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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 consecutiv...

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Autores principales: Georgakopoulou, Vasiliki E., Vlachogiannis, Nikolaos I., Basoulis, Dimitrios, Eliadi, Irene, Georgiopoulos, Georgios, Karamanakos, Georgios, Makrodimitri, Sotiria, Samara, Stamatia, Triantafyllou, Maria, Voutsinas, Pantazis M., Ntziora, Fotinie, Psichogiou, Mina, Samarkos, Michael, Sfikakis, Petros P., Sipsas, Nikolaos V.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8999885/
https://www.ncbi.nlm.nih.gov/pubmed/35407418
http://dx.doi.org/10.3390/jcm11071810
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author Georgakopoulou, Vasiliki E.
Vlachogiannis, Nikolaos I.
Basoulis, Dimitrios
Eliadi, Irene
Georgiopoulos, Georgios
Karamanakos, Georgios
Makrodimitri, Sotiria
Samara, Stamatia
Triantafyllou, Maria
Voutsinas, Pantazis M.
Ntziora, Fotinie
Psichogiou, Mina
Samarkos, Michael
Sfikakis, Petros P.
Sipsas, Nikolaos V.
author_facet Georgakopoulou, Vasiliki E.
Vlachogiannis, Nikolaos I.
Basoulis, Dimitrios
Eliadi, Irene
Georgiopoulos, Georgios
Karamanakos, Georgios
Makrodimitri, Sotiria
Samara, Stamatia
Triantafyllou, Maria
Voutsinas, Pantazis M.
Ntziora, Fotinie
Psichogiou, Mina
Samarkos, Michael
Sfikakis, Petros P.
Sipsas, Nikolaos V.
author_sort Georgakopoulou, Vasiliki E.
collection PubMed
description 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.
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spelling pubmed-89998852022-04-12 A Simple Prognostic Score for Critical COVID-19 Derived from Patients without Comorbidities Performs Well in Unselected Patients Georgakopoulou, Vasiliki E. Vlachogiannis, Nikolaos I. Basoulis, Dimitrios Eliadi, Irene Georgiopoulos, Georgios Karamanakos, Georgios Makrodimitri, Sotiria Samara, Stamatia Triantafyllou, Maria Voutsinas, Pantazis M. Ntziora, Fotinie Psichogiou, Mina Samarkos, Michael Sfikakis, Petros P. Sipsas, Nikolaos V. J Clin Med Article 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. MDPI 2022-03-25 /pmc/articles/PMC8999885/ /pubmed/35407418 http://dx.doi.org/10.3390/jcm11071810 Text en © 2022 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
Georgakopoulou, Vasiliki E.
Vlachogiannis, Nikolaos I.
Basoulis, Dimitrios
Eliadi, Irene
Georgiopoulos, Georgios
Karamanakos, Georgios
Makrodimitri, Sotiria
Samara, Stamatia
Triantafyllou, Maria
Voutsinas, Pantazis M.
Ntziora, Fotinie
Psichogiou, Mina
Samarkos, Michael
Sfikakis, Petros P.
Sipsas, Nikolaos V.
A Simple Prognostic Score for Critical COVID-19 Derived from Patients without Comorbidities Performs Well in Unselected Patients
title A Simple Prognostic Score for Critical COVID-19 Derived from Patients without Comorbidities Performs Well in Unselected Patients
title_full A Simple Prognostic Score for Critical COVID-19 Derived from Patients without Comorbidities Performs Well in Unselected Patients
title_fullStr A Simple Prognostic Score for Critical COVID-19 Derived from Patients without Comorbidities Performs Well in Unselected Patients
title_full_unstemmed A Simple Prognostic Score for Critical COVID-19 Derived from Patients without Comorbidities Performs Well in Unselected Patients
title_short A Simple Prognostic Score for Critical COVID-19 Derived from Patients without Comorbidities Performs Well in Unselected Patients
title_sort simple prognostic score for critical covid-19 derived from patients without comorbidities performs well in unselected patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8999885/
https://www.ncbi.nlm.nih.gov/pubmed/35407418
http://dx.doi.org/10.3390/jcm11071810
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