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Derived inflammatory indexes from routine hematological parameters might be useful for predicting early-response vs. late/non-response to dupilumab, the first biological agent approved for moderate-to-severe atopic dermatitis (AD). We tested this hypothesis by retrospectively investigating the association between pre-specified baseline inflammatory indexes and dupilumab response (≥50% reduction in the Eczema Area and Severity Index, EASI 50) at 4 and 16 weeks in a consecutive series of 66 AD patients (38 males and 28 females). Forty-six patients (69.7%) were early-responders at 4 weeks, whereas the remaining twenty (30.3%) were late/non-responders at 16 weeks. In logistic regression, the platelet-to-lymphocyte ratio (PLR) was independently associated with early-response (OR = 1.0159, 95% CI 1.0005 to 1.0315, p = 0.0426). The predictive performance of PLR and other derived indexes towards early-response was further improved by their combination with serum IgE concentrations, with a maximum AUC value for the combined systemic immune inflammation index (SII)-IgE of 0.797 (95% CI = 0.677 to 0.884, p < 0.0001). Derived inflammatory indexes, particularly SII-IgE, might be useful to identify early-responders to dupilumab and develop alternative treatment protocols for late/non-responders. [ABSTRACT FROM AUTHOR]

Background: Since the beginning of the SARS-CoV-2 pandemic, the ability to predict the trajectory of the disease has represented a major challenge for clinicians. There is recent evidence that complete blood cell count (CBC)-derived inflammation indexes have predictive value in COVID-19. We aimed to describe any changes in the clinical features, CBC-derived ratios, and outcomes of patients admitted to our hospital across two temporally distinct waves. Methods: We retrospectively assessed and compared the clinical characteristics and blood cell count values of patients hospitalized during the second and fourth waves of COVID-19, and explored any outcome differences in terms of the level of respiratory support required and transfer to intensive care. Results: We observed that fourth-wave patients were older, less male-predominant, and carried more comorbidities compared to the second-wave patients but, nevertheless, experienced more favorable outcomes. A strong internal correlation was documented for both waves between outcomes and CBC-derived ratios, with the fourth-wave cases displaying lower admission values of the neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammation index (SII). No significant differences were found for lymphocyte-to-monocyte ratio (LMR), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI). Conclusions: We observed that both admission values of CBC-derived indexes and adverse respiratory outcomes decreased from the second to the fourth wave of COVID-19. These data represent a contribution to the existing knowledge on the role of CBC-derived indexes as a potential tool to help clinicians to quickly differentiate in-hospital patients at increased risk of serious illness and death. [ABSTRACT FROM AUTHOR]

Variable patterns of disease progression are typically observed in patients with idiopathic pulmonary fibrosis (IPF). We sought to determine the prognostic capacity of blood cell count indexes, derived from routine complete blood cell (CBC) count, in a cohort of IPF patients. The neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) were calculated at baseline in a consecutive series of 82 IPF patients followed for four years. After adjusting for age, gender, body mass index, smoking status, and disease stage, only the AISI was significantly associated with mortality (HR 1.0013, 95% CI 1.0003–1.0023, p = 0.015). Patients with AISI <434 and ≥434 had a median survival from the diagnosis of 35.3 ± 15.2 and 26.6 ± 16.3 months (p = 0.015), and a four-year survival rate of 54% and 34%, respectively. The AISI, easily derivable from routine laboratory tests, is independently associated with mortality in patients with IPF. Prospective studies in larger cohorts are required to confirm this association. [ABSTRACT FROM AUTHOR]