Association of inflammatory scoring tools with spirometry indices in COVID-19 patients: a single center cohort study
-
Mohsen Farrokhpour
,
Fahimeh Safarnezhad Tameshkel
,
Niloufar Sadat Kalaki
,
Azra Asghari Marzidareh
,
Aliarash Anoushirvani
,
Neda Rahimian
,
Mohammad Hadi Karbalaie Niya
Abstract
Background and Objectives: Patients with COVID-19 have spirometry parameters linked to various biological markers, including CRP, NLR, MPV, RDW, and APACHE II score. The objective of this study was to investigate the association of inflammatory scoring tools with spirometry indices in a three-month follow-up of COVID-19 patients.
Materials and Methods: Spirometry records of 369 COVID-19 cases with complications were analyzed at baseline and three months after discharge. Generalized linear models and logistic regression analysis were performed to compare the variables using SPSS version 25 software.
Results: The baseline NLR was 3.20 (95% CI: 2.96, 3.43); PCT was 0.26 (95% CI: 0.25, 0.27); and MPV was 7.23 (95% CI: 7.10, 7.35). We found that the effects of NLR, CRP, and APACHE II score on the respiratory indices FEV1 and FEV1/FVC three months after discharge had an inverse relationship. Patients with asthma had significantly lower FEV1 and FEV1/FVC values, and the level of FVC did not have any significant difference between people with asthma and COPD patients.
Conclusion: CRP, NLR, and APACHE II score are among the main factors that are directly related to respiratory indices and they are considered to be appropriate indicators of prognosis for these conditions in COVID-19 patients.
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24. Hlapčić I, Somborac-Bačura A, Popović-Grle S, Vukić Dugac A, Rogić D, Rako I, et al. Platelet indices in stable chronic obstructive pulmonary disease - association with inflammatory markers, comorbidities and therapy. Biochem Med (Zagreb) 2020; 30: 010701.
25. Wang JM, Yang KD, Wu SY, Zou XG, Liao YS, Yang B, et al. Platelet Parameters, C-Reactive Protein, and Depression: An Association Study. Int J Gen Med 2022; 15: 243-251.
26. Yuksel H, Dirik EB, Gursoy GT, Tan OO, Bektaş H, Yamanel L, et al. A simple scoring system in COVID-19 patients with neurological manifestations. Neurol Asia 2021; 26: 521-526.
2. Shang W, Wang Y, Yuan J, Guo Z, Liu J, Liu M. Global Excess Mortality during COVID-19 Pandemic: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10: 1702.
3. Tian W, Jiang W, Yao J, Nicholson CJ, Li RH, Sigurslid HH, et al. Predictors of mortality in hospitalized COVID-19 patients: A systematic review and meta-analysis. J Med Virol 2020; 92: 1875-1883.
4. COVID-ICU Group on behalf of the REVA Network and the COVID-ICU Investigators.Clinical characteristics and day-90 outcomes of 4244 critically ill adults with COVID-19: a prospective cohort study. Intensive Care Med 2021; 47: 60-73.
5. Aly MM, Meshref TS, Abdelhameid MA, Ahmed SA, Shaltout AS, Abdel-Moniem AE, et al. Can hematological ratios predict outcome of COVID-19 patients? a multicentric study. J Blood Med 2021; 12: 505-515.
6. Denorme F, Ajanel A, Campbell RA. Shining a light on platelet activation in COVID-19. J Thromb Haemost 2022; 20: 1286-1289.
7. Aydınyılmaz F, Aksakal E, Pamukcu HE, Aydemir S, Doğan R, Saraç İ, et al. Significance of MPV, RDW and PDW with the Severity and Mortality of COVID-19 and Effects of Acetylsalicylic Acid Use. Clin Appl Thromb Hemost 2021; 27: 10760296211048808.
8. Henry BM, Aggarwal G, Wong J, Benoit S, Vikse J, Plebani M, et al. Lactate dehydrogenase levels predict coronavirus disease 2019 (COVID-19) severity and mortality: A pooled analysis. Am J Emerg Med 2020; 38: 1722-1726.
9. Aon M, Alsaeedi A, Alzafiri A, Ibrahim MM, Al-Shammari A, Al-Shammari O, et al. The association between admission procalcitonin level and the Severity of COVID-19 Pneumonia: A Retrospective Cohort study. Medicina (Kaunas) 2022; 58: 1389.
10. Beigmohammadi MT, Amoozadeh L, Rezaei Motlagh F, Rahimi M, Maghsoudloo M, Jafarnejad B, et al. Mortality predictive value of APACHE II and SOFA scores in COVID-19 patients in the intensive care unit. Can Respir J 2022; 2022: 5129314.
