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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Authors: 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
Format: article
Status:Published version
Publication Date:2024
Country:España
Institution:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repository:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/214067
Online Access:https://hdl.handle.net/2445/214067
Access Level:Open access
Keyword:Malalties immunitàries
COVID-19
Immunologic diseases
Description
Summary: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.

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