Combined Use of D-dimer and NLR as a Prognostic Index in COVID-19
Birsen Pınar Yıldız1, Didem Görgün Hattatoğlu1, Sariha Büyüklüoğlu1, Cihan Aydın21University of Health Sciences Turkey, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Clinic of Chest Diseases, İstanbul, Turkey2Ahi Evran University Training and Research Hospital, Clinic of Chest Diseases, Kırşehir, Turkey
Objective: We aimed to investigate the combined use of D-dimer and neutrophil-to-lymphocyte ratio (NLR) as a prognostic index-coronavirus disease (PRI-COVID) in COVID-19 patients to predict mortality.
Material and Methods: We included 152 COVID-19 patients in our cross-sectional study. The cut-off value of D-dimer to predict mortality was 1.07 μg/mL with a sensitivity of 68% and specificity of 80% [area under curve (AUC) ± SE: 0.752±0.05; positive predictive value (PPV) 39.5%, and negative predictive value (NPV) 92.7%; p<0.001]. Meanwhile, at a cut-off value of 3.83, the sensitivity and specificity of NLR in predicting mortality were 92% and 48.8%, respectively (AUC ± SE: 0.730±0.05; PPV: 26.1%; NPV: 96.9%; p<0.001). We categorized patients as low, moderate, and high risk using the PRI-COVID model (low risk: <1.07 D-dimer and <3.83 NLR; moderate risk: >1.07 D-dimer or >3.83 NLR; high risk: >1.07 D-dimer and NLR >3.83). High-risk PRI-COVID was associated with 6.37 times increased risk of death compared with the low/moderate risk group.
Results: Combined use of coagulation and inflammation parameters might can be associated with mortality.
Conclusion: Our results suggest that PRI-COVID is easy to assess and useful in predicting both 30-day and overall survival in patients with COVID-19.
Manuscript Language: English
