{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:18:50Z","timestamp":1792642730307,"version":"4.5.0"},"reference-count":48,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T00:00:00Z","timestamp":1764201600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Systemic 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. Methods: Retrospective cohort of adults \u226565 years admitted to a geriatric center (March 2020\u2013March 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. Results: Among 450 patients (177 COVID-19 and 273 non-COVID; median age 85\u201386), 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 p &lt; 0.001), while NLR and systemic immune-inflammation index (SII) showed limited discrimination. The best AUC was 0.69. dNLR, PLR, and HLR remained elevated after one week. Conclusions: In 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.<\/jats:p>","DOI":"10.3390\/life15121821","type":"journal-article","created":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T16:31:52Z","timestamp":1764261112000},"page":"1821","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Detection of Mild COVID-19 in Frail Older Adults Using Simple Inflammatory Indices: A Comparative Cohort Analysis"],"prefix":"10.3390","volume":"15","author":[{"given":"Yochai","family":"Levy","sequence":"first","affiliation":[{"name":"Shmuel Harofeh Geriatric Hospital, Beer Yaakov 7033001, Israel"},{"name":"Gray Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4191-504X","authenticated-orcid":false,"given":"Estela","family":"Derazne","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Kagansky","sequence":"additional","affiliation":[{"name":"Gray Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Shamir (Assaf Harofeh) Medical Center, Beer Yaakov 7033001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yichayaou","family":"Beloosesky","sequence":"additional","affiliation":[{"name":"Adelson School of Medicine, Ariel University, Ariel 407000, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Trotzky","sequence":"additional","affiliation":[{"name":"Tel Aviv Sourasky Medical Center (Ichilov), Tel Aviv 6423906, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2892-027X","authenticated-orcid":false,"given":"Miya","family":"Sharfman","sequence":"additional","affiliation":[{"name":"Shmuel Harofeh Geriatric Hospital, Beer Yaakov 7033001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadya","family":"Kagansky","sequence":"additional","affiliation":[{"name":"Shmuel Harofeh Geriatric Hospital, Beer Yaakov 7033001, Israel"},{"name":"Gray Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"100815","DOI":"10.1016\/j.hlpt.2023.100815","article-title":"Learning to Live with COVID-19 in Norway: Moving from a Pandemic to an Endemic State","volume":"13","author":"Skjesol","year":"2024","journal-title":"Health Policy Technol."},{"key":"ref_2","unstructured":"(2025, November 24). 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