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Multiple Approaches at Admission Based on Lung Ultrasound and Biomarkers Improves Risk Identification in COVID-19 Patients
Background: Risk stratification of COVID-19 patients is fundamental to improving prognosis and selecting the right treatment. We hypothesized that a combination of lung ultrasound (LUZ-score), biomarkers (sST2), and clinical models (PANDEMYC score) could be useful to improve risk stratification. Met...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8658110/ https://www.ncbi.nlm.nih.gov/pubmed/34884180 http://dx.doi.org/10.3390/jcm10235478 |
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author | Jorge, Rubio-Gracia Marta, Sánchez-Marteles Vanesa, Garcés-Horna Luis, Martínez-Lostao Fernando, Ruiz-Laiglesia Silvia, Crespo-Aznarez Natacha, Peña-Fresneda Borja, Gracia-Tello Alberto, Cebollada Patricia, Carrera-Lasfuentes Ignacio, Pérez-Calvo Juan Ignacio, Giménez-López |
author_facet | Jorge, Rubio-Gracia Marta, Sánchez-Marteles Vanesa, Garcés-Horna Luis, Martínez-Lostao Fernando, Ruiz-Laiglesia Silvia, Crespo-Aznarez Natacha, Peña-Fresneda Borja, Gracia-Tello Alberto, Cebollada Patricia, Carrera-Lasfuentes Ignacio, Pérez-Calvo Juan Ignacio, Giménez-López |
author_sort | Jorge, Rubio-Gracia |
collection | PubMed |
description | Background: Risk stratification of COVID-19 patients is fundamental to improving prognosis and selecting the right treatment. We hypothesized that a combination of lung ultrasound (LUZ-score), biomarkers (sST2), and clinical models (PANDEMYC score) could be useful to improve risk stratification. Methods: This was a prospective cohort study designed to analyze the prognostic value of lung ultrasound, sST2, and PANDEMYC score in COVID-19 patients. The primary endpoint was in-hospital death and/or admission to the intensive care unit. The total length of hospital stay, increase of oxygen flow, or escalated medical treatment during the first 72 h were secondary endpoints. Results: a total of 144 patients were included; the mean age was 57.5 ± 12.78 years. The median PANDEMYC score was 243 (52), the median LUZ-score was 21 (10), and the median sST2 was 53.1 ng/mL (30.9). Soluble ST2 showed the best predictive capacity for the primary endpoint (AUC = 0.764 (0.658–0.871); p = 0.001), towards the PANDEMYC score (AUC = 0.762 (0.655–0.870); p = 0.001) and LUZ-score (AUC = 0.749 (0.596–0.901); p = 0.002). Taken together, these three tools significantly improved the risk capacity (AUC = 0.840 (0.727–0.953); p ≤ 0.001). Conclusions: The PANDEMYC score, lung ultrasound, and sST2 concentrations upon admission for COVID-19 are independent predictors of intra-hospital death and/or the need for admission to the ICU for mechanical ventilation. The combination of these predictive tools improves the predictive power compared to each one separately. The use of decision trees, based on multivariate models, could be useful in clinical practice. |
format | Online Article Text |
id | pubmed-8658110 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-86581102021-12-10 Multiple Approaches at Admission Based on Lung Ultrasound and Biomarkers Improves Risk Identification in COVID-19 Patients Jorge, Rubio-Gracia Marta, Sánchez-Marteles Vanesa, Garcés-Horna Luis, Martínez-Lostao Fernando, Ruiz-Laiglesia Silvia, Crespo-Aznarez Natacha, Peña-Fresneda Borja, Gracia-Tello Alberto, Cebollada Patricia, Carrera-Lasfuentes Ignacio, Pérez-Calvo Juan Ignacio, Giménez-López J Clin Med Article Background: Risk stratification of COVID-19 patients is fundamental to improving prognosis and selecting the right treatment. We hypothesized that a combination of lung ultrasound (LUZ-score), biomarkers (sST2), and clinical models (PANDEMYC score) could be useful to improve risk stratification. Methods: This was a prospective cohort study designed to analyze the prognostic value of lung ultrasound, sST2, and PANDEMYC score in COVID-19 patients. The primary endpoint was in-hospital death and/or admission to the intensive care unit. The total length of hospital stay, increase of oxygen flow, or escalated medical treatment during the first 72 h were secondary endpoints. Results: a total of 144 patients were included; the mean age was 57.5 ± 12.78 years. The median PANDEMYC score was 243 (52), the median LUZ-score was 21 (10), and the median sST2 was 53.1 ng/mL (30.9). Soluble ST2 showed the best predictive capacity for the primary endpoint (AUC = 0.764 (0.658–0.871); p = 0.001), towards the PANDEMYC score (AUC = 0.762 (0.655–0.870); p = 0.001) and LUZ-score (AUC = 0.749 (0.596–0.901); p = 0.002). Taken together, these three tools significantly improved the risk capacity (AUC = 0.840 (0.727–0.953); p ≤ 0.001). Conclusions: The PANDEMYC score, lung ultrasound, and sST2 concentrations upon admission for COVID-19 are independent predictors of intra-hospital death and/or the need for admission to the ICU for mechanical ventilation. The combination of these predictive tools improves the predictive power compared to each one separately. The use of decision trees, based on multivariate models, could be useful in clinical practice. MDPI 2021-11-23 /pmc/articles/PMC8658110/ /pubmed/34884180 http://dx.doi.org/10.3390/jcm10235478 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Jorge, Rubio-Gracia Marta, Sánchez-Marteles Vanesa, Garcés-Horna Luis, Martínez-Lostao Fernando, Ruiz-Laiglesia Silvia, Crespo-Aznarez Natacha, Peña-Fresneda Borja, Gracia-Tello Alberto, Cebollada Patricia, Carrera-Lasfuentes Ignacio, Pérez-Calvo Juan Ignacio, Giménez-López Multiple Approaches at Admission Based on Lung Ultrasound and Biomarkers Improves Risk Identification in COVID-19 Patients |
title | Multiple Approaches at Admission Based on Lung Ultrasound and Biomarkers Improves Risk Identification in COVID-19 Patients |
title_full | Multiple Approaches at Admission Based on Lung Ultrasound and Biomarkers Improves Risk Identification in COVID-19 Patients |
title_fullStr | Multiple Approaches at Admission Based on Lung Ultrasound and Biomarkers Improves Risk Identification in COVID-19 Patients |
title_full_unstemmed | Multiple Approaches at Admission Based on Lung Ultrasound and Biomarkers Improves Risk Identification in COVID-19 Patients |
title_short | Multiple Approaches at Admission Based on Lung Ultrasound and Biomarkers Improves Risk Identification in COVID-19 Patients |
title_sort | multiple approaches at admission based on lung ultrasound and biomarkers improves risk identification in covid-19 patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8658110/ https://www.ncbi.nlm.nih.gov/pubmed/34884180 http://dx.doi.org/10.3390/jcm10235478 |
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