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Early risk markers for severe clinical course and fatal outcome in German patients with COVID-19
BACKGROUND: Some patients with Corona Virus Disease 2019 (COVID-19) develop a severe clinical course with acute respiratory distress syndrome (ARDS) and fatal outcome. Clinical manifestations and biomarkers in early stages of disease with relevant predictive impact for outcomes remain largely unexpl...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7845994/ https://www.ncbi.nlm.nih.gov/pubmed/33513168 http://dx.doi.org/10.1371/journal.pone.0246182 |
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author | Balfanz, Paul Hartmann, Bojan Müller-Wieland, Dirk Kleines, Michael Häckl, Dennis Kossack, Nils Kersten, Alexander Cornelissen, Christian Müller, Tobias Daher, Ayham Stöhr, Robert Bickenbach, Johannes Marx, Gernot Marx, Nikolaus Dreher, Michael |
author_facet | Balfanz, Paul Hartmann, Bojan Müller-Wieland, Dirk Kleines, Michael Häckl, Dennis Kossack, Nils Kersten, Alexander Cornelissen, Christian Müller, Tobias Daher, Ayham Stöhr, Robert Bickenbach, Johannes Marx, Gernot Marx, Nikolaus Dreher, Michael |
author_sort | Balfanz, Paul |
collection | PubMed |
description | BACKGROUND: Some patients with Corona Virus Disease 2019 (COVID-19) develop a severe clinical course with acute respiratory distress syndrome (ARDS) and fatal outcome. Clinical manifestations and biomarkers in early stages of disease with relevant predictive impact for outcomes remain largely unexplored. We aimed to identify parameters which are significantly different between subgroups. DESIGN: 125 patients with COVID-19 were analysed. Patients with ARDS (N = 59) or non-ARDS (N = 66) were compared, as well as fatal outcome versus survival in the two groups. KEY RESULTS: ARDS and non-ARDS patients did not differ with respect to comorbidities or medication on developing a fatal outcome versus survival. Body mass index was higher in patients with ARDS versus non-ARDS (p = 0.01), but not different within the groups in survivors versus non-survivors. Interleukin-6 levels on admission were higher in patients with ARDS compared to non-ARDS as well as in patients with fatal outcome versus survivors, whereas lymphocyte levels were lower in the different subgroups (all p<0.05). There was a highly significant 3.5-fold difference in fever load in non-survivors compared to survivors (p<0.0001). Extrapulmonary viral spread was detected more often in patients with fatal outcome compared to survivors (P = 0.01). Further the detection of SARS-CoV-2 in serum showed a significantly more severe course and an increased risk of death (both p<0.05). CONCLUSIONS: We have identified early risk markers for a severe clinical course, like ARDS or fatal outcome. This data might help develop a strategy to address new therapeutic options early in patients with COVID-19 and at high risk for fatal outcome. |
format | Online Article Text |
id | pubmed-7845994 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-78459942021-02-04 Early risk markers for severe clinical course and fatal outcome in German patients with COVID-19 Balfanz, Paul Hartmann, Bojan Müller-Wieland, Dirk Kleines, Michael Häckl, Dennis Kossack, Nils Kersten, Alexander Cornelissen, Christian Müller, Tobias Daher, Ayham Stöhr, Robert Bickenbach, Johannes Marx, Gernot Marx, Nikolaus Dreher, Michael PLoS One Research Article BACKGROUND: Some patients with Corona Virus Disease 2019 (COVID-19) develop a severe clinical course with acute respiratory distress syndrome (ARDS) and fatal outcome. Clinical manifestations and biomarkers in early stages of disease with relevant predictive impact for outcomes remain largely unexplored. We aimed to identify parameters which are significantly different between subgroups. DESIGN: 125 patients with COVID-19 were analysed. Patients with ARDS (N = 59) or non-ARDS (N = 66) were compared, as well as fatal outcome versus survival in the two groups. KEY RESULTS: ARDS and non-ARDS patients did not differ with respect to comorbidities or medication on developing a fatal outcome versus survival. Body mass index was higher in patients with ARDS versus non-ARDS (p = 0.01), but not different within the groups in survivors versus non-survivors. Interleukin-6 levels on admission were higher in patients with ARDS compared to non-ARDS as well as in patients with fatal outcome versus survivors, whereas lymphocyte levels were lower in the different subgroups (all p<0.05). There was a highly significant 3.5-fold difference in fever load in non-survivors compared to survivors (p<0.0001). Extrapulmonary viral spread was detected more often in patients with fatal outcome compared to survivors (P = 0.01). Further the detection of SARS-CoV-2 in serum showed a significantly more severe course and an increased risk of death (both p<0.05). CONCLUSIONS: We have identified early risk markers for a severe clinical course, like ARDS or fatal outcome. This data might help develop a strategy to address new therapeutic options early in patients with COVID-19 and at high risk for fatal outcome. Public Library of Science 2021-01-29 /pmc/articles/PMC7845994/ /pubmed/33513168 http://dx.doi.org/10.1371/journal.pone.0246182 Text en © 2021 Balfanz et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Balfanz, Paul Hartmann, Bojan Müller-Wieland, Dirk Kleines, Michael Häckl, Dennis Kossack, Nils Kersten, Alexander Cornelissen, Christian Müller, Tobias Daher, Ayham Stöhr, Robert Bickenbach, Johannes Marx, Gernot Marx, Nikolaus Dreher, Michael Early risk markers for severe clinical course and fatal outcome in German patients with COVID-19 |
title | Early risk markers for severe clinical course and fatal outcome in German patients with COVID-19 |
title_full | Early risk markers for severe clinical course and fatal outcome in German patients with COVID-19 |
title_fullStr | Early risk markers for severe clinical course and fatal outcome in German patients with COVID-19 |
title_full_unstemmed | Early risk markers for severe clinical course and fatal outcome in German patients with COVID-19 |
title_short | Early risk markers for severe clinical course and fatal outcome in German patients with COVID-19 |
title_sort | early risk markers for severe clinical course and fatal outcome in german patients with covid-19 |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7845994/ https://www.ncbi.nlm.nih.gov/pubmed/33513168 http://dx.doi.org/10.1371/journal.pone.0246182 |
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