HALP score as a new prognostic factor for Covid-19

Deniz Çekiç 1 * , Mehmet Emir Arman 1, Ahmed Cihad Genç 1, Didar Şenocak 2, Kubilay İşsever 1, Sümeyye Çekiç 1, Ahmet Nalbant 1, Ahmed Bilal Genç 1, Selçuk Yaylacı 1, Ali Tamer 1, Oğuz Karabay 3
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1 Internal Medicine Department, Sakarya University, Sakarya University Hospital, Sakarya, Turkey
2 Internal Medicine Department, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
3 Infectious Disease Department, Sakarya University, Sakarya University Hospital, Sakarya, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 20, Issue 1, pp. 56-60. https://doi.org/10.23950/jcmk/12930
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ABSTRACT

Objective: This research aims to analyze the HALP. (hemoglobin, albumin, lymphocyte. platelet) score of.survivor-deceased Covid-19 patients.
Material and methods: 590 patients with. Covid-19 were. included. in. this. study. Patients. were. divided. into two groups as survivor (n:296) and deceased (n:294). Patient information was collected from the hospital online system. The Study was conducted retrospectively, and it aims to.investigate.the association.between HALP score and.mortality.in Covid-19.patients.
Results: In.the deceased group.the.mean.age was 71.32±10.9 (n:294) while in the survivor.group, it.was 59.97±16.2 (n:296) (p:0.000). 65,6% of the deceased group were.male, while 55% of survivor group were male (p<0.001). The median HALP score was 11,45 (1,00-1594,00) in the deceased group, while it was 23,58 (1,73-231,75) (p<0.001) in survivor group. Through our analysis,.we have found.that.the.HALP score.was associated with mortality, thus the.relationship.between 1/HALP.score.and.mortality was examined. While the median 1/HALP was 0.08 (0.01-1.00) in deceased group, it was 0.04 (0.01-0.58) in the survivor group. ROC (receiver.operating.characteristic) analysis was executed for determining the cut off value of 1/HALP. The cut.off.value of 1/HALP for mortality was 0,064 ((AUC: 0,724 (0,682-0,767); 67,3% Sensitivity, 67,0% Specificity; p<0.001)).
Conclusion: There is a meaningful correlation established between low HALP score and.mortality. in.Covid-19.patients. We.have reached the.conclusion that using HALP score.to. predict.mortality.in.Covid-19.patients might be useful.

CITATION

Çekiç D, Arman ME, Genç AC, Şenocak D, İşsever K, Çekiç S, et al. HALP score as a new prognostic factor for Covid-19. J CLIN MED KAZ. 2023;20(1):56-60. https://doi.org/10.23950/jcmk/12930

