Cargando…
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...
Autores principales: | , , , , , , , , , , , , , , |
---|---|
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 |
_version_ | 1784685298175705088 |
---|---|
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. |
format | Online Article Text |
id | pubmed-8999885 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT georgakopoulouvasilikie asimpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT vlachogiannisnikolaosi asimpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT basoulisdimitrios asimpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT eliadiirene asimpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT georgiopoulosgeorgios asimpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT karamanakosgeorgios asimpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT makrodimitrisotiria asimpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT samarastamatia asimpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT triantafylloumaria asimpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT voutsinaspantazism asimpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT ntziorafotinie asimpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT psichogioumina asimpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT samarkosmichael asimpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT sfikakispetrosp asimpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT sipsasnikolaosv asimpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT georgakopoulouvasilikie simpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT vlachogiannisnikolaosi simpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT basoulisdimitrios simpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT eliadiirene simpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT georgiopoulosgeorgios simpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT karamanakosgeorgios simpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT makrodimitrisotiria simpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT samarastamatia simpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT triantafylloumaria simpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT voutsinaspantazism simpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT ntziorafotinie simpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT psichogioumina simpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT samarkosmichael simpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT sfikakispetrosp simpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients AT sipsasnikolaosv simpleprognosticscoreforcriticalcovid19derivedfrompatientswithoutcomorbiditiesperformswellinunselectedpatients |