Prognostic Value of Leucocyte to High-Density Lipoprotein-Cholesterol Ratios in COVID-19 Patients and the Diabetes Subgroup
BackgroundBlood parameters, such as neutrophil-to-lymphocyte ratio, have been identified as reliable inflammatory markers with diagnostic and predictive value for the coronavirus disease 2019 (COVID-19). However, novel hematological parameters derived from high-density lipoprotein-cholesterol (HDL-C...
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Frontiers Media S.A.
2021-09-01
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Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2021.727419/full |
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DOAJ |
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English |
format |
Article |
sources |
DOAJ |
author |
Yuxiu Wang Yuxiu Wang Jiaoyue Zhang Jiaoyue Zhang Huiqing Li Huiqing Li Wen Kong Wen Kong Juan Zheng Juan Zheng Yan Li Qi Wei Qin Li Li Yang Ying Xu Li Li Hanyu Wang Hanyu Wang Hui Sun Hui Sun Wenfang Xia Wenfang Xia Geng Liu Geng Liu Xueyu Zhong Xueyu Zhong Kangli Qiu Kangli Qiu Han Wang Han Wang Hua Liu Hua Liu Xiaoli Song Xiaoli Song Si Xiong Yumei Liu Zhenhai Cui Zhenhai Cui Lulu Chen Lulu Chen Tianshu Zeng Tianshu Zeng |
spellingShingle |
Yuxiu Wang Yuxiu Wang Jiaoyue Zhang Jiaoyue Zhang Huiqing Li Huiqing Li Wen Kong Wen Kong Juan Zheng Juan Zheng Yan Li Qi Wei Qin Li Li Yang Ying Xu Li Li Hanyu Wang Hanyu Wang Hui Sun Hui Sun Wenfang Xia Wenfang Xia Geng Liu Geng Liu Xueyu Zhong Xueyu Zhong Kangli Qiu Kangli Qiu Han Wang Han Wang Hua Liu Hua Liu Xiaoli Song Xiaoli Song Si Xiong Yumei Liu Zhenhai Cui Zhenhai Cui Lulu Chen Lulu Chen Tianshu Zeng Tianshu Zeng Prognostic Value of Leucocyte to High-Density Lipoprotein-Cholesterol Ratios in COVID-19 Patients and the Diabetes Subgroup Frontiers in Endocrinology cohort study coronavirus COVID-19 neutrophil to high-density lipoprotein-cholesterol high-density lipoprotein-cholesterol prognosis |
author_facet |
Yuxiu Wang Yuxiu Wang Jiaoyue Zhang Jiaoyue Zhang Huiqing Li Huiqing Li Wen Kong Wen Kong Juan Zheng Juan Zheng Yan Li Qi Wei Qin Li Li Yang Ying Xu Li Li Hanyu Wang Hanyu Wang Hui Sun Hui Sun Wenfang Xia Wenfang Xia Geng Liu Geng Liu Xueyu Zhong Xueyu Zhong Kangli Qiu Kangli Qiu Han Wang Han Wang Hua Liu Hua Liu Xiaoli Song Xiaoli Song Si Xiong Yumei Liu Zhenhai Cui Zhenhai Cui Lulu Chen Lulu Chen Tianshu Zeng Tianshu Zeng |
author_sort |
Yuxiu Wang |
title |
Prognostic Value of Leucocyte to High-Density Lipoprotein-Cholesterol Ratios in COVID-19 Patients and the Diabetes Subgroup |
title_short |
Prognostic Value of Leucocyte to High-Density Lipoprotein-Cholesterol Ratios in COVID-19 Patients and the Diabetes Subgroup |
title_full |
Prognostic Value of Leucocyte to High-Density Lipoprotein-Cholesterol Ratios in COVID-19 Patients and the Diabetes Subgroup |
title_fullStr |
Prognostic Value of Leucocyte to High-Density Lipoprotein-Cholesterol Ratios in COVID-19 Patients and the Diabetes Subgroup |
title_full_unstemmed |
Prognostic Value of Leucocyte to High-Density Lipoprotein-Cholesterol Ratios in COVID-19 Patients and the Diabetes Subgroup |
title_sort |
prognostic value of leucocyte to high-density lipoprotein-cholesterol ratios in covid-19 patients and the diabetes subgroup |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Endocrinology |
issn |
1664-2392 |
publishDate |
2021-09-01 |
description |
