Prognostic Value of Admission Neutrophil Count in Asthma Patients with COVID-19: A Comparative Analysis with other Systemic Inflammation Indices for In-Hospital Mortality Prediction

Despite studies indicating that asthma patients do not exhibit a higher mortality rate or severity compared to the general population when infected with COVID-19, there have been few reports on predictive factors for mortality in this context. This study aimed to assess the predictive value of systemic inflammation indices including neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte (PLR), systemic inflammation response index (SIR-I), and systemic inflammation index (SII) in determining mortality rate among patients with COVID-19 and asthma. In this prospective study, the laboratory parameters of 1792 COVID-19 patients were examined, with a subgroup consisting of 112 patients with asthma and 1680 patients without asthma. Receiver operating characteristic (ROC) analysis was employed to assess the potential of inflammatory indices in indicating COVID-19 severity, while Kaplan-Meier curves were utilized to analyze the survival probability with death as the outcome. In deceased non-asthma patients, the levels of leukocyte and differential cell counts, and the values of PLR, NLR, MLR, SII, and SIR-I were higher than in survivors. In contrast, all the above values except PLR and MLR were significant in the asthma groups. The Kaplan–Meier survival curves were consistent with the ROC analysis. However, a multivariate Cox regression analysis revealed that neutrophil counts in non-asthma subjects and leukocyte and neutrophil counts in asthma patients remained significant for survival. In conclusion, while numerous inflammatory indices were associated with mortality in COVID-19 patients without asthma, neutrophil counts could independently predict mortality risk in asthma COVID-19 patients.