PMO-2 Can we predict CMV colitis with haemogram-based inflammatory indices?

IntroductionThis study aims to assess the predictive value of indices as systemic immune-inflammation index (SII), neutrophil-lymphocyte ratio (NLR) and monocyte/lymphocyte ratio (MLR) on presence of active CMV infection in UC patient.MethodsWe retrospectively reviewed colonoscopy reports of UC patients between January 2011 and January 2021. These indices are derived from the CBC parameters. CMV colitis was diagnosed from PCR of colonic tissue. The patients with CMV colitis were treated with gancyclovir for 21 days. Statistical analyses were performed using SPSS. Receiver operating characteristic (ROC) curve analysis was used to determine the cut-off values for predicting CMV colitis.ResultsA total of 269 UC patients were involved. 19 (7.1%) patients had documented CMV colitis. CMV patients had pancolitis (n=11, 57.9%) and left-sided colitis in 8(42.1%). The drugs used were mesalazine monotherapy (n=9), azathioprine (n=6) and anti-TNF therapy (n=4). The control group consisted of 250 UC patients without active CMV. This group mostly had left-sided colitis (n=128), while the number of proctitis was 40 and pancolitis in 82.There were significant differences between CMV PCR(+) and CMV PCR (-) cases by means of SII (p=0,037), NLR (p=0,040) and MLR (p=0,016) indices. Moreover, there was no significant superiority between SII, NLR, and MLR. According to the ROC curve analysis, the best cut-off MLR value to differentiate between patients with CMV colitis from UC was >0.43 (Sens:36.8 ;Spec:89.1 ; PPV:21.2 ; NPV:94.7), best cut-off NLR value was >3.1(Sens:68.4 ;Spec:57.7 ; PPV:11.4 ; NPV:95.8), and best cut-off SII value was >900 (Sens:68.4 ;Spec:52.3 ; PPV:11.1 ; NPV:95.7) (Table 1).Abstract PMO-2 Table 1Comparison of indices and cut off values according to CMV PCR CMV PCR(+) CMV PCR(-) P value Total (n=269) 19 250 NA Gender F/M 5/14 105/145 0.169 SII900 13 104 NLR3.1 13 101 MLR 0.43 7 26 NA: not available SII : systemic inflammation index; NLR: neutrophil lymphocyte ratio MLR : monocyte lymphocyte ratioConclusionsThis is the first report to demonstrate that SII, NLR, MLR may predict superinfection of CMV colitis in UC patients. The cut-off values were 900, 3.1 and 0.43 for systemic inflammation index, NLR and MLR, respectively. Thus, CMV complicating UC seems to result with higher inflammatory indices. Large scale, prospective studies are needed for further conclusion.