Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19

Objective: To examine any prospective association between neutrophil-to-lymphocyte ratio (NLR) at hospital admission and subsequent delirium in older COVID-19 hospitalized patients comparing by sex and age groups.Methods: The sample consisted of 1,785 COVID-19 adult inpatients (minimum sample size r...

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Autores principales:	Eduardo Fernández-Jiménez, Ainoa Muñoz-Sanjose, Roberto Mediavilla, Gonzalo Martínez-Alés, Iker I. Louzao, Jorge Andreo, Susana Cebolla, María-Fe Bravo-Ortiz, Carmen Bayón
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	neutrophil-to-lymphocyte ratio (NLR) delirium COVID-19 hospitalization older adults Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/815d8226e83145a2a9168da17a38a024
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spelling	oai:doaj.org-article:815d8226e83145a2a9168da17a38a0242021-11-30T13:34:39ZProspective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-191663-436510.3389/fnagi.2021.764334https://doaj.org/article/815d8226e83145a2a9168da17a38a0242021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fnagi.2021.764334/fullhttps://doaj.org/toc/1663-4365Objective: To examine any prospective association between neutrophil-to-lymphocyte ratio (NLR) at hospital admission and subsequent delirium in older COVID-19 hospitalized patients comparing by sex and age groups.Methods: The sample consisted of 1,785 COVID-19 adult inpatients (minimum sample size required of 635 participants) admitted to a public general hospital in Madrid (Spain) between March 16th and April 15th, 2020. Variables were obtained from electronic health records. Binary logistic regression models were performed between baseline NLR and delirium adjusting for age, sex, medical comorbidity, current illness severity, serious mental illness history and use of chloroquine and dexamethasone. An NLR cut-off was identified, and stratified analyses were performed by age and sex. Also, another biomarker was tested as an exposure (the systemic immune-inflammation index –SII).Results: 55.3% of the patients were men, with a mean age of 66.8 years. Roughly 13% of the patients had delirium during hospitalization. NLR on admission predicted subsequent delirium development (adjusted OR = 1.02, 95 percent CI: 1.00–1.04, p = 0.024). Patients between 69 and 80 years with NLR values > 6.3 presented a twofold increased risk for delirium (p = 0.004). There were no sex differences in the association between baseline NLR and delirium (p > 0.05) nor SII predicted delirium development (p = 0.341).Conclusion: NLR is a good predictor of delirium during hospitalization, especially among older adults, independently of medical comorbidity, illness severity, and other covariates. Routine blood tests on admission might provide valuable information to guide the decision-making process to be followed with these especially vulnerable patients.Eduardo Fernández-JiménezEduardo Fernández-JiménezAinoa Muñoz-SanjoseAinoa Muñoz-SanjoseRoberto MediavillaRoberto MediavillaGonzalo Martínez-AlésGonzalo Martínez-AlésGonzalo Martínez-AlésIker I. LouzaoJorge AndreoSusana CebollaSusana CebollaMaría-Fe Bravo-OrtizMaría-Fe Bravo-OrtizMaría-Fe Bravo-OrtizMaría-Fe Bravo-OrtizCarmen BayónCarmen BayónCarmen BayónFrontiers Media S.A.articleneutrophil-to-lymphocyte ratio (NLR)deliriumCOVID-19hospitalizationolder adultsNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENFrontiers in Aging Neuroscience, Vol 13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	neutrophil-to-lymphocyte ratio (NLR) delirium COVID-19 hospitalization older adults Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	neutrophil-to-lymphocyte ratio (NLR) delirium COVID-19 hospitalization older adults Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Eduardo Fernández-Jiménez Eduardo Fernández-Jiménez Ainoa Muñoz-Sanjose Ainoa Muñoz-Sanjose Roberto Mediavilla Roberto Mediavilla Gonzalo Martínez-Alés Gonzalo Martínez-Alés Gonzalo Martínez-Alés Iker I. Louzao Jorge Andreo Susana Cebolla Susana Cebolla María-Fe Bravo-Ortiz María-Fe Bravo-Ortiz María-Fe Bravo-Ortiz María-Fe Bravo-Ortiz Carmen Bayón Carmen Bayón Carmen Bayón Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19
description	Objective: To examine any prospective association between neutrophil-to-lymphocyte ratio (NLR) at hospital admission and subsequent delirium in older COVID-19 hospitalized patients comparing by sex and age groups.Methods: The sample consisted of 1,785 COVID-19 adult inpatients (minimum sample size required of 635 participants) admitted to a public general hospital in Madrid (Spain) between March 16th and April 15th, 2020. Variables were obtained from electronic health records. Binary logistic regression models were performed between baseline NLR and delirium adjusting for age, sex, medical comorbidity, current illness severity, serious mental illness history and use of chloroquine and dexamethasone. An NLR cut-off was identified, and stratified analyses were performed by age and sex. Also, another biomarker was tested as an exposure (the systemic immune-inflammation index –SII).Results: 55.3% of the patients were men, with a mean age of 66.8 years. Roughly 13% of the patients had delirium during hospitalization. NLR on admission predicted subsequent delirium development (adjusted OR = 1.02, 95 percent CI: 1.00–1.04, p = 0.024). Patients between 69 and 80 years with NLR values > 6.3 presented a twofold increased risk for delirium (p = 0.004). There were no sex differences in the association between baseline NLR and delirium (p > 0.05) nor SII predicted delirium development (p = 0.341).Conclusion: NLR is a good predictor of delirium during hospitalization, especially among older adults, independently of medical comorbidity, illness severity, and other covariates. Routine blood tests on admission might provide valuable information to guide the decision-making process to be followed with these especially vulnerable patients.
format	article
author	Eduardo Fernández-Jiménez Eduardo Fernández-Jiménez Ainoa Muñoz-Sanjose Ainoa Muñoz-Sanjose Roberto Mediavilla Roberto Mediavilla Gonzalo Martínez-Alés Gonzalo Martínez-Alés Gonzalo Martínez-Alés Iker I. Louzao Jorge Andreo Susana Cebolla Susana Cebolla María-Fe Bravo-Ortiz María-Fe Bravo-Ortiz María-Fe Bravo-Ortiz María-Fe Bravo-Ortiz Carmen Bayón Carmen Bayón Carmen Bayón
author_facet	Eduardo Fernández-Jiménez Eduardo Fernández-Jiménez Ainoa Muñoz-Sanjose Ainoa Muñoz-Sanjose Roberto Mediavilla Roberto Mediavilla Gonzalo Martínez-Alés Gonzalo Martínez-Alés Gonzalo Martínez-Alés Iker I. Louzao Jorge Andreo Susana Cebolla Susana Cebolla María-Fe Bravo-Ortiz María-Fe Bravo-Ortiz María-Fe Bravo-Ortiz María-Fe Bravo-Ortiz Carmen Bayón Carmen Bayón Carmen Bayón
author_sort	Eduardo Fernández-Jiménez
title	Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19
title_short	Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19
title_full	Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19
title_fullStr	Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19
title_full_unstemmed	Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19
title_sort	prospective analysis between neutrophil-to-lymphocyte ratio on admission and development of delirium among older hospitalized patients with covid-19
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/815d8226e83145a2a9168da17a38a024
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Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19

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