Elsevier

Cytokine

Volume 149, January 2022, 155755
Cytokine

Association and predictive value of biomarkers with severe outcomes in hospitalized patients with SARS-CoV-2 infection

https://doi.org/10.1016/j.cyto.2021.155755Get rights and content

Highlights

  • Risk factors for ICU admission were hyper-inflammation and decreased respiratory function (RF).

  • Risk factors for IMV were low platelets, abnormal neutrophil-lymphocyte ratio, and reduced RF.

  • Risk factors for vasopressor use (VU) were hyperinflammation, low platelets and reduced RF.

  • Risk factors for hospital mortality were hypercoagulability and decreased RF and kidney function.

Abstract

This study analyzed the levels at admission of biomarkers for their association with and ability to predict risk of severe outcomes, including admission to the ICU, need for invasive mechanical ventilation (IMV), need for vasopressor use (VU), and in-hospital mortality (IHM) in 700 patients hospitalized with COVID-19. Biomarker data split by outcomes was compared using Mann-Whitney U tests; frequencies of biomarker values were compared using Chi-square tests and multivariable logistic regression analysis was performed to look at the impact of biomarkers by outcome. Patients that suffered IHM were more likely to have reduced platelet numbers and high blood urea nitrogen (BUN) levels among patients admitted to the ICU. Risk factors for mortality were related to hyper-coagulability (low platelet count and increased D-dimer) and decreased respiratory (PaO2/FiO2 ratio) and kidney function (BUN). Association with risks of other severe outcomes were as follows: ICU with hyper-inflammation (IL-6) and decreased respiratory function; IMV with low platelet count, abnormal neutrophil–lymphocyte ratio with reduced respiratory function, VU with inflammatory markers (IL-6), and low platelet count with respiratory function. Our studies confirmed the association of biomarkers of hematological, inflammatory, coagulation, pulmonary and kidney functions with disease severity. Whether these biomarkers have any mechanistic or causal role in the disease progress requires further investigation.

Keywords

COVID-19
Critical care
Growth factors
Cytokines and inflammatory mediators
Inflammation
Intensive care
Mechanical ventilation

Abbreviations

BNP
Brain natriuretic peptide
BUN
blood urea nitrogen
CRP
C-reactive protein
ESR
erythrocyte sedimentation rate
ICU
intensive care unit
IHM
in-hospital mortality
IMV
invasive mechanical ventilation
PCT
Procalcitonin
VU
vasopressor use

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