11. Barreiro TJ, Perillo I. An approach to interpreting spirometry. Am Fam Physician 2004; 69: 1107-1114.
12. Langan RC, Goodbred AJ. Office spirometry: indications and interpretation. Am Fam Physician 2020; 101: 362-368.
13. Burrill A, McArdle C, Davies B. Lung function in children: a simple guide to performing and interpreting spirometry. J Paediatr Child Health 2021; 31: 276-283.
14. Patil S, Patil R, Gondhali G. Pulmonary functions assessment in post-COVID-19 pneumonia cases by spirometry: Study of 600 cases in tertiary care setting in India. J Appl Sci Clin Pract 2023; 4: 94-100.
15. Brojakowska A, Eskandari A, Bisserier M, Bander J, Garikipati VNS, Hadri L, et al. Comorbidities, sequelae, blood biomarkers and their associated clinical outcomes in the Mount Sinai Health System COVID-19 patients. PLoS One 2021; 16(7): e0253660.
16. Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 2023; 401(10393): e21-e33.
17. Wu JH, Li YN, Chen AQ, Hong CD, Zhang CL, Wang HL, et al. Inhibition of Sema4D/PlexinB1 signaling alleviates vascular dysfunction in diabetic retinopathy. EMBO Mol Med 2020; 12(2): e10154.
18. Sun W, Luo Z, Cao Z, Wang J, Zhang L, Ma Y. A combination of the APACHE II score, neutrophil/lymphocyte ratio, and expired tidal volume could predict non-invasive ventilation failure in pneumonia-induced mild to moderate acute respiratory distress syndrome patients. Ann Transl Med 2022; 10: 407.
19. El Bakry RAR, Sayed AIT. Chest CT manifestations with emphasis on the role of CT scoring and serum ferritin/lactate dehydrogenase in prognosis of coronavirus disease 2019 (COVID-19). Egypt J Radiol Nucl Med 2021; 52: 10.1186/s43055-021-00459-4.
20. Zou X, Li S, Fang M, Hu M, Bian Y, Ling J, et al. Acute physiology and chronic health evaluation II score as a predictor of hospital mortality in patients of coronavirus disease 2019. Crit Care Med 2020; 48(8): e657-e665.
21. Sirayder U, Inal-Ince D, Kepenek-Varol B, Acik C. Long-Term Characteristics of Severe COVID-19: Respiratory Function, Functional Capacity, and Quality of Life. Int J Environ Res Public Health 2022; 19: 6304.
22. Sibila O, Albacar N, Perea L, Faner R, Torralba Y, Hernandez-Gonzalez F, et al. Lung function sequelae in COVID-19 Patients 3 months after hospital discharge. Arch Bronconeumol 2021; 57: 59-61.
23. Sun W, Luo Z, Jin J, Cao Z, Ma Y. The Neutrophil/Lymphocyte ratio could predict noninvasive mechanical ventilation failure in patients with acute exacerbation of chronic obstructive pulmonary disease: A Retrospective observational study. Int J Chron Obstruct Pulmon Dis 2021; 16: 2267-2277.
24. Hlapčić I, Somborac-Bačura A, Popović-Grle S, Vukić Dugac A, Rogić D, Rako I, et al. Platelet indices in stable chronic obstructive pulmonary disease - association with inflammatory markers, comorbidities and therapy. Biochem Med (Zagreb) 2020; 30: 010701.
25. Wang JM, Yang KD, Wu SY, Zou XG, Liao YS, Yang B, et al. Platelet Parameters, C-Reactive Protein, and Depression: An Association Study. Int J Gen Med 2022; 15: 243-251.
26. Yuksel H, Dirik EB, Gursoy GT, Tan OO, Bektaş H, Yamanel L, et al. A simple scoring system in COVID-19 patients with neurological manifestations. Neurol Asia 2021; 26: 521-526.
| Files | ||
| Issue | Vol 17 No 6 (2025) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijm.v17i6.20375 | |
| Keywords | ||
| COVID-19 Biomarkers Respiratory function tests Prognosis Biological factors Inflammation mediators | ||
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How to Cite
1.
Farrokhpour M, Safarnezhad Tameshkel F, Sadat Kalaki N, Asghari Marzidareh A, Anoushirvani A, Rahimian N, Karbalaie Niya MH. Association of inflammatory scoring tools with spirometry indices in COVID-19 patients: a single center cohort study. Iran J Microbiol. 2025;17(6):1042-1048.
