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BackgroundHerpes zoster (HZ) is a very common disease associated with a considerable individual and public health burden.ObjectivesTo evaluate prognostic clinical and laboratory parameters, including systemic immune inflammatory biomarkers (SIIB) in inpatients with HZ.Materials & MethodsWe investigated clinical and laboratory data of 520 inpatients with HZ. Complete blood count was determined at baseline. SIIB was assessed based on neutrophil-to-lymphocyte ratio (NLR), pan-immune-inflammation value (PIV), and absolute eosinopenia (AEP). Both uni- and multivariable statistics were performed.ResultsNRL and PIV were significantly (p vs. healthy controls and. The presence of absolute eosinopenia (OR: 3.9, 95 % CI: 1.9 to 8.3) was a strong predictor of herpes zoster ophthalmicus (HZO). Ramsay-Hunt syndrome (OR: 4.3, 95 % CI: 1.8 to 10.3), bacterial superinfection (OR: 2.3, 95 % CI: 1.3 to 4.1), and age ConclusionWe identified several clinical and laboratory-based independent predictors that may aid prognostication of HZ patients. The increase in SIIB reflects the possible role of systemic inflammatory alterations in HZ. However, the only effective SIIB studied was AEP which was independently associated with HZO. The use of intravenous antiviral therapy decreases the risk of postherpetic neuralgia.