Abstract
Background: The prognostic nutritional index (PNI) has been described as a simple risk-stratified tool for several diseases. We explored the predictive role of the PNI on coronavirus disease 2019 (COVID-19) severity.Methods: A total of 101 patients with COVID-19 were included in this retrospective study from January 2020 to March 2020. They were divided into two groups according to COVID-19 severity: non-critical (n = 56) and critical (n = 45). The PNI was calculated upon hospital admission: 10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (/mm3). Critical COVID-19 was defined as having one of the following features: respiratory failure necessitating mechanical ventilation; shock; organ dysfunction necessitating admission to the intensive care unit (ICU). The correlation between the PNI with COVID-19 severity was analyzed.Results: The PNI was significantly lower in critically ill than that in non-critically ill patients (P < 0.001). The receiver operating characteristic curve indicated that the PNI was a good discrimination factor for identifying COVID-19 severity (P < 0.001). Multivariate logistic regression analysis showed the PNI to be an independent risk factor for critical illness due to COVID-19 (P = 0.002).Conclusions: The PNI is a valuable biomarker that could be used to discriminate COVID-19 severity.
Highlights
Coronavirus disease 2019 (COVID-19) is a life-threatening respiratory illness caused by severe acute respiratory syndrome coronavirus (SARS-CoV)-2 infection
We explored the association of the prognostic nutritional index (PNI) with COVID19 severity and assessed its prognostic value using multivariate models
We explored the ability of the PNI and each of its components using the area under the receiver operating characteristic (ROC) curve (AUC) for the prediction of critical illness due to COVID-19
Summary
Coronavirus disease 2019 (COVID-19) is a life-threatening respiratory illness caused by severe acute respiratory syndrome coronavirus (SARS-CoV)-2 infection. The clinical manifestations of COVID-19 are extremely broad. They range from asymptomatic disease and mild, selflimiting respiratory illness with nonspecific symptoms to severe pneumonia with life-threatening complications, including acute respiratory distress syndrome, multiorgan dysfunction, and death. These complications hamper appropriate care of these patients [1,2,3,4]. We explored the predictive role of the PNI on coronavirus disease 2019 (COVID-19) severity
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