ArticleLife (Basel, Switzerland)2025
Detection of Mild COVID-19 in Frail Older Adults Using Simple Inflammatory Indices: A Comparative Cohort Analysis.
Article in Life (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSystemic inflammatory indices such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are associated with severe COVID-19, but their role in mild disease among frail older adults remains unclear. Early Israeli admission policies enabled hematologic profiling of asymptomatic and mild cases.
methodsRetrospective cohort of adults ≥65 years admitted to a geriatric center (March 2020-March 2021). Patients with Mild/asymptomatic COVID-19 cases were compared with patients hospitalized for other infections (pneumonia, urinary tract infection, cellulitis). Admission indices such as NLR, derived neutrophil-to-lymphocyte ratio (dNLR), PLR, hemoglobin-to-lymphocyte ratio (HLR), red cell distribution width (RDW), and C-reactive protein (CRP) were analyzed using receiver operating characteristic (ROC) curves. Sensitivity analyses compared COVID-19 with bacterial pneumonia and assessed one-week changes.
resultsAmong 450 patients (177 COVID-19 and 273 non-COVID; median age 85-86), COVID-19 cases showed lower white blood cell counts (WBC), neutrophils, and CRP but more marked lymphopenia. The most discriminative indices were dNLR, PLR, HLR, and RDW, which differed most (all
conclusionsIn frail older adults with early or mild COVID-19, modest but consistent hematologic patterns, including lymphopenia with elevated dNLR, PLR, and HLR, and lower RDW, were distinguished COVID-19 from other infections, although single-marker accuracy was limited. These routine indices may assist early differentiation when virologic testing is delayed or unavailable.
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