Prognostic value of the SII Systemic Immune-Inflammation Index a novel biomarker in coronavirus disease 2019 patient’s disease progression to fatality

Sajjad Ali; Ashraf; Ishtiq Ahmad; Nabi Rahman; Shah Zeb; Muhammad Abbas

Abstract
Objective: To identify a novel biomarker with high prognostic value SII Systemic Immune-Inflammation Index in the disease progression of COVID-19 patients with its cost effectiveness and less time consuming.
Methodology: This cross-sectional study was carried out from November 2021 to February 2022 at the Mardan Medical Complex, Khyber Pakhtunkhwah, Pakistan. The receiver operating characteristic (ROC) curve analysis was used to discover the ideal cut-off values for predictors for disease severity stage, i.e. asymptomatic, mild, moderate, severe, critical, based on their greatest Youden's index. The SII (platelet X neutrophil count/lymphocyte counts) formula was used to compute the systemic immune inflammation index.
Results: Of the 311 cases studied, 233 were included; 155(66.52%) were male and 78(33.47%) females. Median age was 38 years (IQR: 18-79). Patients had a significant increase in various blood parameters, with an increase in SII index between admission and hospitalization. Normal patients had a SII median 398(IQR:312-567) upon admission, while abnormal patients had a SII median 659(IQR:475-1540). Throughout hospitalization, SII index of asymptomatic patients median was 684(IQR: 470-933); cut-off value ≥358, mild patients median 909(IQR:183-1930); cut-off value ≥501, moderate patients median ≥992(IQR:248-6099); cut-off value ≥903, severe patients median 1063(IQR:104-5014); cut-off value ≥1147, critical patients median 1230(IQR:100-8438); cut-off value ≥1481.
Conclusion: SII was found to be a significant predictor of COVID-19 patients’ severity progression to fatality as an independent prognostic factor. SII is being recommended as a low-cost and less time-consuming blood test for COVID-19 patients.

Key words: Severity, fatality, SII, prognostic, novel biomarker, COVID-19.

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