Prognostic Value of D-dimer to Lymphocyte Ratio (DLR) in Hospitalized Coronavirus Disease 2019 (COVID-19) Patients: A Validation Study in a National Cohort

Background: This study aimed to validate the role of the D-dimer to lymphocyte ratio (DLR) for mortality prediction in a large national cohort of hospitalized coronavirus disease 2019 (COVID-19) patients. Methods: A retrospective, multicenter, observational study that included hospitalized patients...

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Autores: Oblitas, Crhistian Mario, Demelo Rodríguez, Pablo, Álvarez-Sala Walther, Luis Antonio, Rubio Rivas, Manuel, Navarro Romero, Francisco, Giner Galvañ, Vicente, Jorge Huerta, Lucía de, Fonseca Aizpuru, Eva, García García, Gema María, Beato Pérez, José Luis, Pesqueira Fontán, Paula María, Artero Mora, Arturo, Vargas Núñez, Juan Antonio, Ramírez Perea, Nuria, García Bruñén, José Miguel, Roy Vallejo, Emilia, Perales Fraile, Isabel, Gil Sánchez, Ricardo, López Castro, José, Martínez González, Ángel Luis, Díez García, Luis Felipe, Aroza Espinar, Marina, Casas Rojo, José Manuel, Millán Núñez-Cortés, Jesús
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2024
País:España
Recursos:Universidad de Barcelona
Repositório:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/214067
Acesso em linha:https://hdl.handle.net/2445/214067
Access Level:Acceso aberto
Palavra-chave:Malalties immunitàries
COVID-19
Immunologic diseases
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spelling Prognostic Value of D-dimer to Lymphocyte Ratio (DLR) in Hospitalized Coronavirus Disease 2019 (COVID-19) Patients: A Validation Study in a National CohortOblitas, Crhistian MarioDemelo Rodríguez, PabloÁlvarez-Sala Walther, Luis AntonioRubio Rivas, ManuelNavarro Romero, FranciscoGiner Galvañ, VicenteJorge Huerta, Lucía deFonseca Aizpuru, EvaGarcía García, Gema MaríaBeato Pérez, José LuisPesqueira Fontán, Paula MaríaArtero Mora, ArturoVargas Núñez, Juan AntonioRamírez Perea, NuriaGarcía Bruñén, José MiguelRoy Vallejo, EmiliaPerales Fraile, IsabelGil Sánchez, RicardoLópez Castro, JoséMartínez González, Ángel LuisDíez García, Luis FelipeAroza Espinar, MarinaCasas Rojo, José ManuelMillán Núñez-Cortés, JesúsMalalties immunitàriesCOVID-19Immunologic diseasesCOVID-19Background: This study aimed to validate the role of the D-dimer to lymphocyte ratio (DLR) for mortality prediction in a large national cohort of hospitalized coronavirus disease 2019 (COVID-19) patients. Methods: A retrospective, multicenter, observational study that included hospitalized patients due to SARS-CoV-2 infection in Spain was conducted from March 2020 to March 2022. All biomarkers and laboratory indices analyzed were measured once at admission. Results: A total of 10,575 COVID-19 patients were included in this study. The mean age of participants was 66.9 (+/- 16) years, and 58.6% (6202 patients) of them were male. The overall mortality rate was 16.3% (n = 1726 patients). Intensive care unit admission was needed in 10.5% (n = 1106 patients), non-invasive mechanical ventilation was required in 8.8% (n = 923 patients), and orotracheal intubation was required in 7.5% (789 patients). DLR presented a c-statistic of 0.69 (95% CI, 0.68-0.71) for in-hospital mortality with an optimal cut-off above 1. Multivariate analysis showed an independent association for in-hospital mortality for DLR > 1 (adjusted OR 2.09, 95% CI 1.09-4.04; p = 0.03); in the same way, survival analysis showed a higher mortality risk for DLR > 1 (HR 2.24; 95% CI 2.03-2.47; p < 0.01). Further, no other laboratory indices showed an independent association for mortality in multivariate analysis. Conclusions: This study confirmed the usefulness of DLR as a prognostic biomarker for mortality associated with SARS-CoV-2 infection, being an accessible, cost-effective, and easy-to-use biomarker in daily clinical practice.MDPI AG2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/214067Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.3390/v16030335Viruses, 2024, vol. 16, num. 3https://doi.org/10.3390/v16030335cc by (c) Oblitas, Crhistian Mario et al, 2024http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/2140672026-05-27T06:46:51Z
dc.title.none.fl_str_mv Prognostic Value of D-dimer to Lymphocyte Ratio (DLR) in Hospitalized Coronavirus Disease 2019 (COVID-19) Patients: A Validation Study in a National Cohort
title Prognostic Value of D-dimer to Lymphocyte Ratio (DLR) in Hospitalized Coronavirus Disease 2019 (COVID-19) Patients: A Validation Study in a National Cohort
spellingShingle Prognostic Value of D-dimer to Lymphocyte Ratio (DLR) in Hospitalized Coronavirus Disease 2019 (COVID-19) Patients: A Validation Study in a National Cohort
Oblitas, Crhistian Mario
Malalties immunitàries
COVID-19
Immunologic diseases
COVID-19
title_short Prognostic Value of D-dimer to Lymphocyte Ratio (DLR) in Hospitalized Coronavirus Disease 2019 (COVID-19) Patients: A Validation Study in a National Cohort
