Assessment of Systemic Immune Inflammation Index to Predict SARS-CoV-2 Infection
DOI:
https://doi.org/10.24293/ijcpml.v27i3.1707Keywords:
COVID-19, SARS-CoV-2, systemic immune inflammation indexAbstract
Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and has become a major health problem worldwide. Inflammation plays a vital role in the pathophysiology of COVID-19. Systemic Immune Inflammation Index (SII) is an index obtained from calculating the platelets counts, neutrophils, and lymphocytes, which can indicate the inflammation status and immunity. This study aimed to determine the potential of SII as a predictor of SARS-CoV-2 infection in suspected COVID-19 subjects. A retrospective study was carried out by obtaining medical record data in June 2020 at Sleman General Hospital. An unpaired T-test or the Mann-Whitney test was used to determine the statistical difference. A Receiver Operating Characteristic (ROC) curve was generated and used to get the cut-off values. Bivariate analysis was performed using Chi-Square. There were 84 subjects consisting of 46 (54.8%) males and 38 (45.2%) females with a mean age of 42.4±16.356 years. There was a significant difference in the neutrophils count (p=0.045), monocytes (p=0.001), and eosinophils (p=0.037) between subjects with positive and negative SARS-CoV-2 PCR. The median SII in the positive and negative SARS-CoV-2 PCR group was 780.12 (301.21-2178.90)x103/µL and 584.14 (117.79-1933.87)x103/µL (p=0.045), respectively. Bivariate analysis showed significant results at SII > 705 x103/µL in suspected COVID-19 patients to obtain a positive SARS-CoV-2 PCR result with Odds Ratio (OR) of 4.00 (95% CI 1.580-10.127), p=0.003. Patients with suspected SARS-CoV-2 infection with high SII levels had a greater risk of a positive SARS-CoV-2 in PCR testDownloads
References
Kementerian Kesehatan RI. Pedoman pencegahan dan pengendalian Coronavirus Disesase (COVID-19). Jakarta, Kemenkes, 2020; 17-24.
World Health Organization. WHO COVID-19 preparedness and response progress report February
to June 30, 2020. Geneva, WHO, 2020; 5-6.
Chen G, Wu D, Guo W, Cao Y, Huang D, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest, 2020; 130(5): 2620-2629.
Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune
biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019
(COVID-19): A meta-analysis. Clin Chem Lab Med, 2020; 58(7): 1021-1028.
Frater JL, Zini G, d'Onofrio G, Rogers HJ. COVID-19 and the clinical hematology laboratory. Int J Lab
Hematol, 2020; 42(1): 11–18.
Deeks JJ, Dinnes J, Takwoingi Y, Davenport C, Leeflang MMG, et al. Diagnosis of SARS-CoV-2 infection and COVID-19: Accuracy of signs and symptoms; molecular, antigen, and antibody tests; and routine
laboratory markers (Protocol). Cochrane Database of Systematic Reviews, 2020; 4: Art. No. CD013596.
Chan AS, Rout A. Use of neutrophil-to-lymphocyte and platelet-to- lymphocyte ratios in COVID-19. J Clin Med Res, 2020; 12(7): 448-453.
Ustundag Y, Huysal K, Gecgel SK, Unal D. Relationship between C-reactive protein, systemic immune- inflammation index, and routine hemogram-related inflammatory markers in low-grade inflammation. Int J Med Biochem, 2018; 1(1): 24-8.
Lagunas-Alvarado M, Mijangos-Huesca FJ, Ter´an-Gonz´alez JO, Lagunas-Alvarado MG, Martinez-Zavala M, Reyes Franco I, et al. Systemic immune inflammatory index in sepsis. Med. Int, 2017; 33(3): 303–309.
Zhang B, Zhou X, Qiu Y, Feng F, Feng J, et al. Clinical characteristics of 82 death cases with COVID-19. PLoS One, 2020; 15(7): e0235458.
Ferrari D, Motta, A, Strollo A, Banfi G, Locatelli M. Routine blood tests as a potential diagnostic tool for COVID-19. Clin Chem Lab Med, 2020; 58(7): 1095-99.
Cheng Z, Lu Y, Cao Q, Qin L, Pan Z, et al. Clinical features and chest CT manifestations of Coronavirus
Disease 2019 (COVID-19) in a single-center study in Shangai, China. Cardiopulmunary Imaging, 2020;
: 1–6.
Fei Y, Wang X, Zhang H, Huang M, Chen X, Zhang C. Reference intervals of systemic immune-inflammation index, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume to platelet ratio, mean platelet volume, and red blood cell distribution width-standard deviation in healthy Han adults in Wuhan region in central China. Scandinavian Journal of Clinical and Laboratory Investigation, 2020; 80(6): 500-507.
Ruta VM, Man AM, Alexescu TG, Motoc NS, Tamura S, et al. Neutrophil-to-lymphocyte ratio and systemic immune-inflammation index”biomarkers in interstitial lung disease. Medicine, 2020; 56: 381.
Wang Y, Li Y, Chen P, Xu W, Wu Y, Che G. Prognostic value of the pretreatment Systemic Immune-Inflammation Index (SII) in patients with non-small cell lung cancer: A meta-analysis. Ann. Transl. Med, 2019; 7: 10.
Patra M, Mahapatra C, Kar PK, Prusty N, Nath PK. Multilineage hematologic pattern involvement in
COVID-19 evaluation from peripheral blood elements. National Journal of Laboratory Medicine, 2021; 10(2): PO09-PO13.
Dong M, Shi Y, Yang J, Zhou Q, Lian Y, et al. Prognostic and clinicopathological significance of systemic immune inflammation index in colorectal cancer: A meta-analysis. Ther Adv Med Oncol, 2020; 12: 1–14.
Li H, Huang J, Pan W, Zhang C, Chang X, Yang B. Systemic immune-inflammatory index predicts prognosis of patients with COVID-19: A retrospective study. Research Square, 2020; 1-37.
Luo X, Zhou W, Yan X, Guo T, Wang B, et al. Prognostic value of C-reactive protein in patients with
Coronavirus 2019. Clin Infect Dis, 2020; 23: ciaa641.
Xue G, Gan X, Wu Z, Xie D, Xiong Y, et al. Novel serological biomarkers for inflammation in predicting
disease severity in patients with COVID-19. International Immunopharmacology, 2020; 89: 107065.
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