Predictive Immunological, Virological, and Routine Laboratory Markers for Critical COVID-19 on Admission
Background. Early identification of COVID-19 patients at risk of critical illness is a challenging endeavor for clinicians. We aimed to establish immunological, virological, and routine laboratory markers, which, in combination with clinical information, may allow identifying such patients. Methods....
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Canadian Journal of Infectious Diseases and Medical Microbiology |
| Online Access: | http://dx.doi.org/10.1155/2021/9965850 |
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| author | Mercedes García-Gasalla Juana M. Ferrer Pablo A. Fraile-Ribot Adrián Ferre-Beltrán Adrián Rodríguez Natalia Martínez-Pomar Luisa Ramon-Clar Amanda Iglesias Inés Losada-López Francisco Fanjul Joan Albert Pou Isabel Llompart-Alabern Nuria Toledo Jaime Pons Antonio Oliver Melchor Riera Javier Murillas |
| author_facet | Mercedes García-Gasalla Juana M. Ferrer Pablo A. Fraile-Ribot Adrián Ferre-Beltrán Adrián Rodríguez Natalia Martínez-Pomar Luisa Ramon-Clar Amanda Iglesias Inés Losada-López Francisco Fanjul Joan Albert Pou Isabel Llompart-Alabern Nuria Toledo Jaime Pons Antonio Oliver Melchor Riera Javier Murillas |
| author_sort | Mercedes García-Gasalla |
| collection | DOAJ |
| description | Background. Early identification of COVID-19 patients at risk of critical illness is a challenging endeavor for clinicians. We aimed to establish immunological, virological, and routine laboratory markers, which, in combination with clinical information, may allow identifying such patients. Methods. Blood tests to measure neutrophil/lymphocyte ratio (NLR) and levels of ferritin, CRP, D-dimer, complement components (C3 and C4), cytokines, and lymphocyte subsets, as well as SARS-Cov-2 RT-PCR tests, were performed in COVID-19-confirmed cases within 48 hours of admission. RT-PCR cycle threshold (Ct) values from oropharyngeal or nasopharyngeal swabs were determined on the day of admission. Symptom severity was categorized as mild (grade 1), severe (grade 2), or critical (grade 3). Results. Of 120 patients who were included, 49 had mild, 32 severe, and 39 critical COVID-19. Levels of ferritin >370 ng/mL (OR 16.4, 95% CI 5.3–50.8), D-dimer >440 ng/mL (OR 5.45, 95% CI 2.36–12.61), CRP >7.65 mg/dL (OR 11.54, 95% CI 4.3–30.8), NLR >3.77 (OR 13.4, 95% CI 4.3–41.1), IL-6 >142.5 pg/mL (OR 8.76, 95% CI 3.56–21.54), IL-10 >10.8 pg/mL (OR 16.45, 95% CI 5.32–50.81), sIL-2rα (sCD25) >804.5 pg/mL (OR 14.06, 95% CI 4.56–43.28), IL-1Ra >88.4 pg/mL (OR 4.54, 95% CI 2.03–10.17), and IL-18 >144 pg/mL (OR 17.85, 95% CI 6.54–48.78) were associated with critical COVID-19 in the univariate age-adjusted analysis. This association was confirmed in the multivariate age-adjusted analysis only for ferritin, CRP, NLR, IL-10, sIL-2rα, and IL-18. T, B, and NK cells were significantly decreased in critical patients. SARS-CoV-2 was not detected in blood except in 3 patients who had indeterminate results. RT-PCR Ct values from oropharyngeal or nasopharyngeal swabs on admission were not related to symptom severity. Conclusion. Ferritin, D-dimer, CRP, NLR, cytokine (IL-18 and IL-10), and cytokine receptor (IL-6, IL1-Ra, and sCD25) test results combined with clinical data can contribute to the early identification of critical COVID-19 patients. |
| format | Article |
| id | doaj-art-93915232cdf24aaf9da6c04a58dbd879 |
| institution | Kabale University |
| issn | 1712-9532 1918-1493 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Infectious Diseases and Medical Microbiology |
| spelling | doaj-art-93915232cdf24aaf9da6c04a58dbd8792025-02-03T06:12:30ZengWileyCanadian Journal of Infectious Diseases and Medical Microbiology1712-95321918-14932021-01-01202110.1155/2021/99658509965850Predictive Immunological, Virological, and Routine Laboratory Markers for Critical COVID-19 on AdmissionMercedes García-Gasalla0Juana M. Ferrer1Pablo A. Fraile-Ribot2Adrián Ferre-Beltrán3Adrián Rodríguez4Natalia Martínez-Pomar5Luisa Ramon-Clar6Amanda Iglesias7Inés Losada-López8Francisco Fanjul9Joan Albert Pou10Isabel Llompart-Alabern11Nuria Toledo12Jaime Pons13Antonio Oliver14Melchor Riera15Javier Murillas16Internal Medicine, Hospital Universitari Son Espases-Institut d’Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, SpainImmunology, Hospital Universitari Son Espases-Institut d’Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, SpainMicrobiology, Hospital Universitari Son Espases-Institut d’Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, SpainInternal Medicine, Hospital Universitari Son Espases-Institut d’Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, SpainInternal Medicine, Hospital Universitari Son Llàtzer-Institut d’Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, SpainImmunology, Hospital