Front Immunol 2021; 12: 646095.

Majidpoor J, Mortezaee K. Interleukin-6 in SARS-CoV-2 induced disease: Interactions and therapeutic applications. Biomed Pharmacother 2022; 145: 112419.

Qeadan F, Tingey B, Gu LY, Packard AH, Erdei E, Saeed AI. Prognostic values of serum ferritin and d-dimer trajectory in patients with COVID-19. Viruses 2021; 13: 419.

Park JH, Byeon HJ, Lee KH, et al. Delta neutrophil index (DNI) as a novel diagnostic and prognostic marker of infection: a systematic review and meta-analysis. Inflamm Res 2017; 66: 863-70.

Park BH, Kang YA, Park MS, et al. Delta neutrophil index as an early marker of disease severity in critically ill patients with sepsis. BMC Infect Dis 2011; 11: 299.

Seok Y, Choi JR, Kim J, et al. Delta neutrophil index: a promising diagnostic and prognostic marker for sepsis. Shock 2012; 37: 242e6.

Hamid S, Mir MY, Rohela GK. Novel coronavirus disease (COVID-19): a pandemic (epidemiology, pathogenesis and potential therapeutics). New Microbes New Infect 2020; 35: 100679.

Karagol C, Tehci AK, Gungor A, et al. Delta neutrophil index and C-reactive protein: a potential diagnostic marker of multisystem

inflammatory syndrome in children (MIS-C) with COVID-19. Eur J Pediatr.2022; 181: 775–81

Birben B, Birben OD, Akın T, et al. Efficacy of the delta neutrophil index in predicting 30-day mortality in COVID-19 patients requiring intensive care. Int JClin Pract 2021; 00: e13970.

Kim JW, Park JH, Kim DJ, Choi WH, Cheong JC, Kim JY. The delta neutrophilindex is a prognostic factor for postoperativemortality in

patients with sepsis caused byperitonitis. PLoS ONE 2017; 12: e0182325.

Gong SC, Ryu H, Jang JY. Usefulness of delta neutrophilindex as a biomarker to predict postoperative complication in patients

whounderwent esophagectomy: a case-control study. Medicine 2021; 100: 51.

Kim MJ, Choi WH, Cheong JC, Choi SY, Kim JW, Park JH. Delta neutrophil index and symptomatic time are effective factors for predicting perforated appendicitis. Medicine 2021; 100: 20.

Kong T, Park YS, Lee HS, et al. The delta neutrophil index predicts development of multiple organ dysfunction syndrome and 30-day mortality in trauma patients admitted to an intensive care unit: a retrospective analysis. Scientific reports 2018; 8: 17515.

Kim HW, Yoon JH, Jin SJ, et al. Delta neutrophil index as a prognostic marker of early mortality in gram negative bacteremia. Infect Chemother 2014; 46: 94-102.

Ahn C, Kim W, Lim TH, et al. The delta neutrophil index (DNI)as a prognostic marker for mortality in adults with sepsis: a systematicreview and meta-analysis. Sci Rep 2018; 8: 6621.

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Published

2022-09-22

How to Cite

KÜÇÜK, B., KOCABEYOĞLU, G. M., BALTACI ÖZEN, S., KOSOVALI, B. D., MUTLU, N. M., YAKIŞIK ÇAKIR, E., ÖZKOÇAK TURAN, I., BAĞ, Y. M., & BULĞURCU, A. (2022). Prognostic marker for mortality of COVID-19 patients in the intensive care unit: the delta neutrophil index. Kastamonu Medical Journal, 2(3), 63–67. https://doi.org/10.51271/KMJ-0057