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2021, Number 3

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Med Crit 2021; 35 (3)

The neutrophiles/lymphocytes index: is a predictor of mortality in a patient with infection by SARS-CoV-2

Montalvo AM, González LCA

Language: Spanish
References: 19
Page: 130-135
PDF size: 214.60 Kb.


ABSTRACT

Introduction: In December 2019 it was announced that in the city of Wuhan (China) a new series of pneumonia cases had occurred, apparently caused by a new type of coronavirus. On January 07, 2020, the new coronavirus was officially announced by the Chinese authorities as the causative agent of these infections. The neutrophil/lymphocyte ratio (INL) has taken on interest as a serum biomarker to define severity. Cataudella et al, reported the proportional relationship of INL with the severity of pneumonia and some adverse outcomes, in addition, it has been observed that it can be a predictor of mortality in Intensive Care Units. Material and methods: A prospective, longitudinal, analytical study was carried out in which all patients with diagnoses of SARS-CoV-2 infection were admitted in a period of time from April-August 2020, in the intensive care unit of the Regional Hospital "Lic. Adolfo López Mateos". Results: The study population consisted of 59 subjects, however, for the analysis, two patients were excluded due to insufficient data. Of the remaining 57, 61.4% (n = 35) were men and 38.6% (n = 22) were women. Regarding the ROC curve, which is an analysis whose purpose determines a cut-off value with high sensitivity to predict an event (in our mortality objective), a significant result was carried out and produced only in the neutrophil/lymphocyte index when the patient was in the ICU with an area under the curve of 0.728 (CI 0.597-0.860) (p = 0.004), it showed a specificity of 80% when the index had a value of 10.35 or greater in these patients. The calculation for this parameter in while the patient was admitted to the emergency room was not significant and the hypothesis was denied with an area under the curve of 0.628 (CI 0.480-0.777). Conclusions: Among our results, it stands out that the average reported value in patients who died during their stay in the ICU was 54.56 ± 10.89 years vs those alive, which was 48.23 ± 11.42 (p = 0.037), which is consistent with that reported in the literature by various authors. it was decided to look for a cut-off point in the Mexican population, where Reyes-Gálvez et al. reported in sepsis that a value of 18.1 to 36 or even higher is a value of the neutrophil/lymphocyte index that is associated with a severe or critical state of the disease and is modestly associated with the APACHE scale. According to these cut-off points, the population analyzed did not report significant associations while they were in the emergency services, possibly because the acute inflammatory response had not yet been fully developed, or the primary symptomatology is only respiratory failure that merited his hospitalization and subsequent transfer to the ICU where this value was significant (p = 0.022).


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