BMC infectious diseases · 2025
Lymphocyte-to-procalcitonin ratio: a new predictor of prognosis in COVID-19.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Oğuzlar Furkan Çağrı, Armağan Hamit Hakan, Eryavuz Şengül Teslime, Cesur Ezgi
Аннотация
BACKGROUND: COVID-19 pneumonia remains a major global health concern and is characterized by a dysregulated inflammatory response. This study aimed to evaluate and compare the lymphocyte-to-procalcitonin ratio (LPCT) with conventional inflammatory markers in predicting clinical outcomes in patients with COVID-19.
METHODS: This retrospective observational study was conducted at a tertiary university hospital in Turkey. Adult patients diagnosed with COVID-19 were included between June 1, 2020, and June 1, 2022. Patient demographic and clinical data, including laboratory parameters and comorbidities, were collected from electronic medical records. The primary outcome was in-hospital mortality, while the secondary outcome was the prediction of the requirement for invasive mechanical ventilation.
RESULTS: In total, 535 patients with COVID-19 infection were included (mean age: 67.10 ± 16.77 years; range: 23-100 years), and 124 (23.2%) in-hospital deaths were observed. Among all laboratory parameters analyzed, the LPCT demonstrated superior predictive performance for mortality compared to other parameters, including LCRP. LPCT exhibited the highest positive predictive value at 51.1%. A decrease in LPCT [HR: 4.05 (95% CI: 2.41-6.81)], positive CT findings [HR: 2.54 (95% CI: 1.34-4.81)], and elevated D-Dimer [HR: 1.86 (95% CI: 1.16-2.99)] were identified as independent predictors of in-hospital mortality. Moreover, decreased LPCT was strongly associated with an increased need for mechanical ventilation [OR: 7.53 (95% CI: 3.84-14.78), p < 0.001].
CONCLUSIONS: This study demonstrated the prognostic value of the lymphocyte-to-procalcitonin ratio (LPCT) in predicting in-hospital mortality and the need for mechanical ventilation among COVID-19 patients. To our knowledge, this is the first study to evaluate LPCT as a prognostic biomarker in COVID-19. Future studies should explore the effectiveness of LPCT in other viral infections, particularly in older populations where the sensitivity of CRP may be reduced.
METHODS: This retrospective observational study was conducted at a tertiary university hospital in Turkey. Adult patients diagnosed with COVID-19 were included between June 1, 2020, and June 1, 2022. Patient demographic and clinical data, including laboratory parameters and comorbidities, were collected from electronic medical records. The primary outcome was in-hospital mortality, while the secondary outcome was the prediction of the requirement for invasive mechanical ventilation.
RESULTS: In total, 535 patients with COVID-19 infection were included (mean age: 67.10 ± 16.77 years; range: 23-100 years), and 124 (23.2%) in-hospital deaths were observed. Among all laboratory parameters analyzed, the LPCT demonstrated superior predictive performance for mortality compared to other parameters, including LCRP. LPCT exhibited the highest positive predictive value at 51.1%. A decrease in LPCT [HR: 4.05 (95% CI: 2.41-6.81)], positive CT findings [HR: 2.54 (95% CI: 1.34-4.81)], and elevated D-Dimer [HR: 1.86 (95% CI: 1.16-2.99)] were identified as independent predictors of in-hospital mortality. Moreover, decreased LPCT was strongly associated with an increased need for mechanical ventilation [OR: 7.53 (95% CI: 3.84-14.78), p < 0.001].
CONCLUSIONS: This study demonstrated the prognostic value of the lymphocyte-to-procalcitonin ratio (LPCT) in predicting in-hospital mortality and the need for mechanical ventilation among COVID-19 patients. To our knowledge, this is the first study to evaluate LPCT as a prognostic biomarker in COVID-19. Future studies should explore the effectiveness of LPCT in other viral infections, particularly in older populations where the sensitivity of CRP may be reduced.