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Article Dans Une Revue Clinical Kidney Journal Année : 2021

Neutrophil:lymphocyte ratio predicts short-term outcome of COVID-19 in haemodialysis patients

Prisca Mutinelli-Szymanski
  • Fonction : Auteur
Iulia Hude
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Emilie Merle
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Medhi Abtahi
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Latifa Azeroual
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Cecile Bourgain
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Gael Ensergueix
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Ioannis Katerinis
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Anne Kolko
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Amir Kolta
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Catherine Maheas
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Saeed Mehrbanian
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Rim Ossman
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Hélène De Préneuf
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Claudine Saltiel
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Florence Vendé
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Anne-Sophie Verhoeven
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Béatrice Viron
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Sophie Laplanche
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Christophe Ridel
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Pablo Ureña-Torres
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Maxime Touzot
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Résumé

Abstract Background Information regarding coronavirus disease 2019 (COVID-19) in haemodialysis (HD) patients is limited and early studies suggest a poor outcome. We aimed to identify clinical and biological markers associated with severe forms of COVID-19 in HD patients. Methods We conducted a prospective, observational and multicentric study. Sixty-two consecutive adult HD patients with confirmed COVID-19 from four dialysis facilities in Paris, France, from 19 March to 19 May 2020 were included. Blood tests were performed before diagnosis and at Days 7 and 14 after diagnosis. Severe forms of COVID-19 were defined as requiring oxygen therapy, admission in an intensive care unit or death. Cox regression models were used to compute adjusted hazard ratios (aHRs). Kaplan–Meier curves and log-rank tests were used for survival analysis. Results Twenty-eight patients (45%) displayed severe forms of COVID-19. Compared with non-severe forms, these patients had more fever (93% versus 56%, P < 0.01), cough (71% versus 38%, P = 0.02) and dyspnoea (43% versus 6%, P < 0.01) at diagnosis. At Day 7 post-diagnosis, neutrophil counts, neutrophil:lymphocyte (N:L) ratio, C-reactive protein, ferritin, fibrinogen and lactate dehydrogenase levels were significantly higher in severe COVID-19 patients. Multivariate analysis revealed an N:L ratio >3.7 was the major marker associated with severe forms, with an aHR of 4.28 (95% confidence interval 1.52–12.0; P = 0.006). After a median follow-up time of 48 days (range 27–61), six patients with severe forms died (10%). Conclusions HD patients are at increased risk of severe forms of COVID-19. An elevated N:L ratio at Day 7 was highly associated with the severe forms. Assessing the N:L ratio could inform clinicians for early treatment decisions.

Dates et versions

hal-04144836 , version 1 (28-06-2023)

Identifiants

Citer

Prisca Mutinelli-Szymanski, Iulia Hude, Emilie Merle, Yannis Lombardi, Pascal Seris, et al.. Neutrophil:lymphocyte ratio predicts short-term outcome of COVID-19 in haemodialysis patients. Clinical Kidney Journal, 2021, 14 (1), pp.124-131. ⟨10.1093/ckj/sfaa194⟩. ⟨hal-04144836⟩
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