To reduce the mortality of COVID-19 older patients, clear criteria to predict in-hospital mortality are urgently needed. Here, we aimed to evaluate the performance of selected routine laboratory biomarkers in improving the prediction of in-hospital mortality in 641 consecutive COVID-19 geriatric patients (mean age 86.6 ± 6.8) who were hospitalized at the INRCA hospital (Ancona, Italy). Thirty-four percent of the enrolled patients were deceased during the in-hospital stay. The percentage of severely frail patients, assessed with the Clinical Frailty Scale, was significantly increased in deceased patients compared to the survived ones. The age-adjusted Charlson comorbidity index (CCI) score was not significantly associated with an increased risk of death. Among the routine parameters, neutrophilia, eosinopenia, lymphopenia, neutrophil-to-lymphocyte ratio (NLR), C-reactive protein, procalcitonin, IL-6, and NT-proBNP showed the highest predictive values. The fully adjusted Cox regressions models confirmed that high neutrophil %, NLR, derived NLR (dNLR), platelet-to-lymphocyte ratio (PLR), and low lymphocyte count, eosinophil %, and lymphocyte-to-monocyte ratio (LMR) were the best predictors of in-hospital mortality, independently from age, gender, and other potential confounders. Overall, our results strongly support the use of routine parameters, including complete blood count, in geriatric patients to predict COVID-19 in-hospital mortality, independent from baseline comorbidities and frailty.

为了降低 COVID-19 老年患者的死亡率，迫切需要明确的标准来预测院内死亡率。在这里，我们旨在评估选定的常规实验室生物标志物在改善 641 名连续 COVID-19 老年患者（平均年龄 86.6 ± 6.8）住院死亡率预测方面的表现，这些患者在 INRCA 医院（意大利安科纳）住院。34% 的入组患者在住院期间死亡。与幸存者相比，使用临床虚弱量表评估的严重虚弱患者的百分比在已故患者中显着增加。年龄调整后的 Charlson 合并症指数 (CCI) 评分与死亡风险增加无显着相关性。在常规参数中，中性粒细胞增多、嗜酸细胞减少、淋巴细胞减少、中性粒细胞与淋巴细胞比率 (NLR)、C 反应蛋白、降钙素原、IL-6 和 NT-proBNP 显示出最高的预测值。完全调整的 Cox 回归模型证实，高中性粒细胞 %、NLR、衍生 NLR (dNLR)、血小板与淋巴细胞比率 (PLR) 和低淋巴细胞计数、嗜酸性粒细胞 % 和淋巴细胞与单核细胞比率 (LMR)独立于年龄、性别和其他潜在混杂因素的院内死亡率的最佳预测因子。总体而言，我们的结果强烈支持在老年患者中使用常规参数（包括全血细胞计数）来预测 COVID-19 院内死亡率，这与基线合并症和虚弱无关。完全调整的 Cox 回归模型证实，高中性粒细胞 %、NLR、衍生 NLR (dNLR)、血小板与淋巴细胞比率 (PLR) 和低淋巴细胞计数、嗜酸性粒细胞 % 和淋巴细胞与单核细胞比率 (LMR)独立于年龄、性别和其他潜在混杂因素的院内死亡率的最佳预测因子。总体而言，我们的结果强烈支持在老年患者中使用常规参数（包括全血细胞计数）来预测 COVID-19 院内死亡率，这与基线合并症和虚弱无关。完全调整的 Cox 回归模型证实，高中性粒细胞 %、NLR、衍生 NLR (dNLR)、血小板与淋巴细胞比率 (PLR) 和低淋巴细胞计数、嗜酸性粒细胞 % 和淋巴细胞与单核细胞比率 (LMR)独立于年龄、性别和其他潜在混杂因素的院内死亡率的最佳预测因子。总体而言，我们的结果强烈支持在老年患者中使用常规参数（包括全血细胞计数）来预测 COVID-19 院内死亡率，这与基线合并症和虚弱无关。