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Gambadauro A, Mollica S, Rosa E, Xerra F, Li Pomi A, Valenzise M, Messina MF, Vitale A, Gitto E, Wasniewska M, Zirilli G, Manti S. Bronchiolitis Severity Affects Blood Count and Inflammatory Marker Levels: A Real-Life Experience. Viruses 2025; 17:77. [PMID: 39861866 PMCID: PMC11769181 DOI: 10.3390/v17010077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2024] [Revised: 01/03/2025] [Accepted: 01/07/2025] [Indexed: 01/27/2025] Open
Abstract
BACKGROUND Bronchiolitis is the most common cause of lower respiratory tract infection (LRTI) in the first year of life. We analyzed the association between complete blood count (CBC), c-reactive protein (CRP), and novel inflammatory indexes (NLR, PLR, MLR, ELR, LMR, NPR, LPR, LNR, PNR, SII, SIRI) in predicting bronchiolitis severity at hospital admission. METHODS We retrospectively collected data from 95 infants hospitalized for bronchiolitis in a third-level hospital during three epidemic seasons. Five outcomes of severity were analyzed: BRAS; pediatric intensive care unit (PICU) admission; ventilatory support; intravenous (IV) rehydration; and length of stay (LOS). RESULTS Lower age and weight at admission were statistically associated with four of the five severity outcomes. Prolonged LOS (≥6 days) was associated with high values of total white blood cells, lymphocytes, and eosinophils. Only three inflammatory indexes (PLR, MLR, and PNR) showed a significant association with one outcome (prolonged LOS). A new index (RBC/AiW/1000) was statistically associated with each severity outcome for a value > 350. CONCLUSIONS We proposed a comprehensive analysis of the association between CBC, CRP, and novel inflammatory indexes and bronchiolitis severity. RBC/AiW/1000 could represent a future predictive marker of disease severity at hospital admission in infants with bronchiolitis.
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Affiliation(s)
- Antonella Gambadauro
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Via Consolare Valeria 1, 98124 Messina, Italy; (S.M.); (F.X.); (M.V.); (M.F.M.); (A.V.); (M.W.); (G.Z.); (S.M.)
| | - Salvatore Mollica
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Via Consolare Valeria 1, 98124 Messina, Italy; (S.M.); (F.X.); (M.V.); (M.F.M.); (A.V.); (M.W.); (G.Z.); (S.M.)
| | - Emanuela Rosa
- Faculty of Medicine and Surgery, University of Messina, Piazza Pugliatti 1, 98122 Messina, Italy;
| | - Federica Xerra
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Via Consolare Valeria 1, 98124 Messina, Italy; (S.M.); (F.X.); (M.V.); (M.F.M.); (A.V.); (M.W.); (G.Z.); (S.M.)
| | - Alessandra Li Pomi
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Via Consolare Valeria 1, 98124 Messina, Italy; (S.M.); (F.X.); (M.V.); (M.F.M.); (A.V.); (M.W.); (G.Z.); (S.M.)
| | - Mariella Valenzise
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Via Consolare Valeria 1, 98124 Messina, Italy; (S.M.); (F.X.); (M.V.); (M.F.M.); (A.V.); (M.W.); (G.Z.); (S.M.)
| | - Maria Francesca Messina
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Via Consolare Valeria 1, 98124 Messina, Italy; (S.M.); (F.X.); (M.V.); (M.F.M.); (A.V.); (M.W.); (G.Z.); (S.M.)
| | - Agata Vitale
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Via Consolare Valeria 1, 98124 Messina, Italy; (S.M.); (F.X.); (M.V.); (M.F.M.); (A.V.); (M.W.); (G.Z.); (S.M.)
| | - Eloisa Gitto
- Neonatal and Pediatric Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Via Consolare Valeria 1, 98124 Messina, Italy;
| | - Malgorzata Wasniewska
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Via Consolare Valeria 1, 98124 Messina, Italy; (S.M.); (F.X.); (M.V.); (M.F.M.); (A.V.); (M.W.); (G.Z.); (S.M.)
| | - Giuseppina Zirilli
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Via Consolare Valeria 1, 98124 Messina, Italy; (S.M.); (F.X.); (M.V.); (M.F.M.); (A.V.); (M.W.); (G.Z.); (S.M.)
| | - Sara Manti
- Pediatric Unit, Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, University of Messina, Via Consolare Valeria 1, 98124 Messina, Italy; (S.M.); (F.X.); (M.V.); (M.F.M.); (A.V.); (M.W.); (G.Z.); (S.M.)