BackgroundBlood parameters, such as neutrophil-to-lymphocyte ratio, have been identified as reliable inflammatory markers with diagnostic and predictive value for the coronavirus disease 2019 (COVID-19). However, novel hematological parameters derived from high-density lipoprotein-cholesterol (HDL-C) have rarely been studied as indicators for the risk of poor outcomes in patients with severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) infection. Here, we aimed to assess the prognostic value of these novel biomarkers in COVID-19 patients and the diabetes subgroup.MethodsWe conducted a multicenter retrospective cohort study involving all hospitalized patients with COVID-19 from January to March 2020 in five hospitals in Wuhan, China. Demographics, clinical and laboratory findings, and outcomes were recorded. Neutrophil to HDL-C ratio (NHR), monocyte to HDL-C ratio (MHR), lymphocyte to HDL-C ratio (LHR), and platelet to HDL-C ratio (PHR) were investigated and compared in both the overall population and the subgroup with diabetes. The associations between blood parameters at admission with primary composite end-point events (including mechanical ventilation, admission to the intensive care unit, or death) were analyzed using Cox proportional hazards regression models. Receiver operating characteristic curves were used to compare the utility of different blood parameters.ResultsOf 440 patients with COVID-19, 67 (15.2%) were critically ill. On admission, HDL-C concentration was decreased while NHR was high in patients with critical compared with non-critical COVID-19, and were independently associated with poor outcome as continuous variables in the overall population (HR: 0.213, 95% CI 0.090–0.507; HR: 1.066, 95% CI 1.030–1.103, respectively) after adjusting for confounding factors. Additionally, when HDL-C and NHR were examined as categorical variables, the HRs and 95% CIs for tertile 3 vs. tertile 1 were 0.280 (0.128–0.612) and 4.458 (1.817–10.938), respectively. Similar results were observed in the diabetes subgroup. ROC curves showed that the NHR had good performance in predicting worse outcomes. The cutoff point of the NHR was 5.50. However, the data in our present study could not confirm the possible predictive effect of LHR, MHR, and PHR on COVID-19 severity.ConclusionLower HDL-C concentrations and higher NHR at admission were observed in patients with critical COVID-19 than in those with noncritical COVID-19, and were significantly associated with a poor prognosis in COVID-19 patients as well as in the diabetes subgroup. |
topic |
cohort study coronavirus COVID-19 neutrophil to high-density lipoprotein-cholesterol high-density lipoprotein-cholesterol prognosis |
url |
https://www.frontiersin.org/articles/10.3389/fendo.2021.727419/full |
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doaj-1429f2d6136f433b88ad7a04628004152021-09-13T05:38:14ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922021-09-011210.3389/fendo.2021.727419727419Prognostic Value of Leucocyte to High-Density Lipoprotein-Cholesterol Ratios in COVID-19 Patients and the Diabetes SubgroupYuxiu Wang0Yuxiu Wang1Jiaoyue Zhang2Jiaoyue Zhang3Huiqing Li4Huiqing Li5Wen Kong6Wen Kong7Juan Zheng8Juan Zheng9Yan Li10Qi Wei11Qin Li12Li Yang13Ying Xu14Li Li15Hanyu Wang16Hanyu Wang17Hui Sun18Hui Sun19Wenfang Xia20Wenfang Xia21Geng Liu22Geng Liu23Xueyu Zhong24Xueyu Zhong25Kangli Qiu26Kangli Qiu27Han Wang28Han Wang29Hua Liu30Hua Liu31Xiaoli Song32Xiaoli Song33Si Xiong34Yumei Liu35Zhenhai Cui36Zhenhai Cui37Lulu Chen38Lulu Chen39Tianshu Zeng40Tianshu Zeng41Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, ChinaDepartment of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, ChinaDepartment of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, ChinaDepartment of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, ChinaDepartment of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, ChinaDepartment of Endocrinology, Wuhan Wuchang Hospital, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, ChinaDepartment of Endocrinology, Red Cross Hospital of Wuhan City, Wuhan, ChinaDepartment of Endocrinology, General Hospital of the Yangtze River Shipping, Wuhan, ChinaDepartment of Endocrinology, Hankou Hospital of Wuhan City, Wuhan, ChinaDepartment of Endocrinology, The Fifth Hospital of Wuhan, Wuhan, ChinaDepartment of Endocrinology, Wuhan Wuchang