Universitari Son Espases-Institut d’Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, SpainPneumology, Hospital Universitari Son Espases-Institut d’Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, SpainCIBER de Enfermedades Respiratorias, Hospital Universitari Son Espases-Institut d’Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, SpainInternal Medicine, Hospital Universitari Son Llàtzer-Institut d’Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, SpainInternal Medicine, Hospital Universitari Son Espases-Institut d’Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, SpainInternal Medicine, Hospital Universitari Son Espases-Institut d’Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, SpainAnálisis Clínicos, Hospital Universitari Son Espases, Palma, Balearic Islands, SpainPneumology, Hospital Universitari Son Espases-Institut d’Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, SpainImmunology, Hospital Universitari Son Espases-Institut d’Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, SpainMicrobiology, Hospital Universitari Son Espases-Institut d’Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, SpainInternal Medicine, Hospital Universitari Son Espases-Institut d’Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, SpainInternal Medicine, Hospital Universitari Son Espases-Institut d’Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, SpainBackground. Early identification of COVID-19 patients at risk of critical illness is a challenging endeavor for clinicians. We aimed to establish immunological, virological, and routine laboratory markers, which, in combination with clinical information, may allow identifying such patients. Methods. Blood tests to measure neutrophil/lymphocyte ratio (NLR) and levels of ferritin, CRP, D-dimer, complement components (C3 and C4), cytokines, and lymphocyte subsets, as well as SARS-Cov-2 RT-PCR tests, were performed in COVID-19-confirmed cases within 48 hours of admission. RT-PCR cycle threshold (Ct) values from oropharyngeal or nasopharyngeal swabs were determined on the day of admission. Symptom severity was categorized as mild (grade 1), severe (grade 2), or critical (grade 3). Results. Of 120 patients who were included, 49 had mild, 32 severe, and 39 critical COVID-19. Levels of ferritin >370 ng/mL (OR 16.4, 95% CI 5.3–50.8), D-dimer >440 ng/mL (OR 5.45, 95% CI 2.36–12.61), CRP >7.65 mg/dL (OR 11.54, 95% CI 4.3–30.8), NLR >3.77 (OR 13.4, 95% CI 4.3–41.1), IL-6 >142.5 pg/mL (OR 8.76, 95% CI 3.56–21.54), IL-10 >10.8 pg/mL (OR 16.45, 95% CI 5.32–50.81), sIL-2rα (sCD25) >804.5 pg/mL (OR 14.06, 95% CI 4.56–43.28), IL-1Ra >88.4 pg/mL (OR 4.54, 95% CI 2.03–10.17), and IL-18 >144 pg/mL (OR 17.85, 95% CI 6.54–48.78) were associated with critical COVID-19 in the univariate age-adjusted analysis. This association was confirmed in the multivariate age-adjusted analysis only for ferritin, CRP, NLR, IL-10, sIL-2rα, and IL-18. T, B, and NK cells were significantly decreased in critical patients. SARS-CoV-2 was not detected in blood except in 3 patients who had indeterminate results. RT-PCR Ct values from oropharyngeal or nasopharyngeal swabs on admission were not related to symptom severity. Conclusion. Ferritin, D-dimer, CRP, NLR, cytokine (IL-18 and IL-10), and cytokine receptor (IL-6, IL1-Ra, and sCD25) test results combined with clinical data can contribute to the early identification of critical COVID-19 patients.http://dx.doi.org/10.1155/2021/9965850 |
| spellingShingle | Mercedes García-Gasalla Juana M. Ferrer Pablo A. Fraile-Ribot Adrián Ferre-Beltrán Adrián Rodríguez Natalia Martínez-Pomar Luisa Ramon-Clar Amanda Iglesias Inés Losada-López Francisco Fanjul Joan Albert Pou Isabel Llompart-Alabern Nuria Toledo Jaime Pons Antonio Oliver Melchor Riera Javier Murillas Predictive Immunological, Virological, and Routine Laboratory Markers for Critical COVID-19 on Admission Canadian Journal of Infectious Diseases and Medical Microbiology |
| title | Predictive Immunological, Virological, and Routine Laboratory Markers for Critical COVID-19 on Admission |
| title_full | Predictive Immunological, Virological, and Routine Laboratory Markers for Critical COVID-19 on Admission |
| title_fullStr | Predictive Immunological, Virological, and Routine Laboratory Markers for Critical COVID-19 on Admission |
| title_full_unstemmed | Predictive Immunological, Virological, and Routine Laboratory Markers for Critical COVID-19 on Admission |
| title_short | Predictive Immunological, Virological, and Routine Laboratory Markers for Critical COVID-19 on Admission |
| title_sort | predictive immunological virological and routine laboratory markers for critical covid 19 on admission |
| url | http://dx.doi.org/10.1155/2021/9965850 |
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