Relación neutrófilo-plaquetaria como factor pronóstico de severidad y mortalidad en pacientes con Covid-19
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Date
2025-01-15
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Universidad Nacional de Trujillo
Abstract
La COVID-19, responsable de una alta mortalidad en Perú, resaltó la necesidad de optimizar recursos en salud. El hemograma y sus relaciones derivadas, como la relación neutrófilo-plaquetaria (NPR), muestran potencial como herramientas pronósticas en diversas patologías. Este estudio analiza la utilidad de la NPR para predecir severidad y mortalidad en pacientes con COVID-19.
Métodos: Este estudio de cohorte retrospectiva, realizado en el Hospital Regional Docente de Trujillo, evaluó la relación neutrófilos/plaquetas (NPR) como marcador pronóstico de mortalidad por COVID-19. Se analizaron historias clínicas de pacientes hospitalizados entre 2020-2022. El desenlace principal fue mortalidad, y los secundarios severidad y estancia hospitalaria. Se desarrollaron análisis multivariados estimando Odds Ratios (OR).
Resultados: NPR mostró asociación significativa con la mortalidad por COVID-19 en análisis multivariado (Modelo 1: aOR 1.5; IC95%:1.1-2.0; p=0.002; Modelo 2: aOR 1.3; IC95%:1.1-1.6; p=0.001) y predicción de mortalidad (AUC=0.75). También se asoció con estancias hospitalarias >30 días (Modelo A: aOR 1.2; IC95%:1.01-1.52; p=0.04). NPR categorizado (≥3.7) mantuvo la asociación con estancias prolongadas en Modelos B (aOR 6.3; IC95%:1.01-39.1; p=0.048) y C (aOR 5.8; IC95%:1.07-31.4; p=0.041).
Conclusiones: La NPR posee un valor pronóstico de mortalidad por COVID-19, y se asoció a una estancia hospitalaria mayor a 30 días.
Palabras clave: COVID-19, mortalidad, índice neutrófilo-plaquetas
Abstract COVID-19, responsible for high mortality in Peru, highlighted the need to optimize healthcare resources. The complete blood count and its derived ratios, such as the neutrophil-to-platelet ratio (NPR), show potential as prognostic tools in various diseases. This study analyzes the usefulness of NPR in predicting severity and mortality in COVID-19 patients. Methods: This retrospective cohort study, conducted at the Regional Teaching Hospital of Trujillo, evaluated the neutrophil-to-platelet ratio (NPR) as a prognostic marker of COVID-19 mortality. Medical records of hospitalized patients from 2020–2022 were analyzed. The primary outcome was mortality, while secondary outcomes included severity and length of hospital stay. Multivariate analyses estimating Odds Ratios (ORs) were performed. Results: NPR showed a significant association with COVID-19 mortality in multivariate analysis (Model 1: aOR 1.5; 95%CI:1.1–2.0; p=0.002; Model 2: aOR 1.3; 95%CI:1.1–1.6; p=0.001) and mortality prediction (AUC=0.75). It was also associated with hospital stays longer than 30 days (Model A: aOR 1.2; 95%CI:1.01–1.52; p=0.04). Categorized NPR (≥3.7) remained associated with prolonged stays in Models B (aOR 6.3; 95%CI:1.01–39.1; p=0.048) and C (aOR 5.8; 95%CI:1.07–31.4; p=0.041). Conclusions: NPR has prognostic value for COVID-19 mortality and was associated with hospital stays longer than 30 days.
Abstract COVID-19, responsible for high mortality in Peru, highlighted the need to optimize healthcare resources. The complete blood count and its derived ratios, such as the neutrophil-to-platelet ratio (NPR), show potential as prognostic tools in various diseases. This study analyzes the usefulness of NPR in predicting severity and mortality in COVID-19 patients. Methods: This retrospective cohort study, conducted at the Regional Teaching Hospital of Trujillo, evaluated the neutrophil-to-platelet ratio (NPR) as a prognostic marker of COVID-19 mortality. Medical records of hospitalized patients from 2020–2022 were analyzed. The primary outcome was mortality, while secondary outcomes included severity and length of hospital stay. Multivariate analyses estimating Odds Ratios (ORs) were performed. Results: NPR showed a significant association with COVID-19 mortality in multivariate analysis (Model 1: aOR 1.5; 95%CI:1.1–2.0; p=0.002; Model 2: aOR 1.3; 95%CI:1.1–1.6; p=0.001) and mortality prediction (AUC=0.75). It was also associated with hospital stays longer than 30 days (Model A: aOR 1.2; 95%CI:1.01–1.52; p=0.04). Categorized NPR (≥3.7) remained associated with prolonged stays in Models B (aOR 6.3; 95%CI:1.01–39.1; p=0.048) and C (aOR 5.8; 95%CI:1.07–31.4; p=0.041). Conclusions: NPR has prognostic value for COVID-19 mortality and was associated with hospital stays longer than 30 days.
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Keywords
COVID-19, Mortalidad, Indice Neutrófilo-Plaquetas