Prognostic Nutritional Index, Controlling Nutritional Status (CONUT) Score, and Inflammatory Biomarkers as Predictors of Deep Vein Thrombosis, Acute Pulmonary Embolism, and Mortality in COVID-19 Patients
Adrian Vasile Mureșan,
Ioana Hălmaciu,
Emil Marian Arbănași,
Réka Kaller,
Eliza Mihaela Arbănași,
Ovidiu Aurelian Budișcă,
Răzvan Marian Melinte,
Vlad Vunvulea,
Rareș Cristian Filep,
Lucian Mărginean,
Bogdan Andrei Suciu,
Klara Brinzaniuc,
Raluca Niculescu,
Eliza Russu
Affiliations
Adrian Vasile Mureșan
Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania
Ioana Hălmaciu
Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
Emil Marian Arbănași
Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania
Réka Kaller
Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania
Eliza Mihaela Arbănași
Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
Ovidiu Aurelian Budișcă
Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
Răzvan Marian Melinte
Department of Orthopedics, Regina Maria Health Network, 540098 Targu Mures, Romania
Vlad Vunvulea
Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
Rareș Cristian Filep
Department of Radiology, Mureș County Emergency Hospital, 540136 Targu Mureș, Romania
Lucian Mărginean
Department of Radiology, Mureș County Emergency Hospital, 540136 Targu Mureș, Romania
Bogdan Andrei Suciu
Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
Klara Brinzaniuc
Department of Anatomy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
Raluca Niculescu
Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
Eliza Russu
Clinic of Vascular Surgery, Mures County Emergency Hospital, 540136 Targu Mures, Romania
Background: Numerous tools, including nutritional and inflammatory markers, have been evaluated as the predictors of poor outcomes in COVID-19 patients. This study aims to verify the predictive role of the prognostic nutritional index (PNI), CONUT Score, and inflammatory markers (monocyte to lymphocyte ratio (MLR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic inflammatory index (SII), Systemic Inflammation Response Index (SIRI), and Aggregate Index of Systemic Inflammation (AISI)) in cases of deep vein thrombosis (DVT) and acute pulmonary embolism (APE) risk, as well as mortality, in COVID-19 patients. Methods: The present study was designed as an observational, analytical, retrospective cohort study, and included 899 patients over the age of 18 who had a COVID-19 infection, confirmed through real time-polymerase chain reaction (RT-PCR), and were admitted to the County Emergency Clinical Hospital and Modular Intensive Care Unit of UMFST “George Emil Palade” of Targu Mures, Romania between January 2020 and March 20212. Results: Non-Surviving patients were associated with a higher incidence of chronic kidney disease (p = 0.01), cardiovascular disease (atrial fibrillation (AF) p = 0.01; myocardial infarction (MI) p = 0.02; peripheral arterial disease (PAD) p = 0.0003), malignancy (p = 0.0001), tobacco (p = 0.0001), obesity (p = 0.01), dyslipidemia (p = 0.004), and malnutrition (p p < 0.0001). The presence of PAD, malignancy, and tobacco, were also independent predictors of all outcomes. Conclusions: According to our findings, higher MLR, NLR, PLR, SII, SIRI, AISI, CONUT Score, and lower PNI values at admission strongly predict DVT risk, APE risk, and mortality in COVID-19 patients. Moreover, PAD, malignancy, and tobacco, all predicted all outcomes, while CKD predicts APE risk and mortality, but not the DVT risk.
