Inflammatory markers are poorly predictive of clinical outcomes among hospitalized patients with COVID-19

Copyright © 2020 Elsevier Inc. All rights reserved..

BACKGROUND: Inflammatory markers are often elevated in patients with COVID-19. The objective of this study is to assess the prognostic capability of these tests in predicting clinical outcomes.

METHODS: This was a retrospective cohort study including all patients at least 16 years old with COVID-19 who were admitted from one of five Emergency Departments between March 6th and April 4th, 2020. We included 1123 laboratory-confirmed cases of COVID-19. We analyzed white blood cell count (WBC), absolute lymphocyte count (ALC), lactate dehydrogenase (LDH), C-reactive protein (CRP), procalcitonin (PCT), D-dimer, ferritin, and erythrocyte sedimentation rate (ESR). We looked at clinical outcomes including death, the need for endotracheal intubation (ETT), the need for renal replacement therapy (RRT), and ICU admission. We report Spearman's ρ2 and statistical significance for each correlation with outcomes. We also report positive predictive value, negative predictive value, sensitivity, specificity, positive likelihood ratios, and negative likelihood ratios.

RESULTS: The mean age of our patient population was 62 (SD 16). Thirty-seven percent of patients self-reported Spanish/Hispanic/Latino ethnicity, 47% reported their race as Black or African-American, and 10% reported their race as non-Hispanic white. Inter-rater reliability was 96%. There was no laboratory value that had both sensitivity and specificity of at least 0.90, or that had a positive predictive value and negative predictive value of at least 0.90, or that had likelihood ratios that could reliably predict a severe course of disease.

CONCLUSION: Inflammatory markers drawn within 48 h of arrival, though often correlated with clinical outcomes, are not individually highly predictive of which patients in a predominantly older and minority population will die or require intubation, RRT, or ICU admission.

Media Type:

Electronic Article

Year of Publication:

2020

Contained In:

The American journal of emergency medicine - (24.11.2020)

Language:

English

Contributors:

Barrett, Brendan
Pamphile, Styve
Yang, Fan
Naeem, Farnia
Kim, Jinsung
Annam, Jayabhargav
Borczuk, Rachel
Yellin, Shira
Bass, Carly
Fowler, Sabrina
Mosheyev, Maykl
Mayer, Yael Jessica
Friedman, Benjamin W

Links:

Volltext

Keywords:

COVID-19
Inflammatory markers
Journal Article
Prognosis

Notes:

Date Revised 25.01.2021

published: Print-Electronic

Citation Status Publisher

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1016/j.ajem.2020.11.038

PMID:

33280969

PPN (Catalogue-ID):

NLM319471349