title_full Prognostic Value of D-dimer to Lymphocyte Ratio (DLR) in Hospitalized Coronavirus Disease 2019 (COVID-19) Patients: A Validation Study in a National Cohort
title_fullStr Prognostic Value of D-dimer to Lymphocyte Ratio (DLR) in Hospitalized Coronavirus Disease 2019 (COVID-19) Patients: A Validation Study in a National Cohort
title_full_unstemmed Prognostic Value of D-dimer to Lymphocyte Ratio (DLR) in Hospitalized Coronavirus Disease 2019 (COVID-19) Patients: A Validation Study in a National Cohort
title_sort Prognostic Value of D-dimer to Lymphocyte Ratio (DLR) in Hospitalized Coronavirus Disease 2019 (COVID-19) Patients: A Validation Study in a National Cohort
dc.creator.none.fl_str_mv Oblitas, Crhistian Mario
Demelo Rodríguez, Pablo
Álvarez-Sala Walther, Luis Antonio
Rubio Rivas, Manuel
Navarro Romero, Francisco
Giner Galvañ, Vicente
Jorge Huerta, Lucía de
Fonseca Aizpuru, Eva
García García, Gema María
Beato Pérez, José Luis
Pesqueira Fontán, Paula María
Artero Mora, Arturo
Vargas Núñez, Juan Antonio
Ramírez Perea, Nuria
García Bruñén, José Miguel
Roy Vallejo, Emilia
Perales Fraile, Isabel
Gil Sánchez, Ricardo
López Castro, José
Martínez González, Ángel Luis
Díez García, Luis Felipe
Aroza Espinar, Marina
Casas Rojo, José Manuel
Millán Núñez-Cortés, Jesús
author Oblitas, Crhistian Mario
author_facet Oblitas, Crhistian Mario
Demelo Rodríguez, Pablo
Álvarez-Sala Walther, Luis Antonio
Rubio Rivas, Manuel
Navarro Romero, Francisco
Giner Galvañ, Vicente
Jorge Huerta, Lucía de
Fonseca Aizpuru, Eva
García García, Gema María
Beato Pérez, José Luis
Pesqueira Fontán, Paula María
Artero Mora, Arturo
Vargas Núñez, Juan Antonio
Ramírez Perea, Nuria
García Bruñén, José Miguel
Roy Vallejo, Emilia
Perales Fraile, Isabel
Gil Sánchez, Ricardo
López Castro, José
Martínez González, Ángel Luis
Díez García, Luis Felipe
Aroza Espinar, Marina
Casas Rojo, José Manuel
Millán Núñez-Cortés, Jesús
author_role author
author2 Demelo Rodríguez, Pablo
Álvarez-Sala Walther, Luis Antonio
Rubio Rivas, Manuel
Navarro Romero, Francisco
Giner Galvañ, Vicente
Jorge Huerta, Lucía de
Fonseca Aizpuru, Eva
García García, Gema María
Beato Pérez, José Luis
Pesqueira Fontán, Paula María
Artero Mora, Arturo
Vargas Núñez, Juan Antonio
Ramírez Perea, Nuria
García Bruñén, José Miguel
Roy Vallejo, Emilia
Perales Fraile, Isabel
Gil Sánchez, Ricardo
López Castro, José
Martínez González, Ángel Luis
Díez García, Luis Felipe
Aroza Espinar, Marina
Casas Rojo, José Manuel
Millán Núñez-Cortés, Jesús
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Malalties immunitàries
COVID-19
Immunologic diseases
COVID-19
topic Malalties immunitàries
COVID-19
Immunologic diseases
COVID-19
description Background: This study aimed to validate the role of the D-dimer to lymphocyte ratio (DLR) for mortality prediction in a large national cohort of hospitalized coronavirus disease 2019 (COVID-19) patients. Methods: A retrospective, multicenter, observational study that included hospitalized patients due to SARS-CoV-2 infection in Spain was conducted from March 2020 to March 2022. All biomarkers and laboratory indices analyzed were measured once at admission. Results: A total of 10,575 COVID-19 patients were included in this study. The mean age of participants was 66.9 (+/- 16) years, and 58.6% (6202 patients) of them were male. The overall mortality rate was 16.3% (n = 1726 patients). Intensive care unit admission was needed in 10.5% (n = 1106 patients), non-invasive mechanical ventilation was required in 8.8% (n = 923 patients), and orotracheal intubation was required in 7.5% (789 patients). DLR presented a c-statistic of 0.69 (95% CI, 0.68-0.71) for in-hospital mortality with an optimal cut-off above 1. Multivariate analysis showed an independent association for in-hospital mortality for DLR > 1 (adjusted OR 2.09, 95% CI 1.09-4.04; p = 0.03); in the same way, survival analysis showed a higher mortality risk for DLR > 1 (HR 2.24; 95% CI 2.03-2.47; p < 0.01). Further, no other laboratory indices showed an independent association for mortality in multivariate analysis. Conclusions: This study confirmed the usefulness of DLR as a prognostic biomarker for mortality associated with SARS-CoV-2 infection, being an accessible, cost-effective, and easy-to-use biomarker in daily clinical practice.
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/214067
url https://hdl.handle.net/2445/214067
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.3390/v16030335
Viruses, 2024, vol. 16, num. 3
https://doi.org/10.3390/v16030335
dc.rights.none.fl_str_mv cc by (c) Oblitas, Crhistian Mario et al, 2024
http://creativecommons.org/licenses/by/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by (c) Oblitas, Crhistian Mario et al, 2024
http://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv MDPI AG
publisher.none.fl_str_mv MDPI AG
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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