A Simple Prognostic Score for Critical COVID-19 Derived from Patients without Comorbidities Performs Well in Unselected Patients
We aimed to search for laboratory predictors of critical COVID-19 in consecutive adults admitted in an academic center between 16 September 2020−20 December 2021. Patients were uniformly treated with low-molecular-weight heparin, and dexamethasone plus remdesivir when SpO2 < 94%. Among consecutive unvaccinated patients without underlying medical conditions (n = 241, 49 year-old median, 71% males), 22 (9.1%) developed critical disease and 2 died (0.8%). White-blood-cell counts, neutrophils, neutrophil-to-lymphocyte ratio, CRP, fibrinogen, ferritin, LDH and γ-GT at admission were each univariably associated with critical disease. ROC-defined cutoffs revealed that CRP > 61.8 mg/L, fibrinogen > 616.5 mg/dL and LDH > 380.5 U/L were each associated with critical disease development, independently of age, sex and days from symptom-onset. A score combining higher-than-cutoff CRP (0/2), LDH (0/1) and fibrinogen (0/1) predicted critical disease (AUC: 0.873, 95% CI: 0.820−0.926). This score performed well in an unselected patient cohort (n = 1228, 100% unvaccinated) predominantly infected by the alpha variant (AUC: 0.718, 95% CI: 0.683−0.753), as well as in a mixed cohort (n = 527, 65% unvaccinated) predominantly infected by the delta variant (AUC: 0.708, 95% CI: 0.656−0.760). Therefore, we propose that a combination of standard biomarkers of acute inflammatory response, cell death and hypercoagulability reflects the severity of COVID-19 per se independently of comorbidities, age and sex, being of value for risk stratification in unselected patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:11 |
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| Enthalten in: |
Journal of clinical medicine - 11(2022), 7 vom: 25. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Georgakopoulou, Vasiliki E [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Revised 08.03.2023 published: Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3390/jcm11071810 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM339370254 |
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| 100 | 1 | |a Georgakopoulou, Vasiliki E |e verfasserin |4 aut | |
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| 520 | |a We aimed to search for laboratory predictors of critical COVID-19 in consecutive adults admitted in an academic center between 16 September 2020−20 December 2021. Patients were uniformly treated with low-molecular-weight heparin, and dexamethasone plus remdesivir when SpO2 < 94%. Among consecutive unvaccinated patients without underlying medical conditions (n = 241, 49 year-old median, 71% males), 22 (9.1%) developed critical disease and 2 died (0.8%). White-blood-cell counts, neutrophils, neutrophil-to-lymphocyte ratio, CRP, fibrinogen, ferritin, LDH and γ-GT at admission were each univariably associated with critical disease. ROC-defined cutoffs revealed that CRP > 61.8 mg/L, fibrinogen > 616.5 mg/dL and LDH > 380.5 U/L were each associated with critical disease development, independently of age, sex and days from symptom-onset. A score combining higher-than-cutoff CRP (0/2), LDH (0/1) and fibrinogen (0/1) predicted critical disease (AUC: 0.873, 95% CI: 0.820−0.926). This score performed well in an unselected patient cohort (n = 1228, 100% unvaccinated) predominantly infected by the alpha variant (AUC: 0.718, 95% CI: 0.683−0.753), as well as in a mixed cohort (n = 527, 65% unvaccinated) predominantly infected by the delta variant (AUC: 0.708, 95% CI: 0.656−0.760). Therefore, we propose that a combination of standard biomarkers of acute inflammatory response, cell death and hypercoagulability reflects the severity of COVID-19 per se independently of comorbidities, age and sex, being of value for risk stratification in unselected patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a comorbidities | |
| 650 | 4 | |a critical disease | |
| 650 | 4 | |a prognosis | |
| 650 | 4 | |a vaccination | |
| 700 | 1 | |a Vlachogiannis, Nikolaos I |e verfasserin |4 aut | |
| 700 | 1 | |a Basoulis, Dimitrios |e verfasserin |4 aut | |
| 700 | 1 | |a Eliadi, Irene |e verfasserin |4 aut | |
| 700 | 1 | |a Georgiopoulos, Georgios |e verfasserin |4 aut | |
| 700 | 1 | |a Karamanakos, Georgios |e verfasserin |4 aut | |
| 700 | 1 | |a Makrodimitri, Sotiria |e verfasserin |4 aut | |
| 700 | 1 | |a Samara, Stamatia |e verfasserin |4 aut | |
| 700 | 1 | |a Triantafyllou, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Voutsinas, Pantazis M |e verfasserin |4 aut | |
| 700 | 1 | |a Ntziora, Fotinie |e verfasserin |4 aut | |
| 700 | 1 | |a Psichogiou, Mina |e verfasserin |4 aut | |
| 700 | 1 | |a Samarkos, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Sfikakis, Petros P |e verfasserin |4 aut | |
| 700 | 1 | |a Sipsas, Nikolaos V |e verfasserin |4 aut | |
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