A scoring system based on hematochemical parameters in predicting the prognosis of patients hospitalized with COVID-19 in Wuhan, China: a cross-sectional study (Preprint)

Abstract

To determine predictors of in-hospital mortality related to coronavirus disease 2019(COVID-19) patients.

This study aimed to explore the value of the NLR-LDH-BUN score based on the neutrophil to lymphocyte ratio (NLR), lactate dehydrogenase (LDH), and blood urea nitrogen (BUN) in predicting the prognosis of patients with COVID-19.

A total of 2,957 COVID-19 patients between December 2019 and March 2020 were retrospectively analyzed. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cutoff values for NLR, LDH, and BUN. According to these cutoff values, patients with high NLR (≥3.83), high LDH (≥276 U/L), and elevated BUN (≥6.4 mmol/L) were defined as having a score of 3; if none of the patients’ three parameters met these standards, they were given a score of 0; if any two or one parameters met these standards, they were scored as 2 or 1, respectively. The correlation between the NLR-LDH-BUN score and COVID-19 mortality was also evaluated.

The mean overall survival in patients with NLR-LDH-BUN =3 was lower than that in patients with NLR-LDH-BUN = 2, 1, or 0 (P<0.001). Multivariate analysis revealed that age, dyspnea, expectoration, the status of illness on admission, and the NLR-LDH-BUN score were independent prognostic factors for COVID-19 mortality. Patients with NLR-LDH-BUN scores of 2 and 3 were demonstrated to have a higher mortality risk.

A high NLR-LDH-BUN score was an independent risk factor for COVID-19 mortality. Therefore, the scoring system may be applied to predict prognosis and identify high-risk patients.