Predictive Significance of the Prognostic Nutritional Index (PNI) in Patients with Severe COVID-19
Background. The prognostic nutritional index (PNI) has been reported to significantly correlate with poor survival and postoperative complications in patients with various diseases, but its relationship with mortality in COVID-19 patients has not been addressed. Method. A multicenter retrospective s...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Journal of Immunology Research |
| Online Access: | http://dx.doi.org/10.1155/2021/9917302 |
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| author | Wei Wei Xingyue Wu Chaoyuan Jin Tong Mu Guorong Gu Min Min Sucheng Mu Yi Han |
| author_facet | Wei Wei Xingyue Wu Chaoyuan Jin Tong Mu Guorong Gu Min Min Sucheng Mu Yi Han |
| author_sort | Wei Wei |
| collection | DOAJ |
| description | Background. The prognostic nutritional index (PNI) has been reported to significantly correlate with poor survival and postoperative complications in patients with various diseases, but its relationship with mortality in COVID-19 patients has not been addressed. Method. A multicenter retrospective study involving patients with severe COVID-19 was conducted to investigate whether malnutrition and other clinical characteristics could be used to stratify the patients based on risk. Results. A total of 395 patients were included in our study, with 236 patients in the training cohort, 59 patients in the internal validation cohort, and 100 patients in the external validation cohort. During hospitalization, 63/236 (26.69%) and 14/59 (23.73%) patients died in the training and validation cohorts, respectively. PNI had the strongest relationships with the neutrophil-lymphocyte ratio (NLR) and lactate dehydrogenase (LDH) level but was less strongly correlated with the CURB65, APACHE II, and SOFA scores. The baseline PNI score, platelet (PLT) count, LDH level, and PaO2/FiO2 (P/F) ratio were independent predictors of mortality in COVID-19 patients. A nomogram incorporating these four predictors showed good calibration and discrimination in the derivation and validation cohorts. A PNI score less than 33.405 was associated with a higher risk of mortality in severe COVID-19 patients in the Cox regression analysis. Conclusion. These findings have implications for predicting the risk of mortality in COVID-19 patients at the time of admission and provide the first direct evidence that a lower PNI is related to a worse prognosis in severe COVID-19 patients. |
| format | Article |
| id | doaj-art-320db63752234da0a8f6e5a286c5c541 |
| institution | OA Journals |
| issn | 2314-8861 2314-7156 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
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| series | Journal of Immunology Research |
| spelling | doaj-art-320db63752234da0a8f6e5a286c5c5412025-08-20T02:07:40ZengWileyJournal of Immunology Research2314-88612314-71562021-01-01202110.1155/2021/99173029917302Predictive Significance of the Prognostic Nutritional Index (PNI) in Patients with Severe COVID-19Wei Wei0Xingyue Wu1Chaoyuan Jin2Tong Mu3Guorong Gu4Min Min5Sucheng Mu6Yi Han7Department of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, ChinaNanjing Sport Institute, Nanjing, ChinaDepartment of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, ChinaDepartment of Emergency Medicine, Zhongshan Hospital, Fudan University, Shanghai, ChinaBackground. The prognostic nutritional index (PNI) has been reported to significantly correlate with poor survival and postoperative complications in patients with various diseases, but its relationship with mortality in COVID-19 patients has not been addressed. Method. A multicenter retrospective study involving patients with severe COVID-19 was conducted to investigate whether malnutrition and other clinical characteristics could be used to stratify the patients based on risk. Results. A total of 395 patients were included in our study, with 236 patients in the training cohort, 59 patients in the internal validation cohort, and 100 patients in the external validation cohort. During hospitalization, 63/236 (26.69%) and 14/59 (23.73%) patients died in the training and validation cohorts, respectively. PNI had the strongest relationships with the neutrophil-lymphocyte ratio (NLR) and lactate dehydrogenase (LDH) level but was less strongly correlated with the CURB65, APACHE II, and SOFA scores. The baseline PNI score, platelet (PLT) count, LDH level, and PaO2/FiO2 (P/F) ratio were independent predictors of mortality in COVID-19 patients. A nomogram incorporating these four predictors showed good calibration and discrimination in the derivation and validation cohorts. A PNI score less than 33.405 was associated with a higher risk of mortality in severe COVID-19 patients in the Cox regression analysis. Conclusion. These findings have implications for predicting the risk of mortality in COVID-19 patients at the time of admission and provide the first direct evidence that a lower PNI is related to a worse prognosis in severe COVID-19 patients.http://dx.doi.org/10.1155/2021/9917302 |
| spellingShingle | Wei Wei Xingyue Wu Chaoyuan Jin Tong Mu Guorong Gu Min Min Sucheng Mu Yi Han Predictive Significance of the Prognostic Nutritional Index (PNI) in Patients with Severe COVID-19 Journal of Immunology Research |
| title | Predictive Significance of the Prognostic Nutritional Index (PNI) in Patients with Severe COVID-19 |
| title_full | Predictive Significance of the Prognostic Nutritional Index (PNI) in Patients with Severe COVID-19 |
| title_fullStr | Predictive Significance of the Prognostic Nutritional Index (PNI) in Patients with Severe COVID-19 |
| title_full_unstemmed | Predictive Significance of the Prognostic Nutritional Index (PNI) in Patients with Severe COVID-19 |
| title_short | Predictive Significance of the Prognostic Nutritional Index (PNI) in Patients with Severe COVID-19 |
| title_sort | predictive significance of the prognostic nutritional index pni in patients with severe covid 19 |
| url | http://dx.doi.org/10.1155/2021/9917302 |
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