REFERENCES

  • Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020;91: 157-160.
  • COVID Live - Coronavirus Statistics - Worldometer. [cited 12 Sep 2022]. Available: https://www.worldometers.info/coronavirus/
  • Gálvez-Barrón C, Arroyo-Huidobro M, Miňarro A, Añaños G, Chamero A, Martín M, et al. COVID-19: Clinical Presentation and Prognostic Factors of Severe Disease and Mortality in the Oldest-Old Population: A Cohort Study. Gerontology. 2022;68: 30-43. https://doi.org/10.1159/000515159
  • Lagunas-Rangel FA. Neutrophil-to-lymphocyte ratio and lymphocyte-to-C-reactive protein ratio in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis. J Med Virol. 2020;92: 1733-1734. https://doi.org/10.1002/jmv.25819
  • Cekic, D., Issever, K., Genc, A. C., Yaylaci, S., Genc, A. B., & Tamer, A. Association of C-reactive Protein/Albumin, Procalcitonin/Albumin, Platelet/Lymphocyte, and Lymphocyte/Monocyte Ratio with Mortality in Hospitalised COVID-19 Patients. Journal of the College of Physicians and Surgeons--Pakistan: JCPSP. 2022; 32(9):1191-1195. https://doi.org/10.29271/jcpsp.2022.09.1191
  • Taneri PE, Gómez-Ochoa SA, Llanaj E, Raguindin PF, Rojas LZ, Roa-Díaz ZM, et al. Anemia and iron metabolism in COVID-19: a systematic review and meta-analysis. Eur J Epidemiol. 2020;35:763-773. https://doi.org/10.1007/s10654-020-00678-5
  • Huang J, Cheng A, Kumar R, Fang Y, Chen G, Zhu Y, et al. Hypoalbuminemia predicts the outcome of COVID-19 independent of age and co-morbidity. J Med Virol. 2020; 92:2152-2158. https://doi.org/10.1002/jmv.26003
  • Wang S, Sheng Y, Tu J, Zhang L. Association between peripheral lymphocyte count and the mortality risk of COVID-19 inpatients. BMC Pulm Med. 2021;21: 55. https://doi.org/10.1186/s12890-021-01422-9
  • Allyn J, Ferdynus C, Bohrer M, Dalban C, Valance D, Allou N. Simplified Acute Physiology Score II as Predictor of Mortality in Intensive Care Units: A Decision Curve Analysis. PLoS One. 2016;11: e0164828. https://doi.org/10.1371/journal.pone.0164828
  • Shen X-B, Zhang Y-X, Wang W, Pan Y-Y. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score in Patients with Small Cell Lung Cancer Before First-Line Treatment with Etoposide and Progression-Free Survival. Med Sci Monit. 2019;25: 5630-5639. https://doi.org/10.12659/MSM.917968
  • Tian M, Li Y, Wang X, Tian X, Pei L-L, Wang X, et al. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score Is Associated With Poor Outcome of Acute Ischemic Stroke. Front Neurol. 2020;11: 610318. https://doi.org/10.3389/fneur.2020.610318
  • Case management. [cited 13 Sep 2022]. Available: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/patient-management
  • Hariyanto TI, Japar KV, Kwenandar F, Damay V, Siregar JI, Lugito NPH, et al. Inflammatory and hematologic markers as predictors of severe outcomes in COVID-19 infection: A systematic review and meta-analysis. Am J Emerg Med. 2021;41: 110-119. https://doi.org/10.1016/j.ajem.2020.12.076
  • Melo AKG, Milby KM, Caparroz ALMA, Pinto ACPN, Santos RRP, Rocha AP, et al. Biomarkers of cytokine storm as red flags for severe and fatal COVID-19 cases: A living systematic review and meta-analysis. PLoS One. 2021;16: e0253894. https://doi.org/10.1371/journal.pone.0253894
  • Thomas T, Stefanoni D, Dzieciatkowska M, Issaian A, Nemkov T, Hill RC, et al. Evidence of Structural Protein Damage and Membrane Lipid Remodeling in Red Blood Cells from COVID-19 Patients. J Proteome Res. 2020;19: 4455-4469. https://doi.org/10.1021/acs.jproteome.0c00606
  • Channappanavar R, Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Semin Immunopathol. 2017;39: 529-539. https://doi.org/10.1007/s00281-017-0629-x
  • Bellmann-Weiler R, Lanser L, Barket R, Rangger L, Schapfl A, Schaber M, et al. Prevalence and Predictive Value of Anemia and Dysregulated Iron Homeostasis in Patients with COVID-19 Infection. J Clin Med Res. 2020;9. https://doi.org/10.3390/jcm9082429
  • Tao Z, Xu J, Chen W, Yang Z, Xu X, Liu L, et al. Anemia is associated with severe illness in COVID-19: A retrospective cohort study. J Med Virol. 2021;93: 1478-1488. https://doi.org/10.1002/jmv.26444
  • Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, et al. Hematological findings and complications of COVID-19. Am J Hematol. 2020;95: 834-847. https://doi.org/10.1002/ajh.25829
  • Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395: 1054-1062. https://doi.org/10.1016/S0140-6736(20)30566-3
  • Cabrerizo S, Cuadras D, Gomez-Busto F, Artaza-Artabe I, Marín-Ciancas F, Malafarina V. Serum albumin and health in older people: Review and meta analysis. Maturitas. 2015;81:17-27. https://doi.org/10.1016/j.maturitas.2015.02.009
  • Liu B-C, Gao J, Li Q, Xu L-M. Albumin caused the increasing production of angiotensin II due to the dysregulation of ACE/ACE2 expression in HK2 cells. Clin Chim Acta. 2009;403:23-30. https://doi.org/10.1016/j.cca.2008.12.015
  • Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71:762-768. https://doi.org/10.1093/cid/ciaa248
  • Huang I, Pranata R. Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and meta-analysis. J Intensive Care Med. 2020;8:1-10. https://doi.org/10.1186/s40560-020-00453-4
  • Li T, Qiu Z, Zhang L, Han Y, He W, Liu Z, et al. Significant changes of peripheral T lymphocyte subsets in patients with severe acute respiratory syndrome. J Infect Dis. 2004;189:648-651. https://doi.org/10.1086/381535
  • Zinellu A, Mangoni AA. A systematic review and meta-analysis of the association between the neutrophil, lymphocyte, and platelet count, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio and COVID-19 progression and mortality. Expert Rev Clin Immunol. 2022; 1-16. https://doi.org/10.1080/1744666X.2022.2120472
  • Liu Y, Sun W, Guo Y, Chen L, Zhang L, Zhao S, et al. Association between platelet parameters and mortality in coronavirus disease 2019: Retrospective cohort study. Platelets. 2020;31:490-496. https://doi.org/10.1080/09537104.2020.1754383
  • Malik P, Patel U, Mehta D, Patel N, Kelkar R, Akrmah M, et al. Biomarkers and outcomes of COVID-19 hospitalisations: systematic review and meta-analysis. BMJ Evid Based Med. 2021;26:107-108. https://doi.org/10.1136/bmjebm-2020-111536
  • Jiang H, Li H, Li A, Tang E, Xu D, Chen Y, et al. Preoperative combined hemoglobin, albumin, lymphocyte and platelet levels predict survival in patients with locally advanced colorectal cancer. Oncotarget. 2016;7:72076-72083. https://doi.org/10.18632/oncotarget.12271
  • Peng D, Zhang C-J, Tang Q, Zhang L, Yang K-W, Yu X-T, et al. Prognostic significance of the combination of preoperative hemoglobin and albumin levels and lymphocyte and platelet counts (HALP) in patients with renal cell carcinoma after nephrectomy. BMC Urol. 2018;18:20. https://doi.org/10.1186/s12894-018-0333-8
  • Peng D, Zhang C-J, Gong Y-Q, Hao H, Guan B, Li X-S, et al. Prognostic significance of HALP (hemoglobin, albumin, lymphocyte and platelet) in patients with bladder cancer after radical cystectomy. Sci Rep. 2018;8:794. https://doi.org/10.1038/s41598-018-19146-y
  • Park PG, Yoo B-W, Song JJ, Park Y-B, Lee S-W. Will the HALP score help to assess the activity and predict the prognosis of antineutrophil cytoplasmic antibody-associated vasculitis? Clin Exp Rheumatol. 2020;38(124):236-237.