Hospital, Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, ChinaDepartment of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, ChinaDepartment of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, ChinaDepartment of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, ChinaDepartment of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, ChinaDepartment of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, ChinaDepartment of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, ChinaDepartment of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, ChinaDepartment of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, ChinaDepartment of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, ChinaDepartment of Endocrinology, The Fifth Hospital of Wuhan, Wuhan, ChinaDepartment of Endocrinology, Hankou Hospital of Wuhan City, Wuhan, ChinaDepartment of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, ChinaDepartment of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, ChinaDepartment of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaHubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, ChinaBackgroundBlood parameters, such as neutrophil-to-lymphocyte ratio, have been identified as reliable inflammatory markers with diagnostic and predictive value for the coronavirus disease 2019 (COVID-19). However, novel hematological parameters derived from high-density lipoprotein-cholesterol (HDL-C) have rarely been studied as indicators for the risk of poor outcomes in patients with severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) infection. Here, we aimed to assess the prognostic value of these novel biomarkers in COVID-19 patients and the diabetes subgroup.MethodsWe conducted a multicenter retrospective cohort study involving all hospitalized patients with COVID-19 from January to March 2020 in five hospitals in Wuhan, China. Demographics, clinical and laboratory findings, and outcomes were recorded. Neutrophil to HDL-C ratio (NHR), monocyte to HDL-C ratio (MHR), lymphocyte to HDL-C ratio (LHR), and platelet to HDL-C ratio (PHR) were investigated and compared in both the overall population and the subgroup with diabetes. The associations between blood parameters at admission with primary composite end-point events (including mechanical ventilation, admission to the intensive care unit, or death) were analyzed using Cox proportional hazards regression models. Receiver operating characteristic curves were used to compare the utility of different blood parameters.ResultsOf 440 patients with COVID-19, 67 (15.2%) were critically ill. On admission, HDL-C concentration was decreased while NHR was high in patients with critical compared with non-critical COVID-19, and were independently associated with poor outcome as continuous variables in the overall population (HR: 0.213, 95% CI 0.090–0.507; HR: 1.066, 95% CI 1.030–1.103, respectively) after adjusting for confounding factors. Additionally, when HDL-C and NHR were examined as categorical variables, the HRs and 95% CIs for tertile 3 vs. tertile 1 were 0.280 (0.128–0.612) and 4.458 (1.817–10.938), respectively. Similar results were observed in the diabetes subgroup. ROC curves showed that the NHR had good performance in predicting worse outcomes. The cutoff point of the NHR was 5.50. However, the data in our present study could not confirm the possible predictive effect of LHR, MHR, and PHR on COVID-19 severity.ConclusionLower HDL-C concentrations and higher NHR at admission were observed in patients with critical COVID-19 than in those with noncritical COVID-19, and were significantly associated with a poor prognosis in COVID-19 patients as well as in the diabetes subgroup.https://www.frontiersin.org/articles/10.3389/fendo.2021.727419/fullcohort studycoronavirusCOVID-19neutrophil to high-density lipoprotein-cholesterolhigh-density lipoprotein-cholesterolprognosis |