Prognostic Value of Admission Neutrophil Count in Asthma Patients with COVID-19: A Comparative Analysis with Other Systemic Inflammation Indices for In-hospital Mortality Prediction

Hassan Ghobadi; Jafar Mohammadshahi; Aylin Tarighi; Seyed Amir Hossein Hosseini; Kara Garjani; Mohammad Reza Aslani

doi:10.18502/ijaai.v22i4.13611

Hassan Ghobadi Lung Diseases Research Center, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
Jafar Mohammadshahi Department of Infectious Diseases and Tropical Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
Aylin Tarighi Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
Seyed Amir Hossein Hosseini Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
Kara Garjani Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
Mohammad Reza Aslani Lung Diseases Research Center, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran

DOI: https://doi.org/10.18502/ijaai.v22i4.13611

Keywords: Asthma; Coronavirus; COVID-19; Neutrophils

Abstract

Despite studies indicating that asthma patients do not exhibit a higher mortality rate or severity compared to the general population when infected with COVID-19, there have been few reports on predictive factors for mortality in this context. This study aimed to assess the predictive value of systemic inflammation indices, including neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte (PLR), systemic inflammation response index (SIR-I), and systemic inflammation index (SII) in determining mortality rate among patients with COVID-19 and asthma.

In this prospective study, the laboratory parameters of 1792 COVID-19 patients were examined, comprising 112 patients with asthma and 1680 without asthma. Receiver operating characteristic (ROC) analysis was employed to assess the potential of inflammatory indices in indicating COVID-19 severity. Kaplan-Meier curves were utilized to analyze the survival probability with death as the outcome.

In deceased patients without asthma, leukocyte and differential cell counts and PLR, NLR, MLR, SII, and SIR-I values were higher than in survivors. In contrast, all the above values except PLR and MLR were significant in the asthma groups. The Kaplan-Meier survival curves were consistent with the ROC analysis. However, a multivariate Cox regression analysis revealed that neutrophil counts in patients without asthma and leukocyte and neutrophil counts in asthma patients were significant for survival.

In conclusion, while numerous inflammatory indices were associated with mortality in COVID-19 patients without asthma, neutrophil counts could independently predict mortality risk in asthma COVID-19 patients.