Comparison of systemic immune-inflammation index (SII), early warning score (ANDC) and prognostic nutritional index (PNI) in hospitalized patients with malignancy, and their influence on mortality from COVID-19

Muge Bilge; Isil Kibar Akilli; Ekrem Bilal Karaayvaz; Aylia Yesilova; Kadriye Kart Yasar

doi:10.1186/s13027-021-00400-4

Comparison of systemic immune-inflammation index (SII), early warning score (ANDC) and prognostic nutritional index (PNI) in hospitalized patients with malignancy, and their influence on mortality from COVID-19

Infect Agent Cancer. 2021 Sep 15;16(1):60. doi: 10.1186/s13027-021-00400-4.

Authors

Muge Bilge¹, Isil Kibar Akilli², Ekrem Bilal Karaayvaz³, Aylia Yesilova⁴, Kadriye Kart Yasar⁵

Affiliations

¹ Department of Internal Medicine, Prof. Dr. Cemil Tascioglu City Hospital, University of Health Sciences, Darulaceze Street, No: 27 Sisli, 34384, Istanbul, Turkey. mugebilge@yahoo.com.
² Department of Pulmonary Disease, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Halaskargazi Street, 34371, Istanbul, Turkey.
³ Department of Cardiology, Istanbul Medical Faculty, University of Istanbul, Turgut Ozal Millet Street, Fatih, 34093, Istanbul, Turkey.
⁴ Department of Internal Medicine, Prof. Dr. Cemil Tascioglu City Hospital, University of Health Sciences, Darulaceze Street, No: 27 Sisli, 34384, Istanbul, Turkey.
⁵ Department of Infectious Disease, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Dr. Tevfik Saglam Street, No: 11, Bakirkoy, 34147, Istanbul, Turkey.

Abstract

Introduction: We evaluated several biological indicators based on inflammation and/or nutritional status, such as systemic immune-inflammation index (SII), early warning score (ANDC) and prognostic nutritional index (PNI) in hospitalized COVID-19 patients with and without malignancies for a prognostic significance.

Methodology: This is a retrospective and observational study on 186 patients with SARS-CoV-2, who were diagnosed with COVID-19 by real-time PCR testing and hospitalized due to COVID-19 pneumonia. 75 patients had various malignancies, and the rest (111), having a similar age and comorbidity profile based on propensity score matching, had no malignancy.

Results: None of the measures as neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, monocyte to lymphocyte ratio, SII, PNI or ANDC was found to be significantly different between two groups. Odds ratio for the mortality, OR 2.39 (%95 CI 1.80-3.16) was found to be significantly higher for the malignancy group, even though the duration of hospitalization was statistically similar for both groups. PNI was found to be significantly lower for deceased patients compared with survivors in the malignancy group. Contrarily, ANDC was found to be significantly higher for deceased patients in the malignancy group.

Conclusions: PNI and ANDC have independent predictive power on determining the in-hospital death in COVID-19 malignancy cases. It is suggested that ANDC seems to be a more sensitive score than SII in COVID-19 cases with malignancies.

Keywords: ANDC; COVID-19 pneumonia; Malignancy; PNI; SII.