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Wiesel V, Weissmann S, Cohen B, Golan-Tripto I, Horev A. Elevated hematologic ratios are correlated with acne severity: a national, retrospective cohort study. Front Med (Lausanne) 2024; 11:1475117. [PMID: 39544384 PMCID: PMC11560776 DOI: 10.3389/fmed.2024.1475117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Accepted: 10/21/2024] [Indexed: 11/17/2024] Open
Abstract
Background Prior studies demonstrated conflicting results regarding hematologic ratios in acne patients. We sought to further characterize hematologic ratios in acne patients, according to demographics and acne severity. Methods National, retrospective cohort study of 122,822 patients using medical records from 2005 to 2024 of patients insured with the largest public healthcare organization in Israel, Clalit Health Maintenance Organization. Results Moderate-severe acne patients had higher neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) than mild acne patients at diagnosis and 12-18 months before diagnosis. A multivariable regression confirmed the significance of the correlation of increased NLR and PLR with acne severity. Adults and females had higher NLR and PLR than children and males, respectively, at diagnosis, and 12-18 months before diagnosis. Conclusion Acne severity was significantly associated with elevated NLR and PLR. NLR and PLR may also serve as indicators of upcoming acne severity, as they were elevated 12-18 months before diagnosis. These biomarkers may contribute to the diagnosis, management, and follow-up of patients with acne.
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Affiliation(s)
- Vered Wiesel
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Sarah Weissmann
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- Clinical Research Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Bracha Cohen
- Clinical Research Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Inbal Golan-Tripto
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- Pediatric Pulmonary Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Amir Horev
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- Pediatric Dermatology Service, Soroka University Medical Center, Beer Sheva, Israel
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Tamir S, Golan-Tripto I, Hazan I, Adar A, Burrack N, Cohen B, Goldbart AD, Geva N. Does weight influence the course of RSV bronchiolitis in hospitalized infants? Eur J Pediatr 2024; 183:2663-2669. [PMID: 38507064 DOI: 10.1007/s00431-024-05521-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 03/04/2024] [Accepted: 03/10/2024] [Indexed: 03/22/2024]
Abstract
Acute bronchiolitis is among the most common causes of hospitalizations in infants worldwide. Associations between weight and severity of respiratory syncytial virus (RSV) bronchiolitis remain unclear. The aim of this study was to evaluate this association. A single-center, retrospective cohort study of infants aged under 24 months, who were hospitalized between 2018 and 2022 for RSV bronchiolitis. Data from computerized medical records were extracted using the MDclone platform. Participants were divided into three groups according to weight percentiles: underweight (below 5th percentile), normal-weight, and overweight (above 85th percentile). A total of 1936 infants (mean age 6.3 months, 55% males) were included, comprising 274 infants who were underweight, 1470 with normal weight, and 192 with overweight. Underweight infants had a higher rate of admission to the pediatric intensive care unit (PICU) (9.1% vs. 3.5%, P < 0.005) and prolonged length of stay (LOS) in the hospital (3.13 vs. 2.79 days P < 0.001) compared to those with normal weight. Hyponatremia was also more common in the underweight group (23% vs. 15%, P < 0.001). A multivariable model accounting for prematurity and birthweight predicted a relative risk of 2.01 (95% CI 1.13-3.48, P = 0.015) for PICU admission and 1.42 (95% CI 1.17-1.7, P < 0.001) for a prolonged LOS. Being overweight was not associated with a more severe disease. Conclusion: Underweight infants, hospitalized for RSV bronchiolitis, had a more severe disease course with a higher complication rate, including PICU admission and prolonged LOS. Thus, careful attention and supervision should be given to this subgroup of infants. What is Known: • Established risk factors for severe bronchiolitis include prematurity, BPD, CHD, and compromised immunity. • Abnormal weight status has been associated with an increased risk for morbidity and mortality from infectious diseases, proposedly due to the effects on endocrine and immunologic systems. What is New: • Underweight infants hospitalized with RSV bronchiolitis face an independent risk of PICU admission and prolonged hospital stay. • Conversely, overweight infants did not display associations with severity measures in our study.
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Affiliation(s)
- Shelly Tamir
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Inbal Golan-Tripto
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel
- Pediatric Pulmonary Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Itai Hazan
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Clinical Research Center, Soroka University Medical Center, Beer Sheva, Israel
| | - Assaf Adar
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel
| | - Nitzan Burrack
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Clinical Research Center, Soroka University Medical Center, Beer Sheva, Israel
| | - Bracha Cohen
- Clinical Research Center, Soroka University Medical Center, Beer Sheva, Israel
| | - Aviv D Goldbart
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel
- Pediatric Pulmonary Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - Neta Geva
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
- Department of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel.
- Department of Neonatology, Soroka University Medical Center, Beer-Sheva, Israel.
- Department of Neonatology, Sheril and Hain Saban Children Hospital, Soroka Medical Center, Ben-Gurion University of the Negev Faculty of Health Sciences, Beer-Sheva, Israel.
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