학술논문
Prognostic Value of D-dimer to Lymphocyte Ratio (DLR) in Hospitalized Coronavirus Disease 2019 (COVID-19) Patients: A Validation Study in a National Cohort.
Document Type
Article
Author
Oblitas, Crhistian-Mario; Demelo-Rodríguez, Pablo; Alvarez-Sala-Walther, Luis-Antonio; Rubio-Rivas, Manuel; Navarro-Romero, Francisco; Giner Galvañ, Vicente; de Jorge-Huerta, Lucía; Fonseca Aizpuru, Eva; García García, Gema María; Beato Pérez, José Luis; Pesqueira Fontan, 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
Source
Subject
*COVID-19
*PROGNOSIS
*FIBRIN fragment D
*LYMPHOCYTES
*INTENSIVE care units
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Language
ISSN
1999-4915
Abstract
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. [ABSTRACT FROM AUTHOR]