The Prognostic Value of Extended Inflammation Parameters and Soluble Fibrin Monomer Complex in Covid-19 Patients in The Intensive Care Unit

Abstract

Objective: This study aimed to investigate how extended inflammation markers (EIM) and soluble fibrin monomer complex (SFMC) affected the prognosis of COVID-19-infected patients in the intensive care unit (ICU). Methods: In this study, 73 adults with COVID-19 were included. Patients were divided into two groups: those who died (Group 1; n = 45) and those who survived (Group 2; n = 28). SFMC and EIM [neutrophil reactivity index (NEUT-RI) and neutrophil granularity index (NEUT-GI), reactive lymphocyte (RE-LYMPH), antibodies synthesizing lymphocyte (AS-LYMP), neutrophil/lymphocyte ratio (NLR) and immature granulocyte/lymphocyte ratio (IGLR)], were analyzed in the first 28 days of these patients' follow-up. Results: The median NLR during the first four weeks, IGLR in the first two weeks, RE-LYMPH in the first three weeks, NEUT-RI and NEUT-GI values in the second week, and AS-LYMP in the third week of follow-up were significantly higher in Group 1 than in Group 2 (p<0.05). The median D-Dimer level during the first three weeks and SFMC value in the first week of follow-up were significantly higher in Group 1 than in Group 2 (p<0.05). In patients with COVID-19, older age (≥65 years), nosocomial infection, blood product use, longer ICU stay (>7 days), high DIC (>5), and comorbidities (>3) scores were all risk factors for mortality. In ROC analysis, the cut-off values for NLR and SFMC to predict mortality were 6 and 6.5, respectively. Conclusion: Our data show that elevated NLR and SFMC values in the first week should alert physicians to the risk of life-threatening COVID-19 complications.