key: cord-1001974-p91etyj9
authors: Wijeratne, Tissa; Wijeratne, Chanith
title: Clinical utility of serial systemic immune inflammation indices (SSIIi) in the context of post covid-19 neurological syndrome (PCNS)
date: 2021-04-15
journal: J Neurol Sci
DOI: 10.1016/j.jns.2021.117356
sha: e4fa903e71dfdedb2940b0e874a74b489f092ff8
doc_id: 1001974
cord_uid: p91etyj9

nan

We present the data of serial systemic immune inflammation indices (SSIIi) over four months in the setting of PCNS. The clinical details of this case were published previously [1] . The patient showed evidence of PCNS on discharge with persistent fatigue, brain fog, tiredness with a modified Rankin score of 3 at three months post-discharge [2] . His SSIIi over four months are shown in Fig. 1 (note the first SII (normal at 252)on 12/02/2020 was three weeks before the COVID-19 infection.).

Systemic immune inflammation index (SII) includes neutrophil, platelet and lymphocyte counts which comprehensively summarizes the interplay between the innate and adaptive immune system in COVID-19, cancer, stroke, venous sinus thrombosis and many other disorders. Each

SSIIi peak was clinically correlated with an additional neurological or thromboembolic event in this case [1] . Shared pathobiology between stroke and COVID-19 associated neurological disorders are well described and likely to benefit from SSIIi in diagnosis, progress and prognosis of these global health problems [3] [4] [5] [6] [7] . We suggest SSIIi to be an excellent, easily available, universal biomarker for many neurological diosrders, in particular, stroke.

The emerging reports suggest that admission SII's clinical utility is a significant prognostic biomarker for survival in COVID-19 [8] . We believe the value of SSIIi is far higher than a single SII as demonstrated here. Given the pandemic's enormity, the routine reporting of SII in simple blood tests might provide extra, useful information universally. 

First Australian case of good recovery of a COVID-19 patient with severe neurological symptoms post prolonged hospitalization

Post-COVID 19 neurological syndrome (PCNS); a novel syndrome with challenges for the global neurology community

COVID-19 and long-term neurological problems: challenges ahead with Post-COVID-19 Neurological Syndrome

COVID-19 pathophysiology predicts that ischemic stroke occurrence is an expectation, not an exception-a systematic review

Inflammation and stroke: an overview

The immunology of stroke: from mechanisms to translation

Effects of COVID-19 on the nervous system

The systemic inflammation index on admission predicts in-hospital mortality in COVID-19 patients