EFFECTIVENESS OF CALCULATED HEMATOLOGICAL INDICES AS PREDICTORS OF MORTALITY IN PATIENTS WITH SEVERE COMMUNITY-ACQUIRED COVID-19- ASSOCIATED PNEUMONIA

The aim of the research. To investigate the informativeness of calculated hematological indices in prediction of mortality in patients with severe community-acquired pneumonia caused by new coronavirus infection (COVID-19). 

Materials and methods. We conducted a prospective case-control observational study which included 450 patients with severe community-acquired COVID-19-associated pneumonia treated in the Anesthesiology and Intensive Care Unit (AICU). Several indices were calculated: the ratios of neutrophils (count) to lymphocytes (count) (NL), neutrophils (%) to albumin (g/L) (NA), fibrinogen (g/L) to albumin (g/L) (FA), platelets (count) to lymphocytes (count) (PL), lactate dehydrogenase (LDH) (U/L) to lymphocytes (count) (LDH-L), C-reactive protein (CRP) (mg/L) to albumin (g/L) (CRP-A), LDH (U/L) to platelets (count) (LDH-P), LDH (U/L) to albumin (g/L) (LDH-A), fibrinogen (g/L)*100 to platelets (count) (FP). Systemic immuno-inflammation index (SII) was calculated according to the formula: platelets (count)*neutrophils (count) / lymphocytes (count). The end point was mortality. The statistical analysis was carried out using the SPSS 26.0 program. To compare prognostic value of hematological laboratory parameters and calculated indices univariate and multifactorial analyses were carried out with prognostic models using binary logistic regression.

Results. The prognostic value of hematological indices was determined in comparison with hematological laboratory indicators. LDH-L (78%), LDH-P (83.9%) and LDH-A (84.4%) indices had the highest prognostic sensitivity and odds ratio 3.27, 4.55, 5.58, respectively. Prognostic models with hematological indicators (specificity  50.7%, sensitivity  88.3%) and calculated indices (specificity  51.1%, sensitivity 90.8%) were constructed.

Conclusion. Calculated hematological indices are highly informative and can be used to predict mortality in patients with severe community-acquired COVID-19-associated pneumonia. Hematological indices include LDH ratio with lymphocytes, platelets and albumin have highest sensitivity and specificity.

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