299. D-dimer as an ICU Admission Risk Predictor in COVID-19 Patients, A Prospective Study

Abstract Background Since the onset of the 2019 coronavirus disease 2019 (COVID-19) pandemic, the rapid increase in community-acquired pneumonia (CAP) cases has led to an excessive rate of intensive care units (ICU) admissions, a rate varying between 5-18%, depending on the country. Consequently, the study of serum biomarkers, such as D-dimer, have been utilized to identify patient with severe disease. However, further data is needed to confirm the association between this serum concentration of D-dimer and the risk of ICU admission. Thus, the aim of this study was to determine if serum concentration of D-dimer predict the risk of ICU admission in patients with COVID-19 and CAP. Methods A prospective observational study was carried out at the Clinica Universidad de La Sabana, Colombia. Patients older than 18 years old, hospitalized for COVID-19 or CAP were included. Then, patients were stratified into ICU and non-ICU patients. Plasma samples were collected within the first 24 hours of hospital admission to quantify D-dimer using the PATHFAST system. Concentrations were compared among groups and to assess the biomarker capacity to predict ICU admission risk, ROC curves were used. Finally, a DeLong test was applied to compare their differences. Results A total of 240 patients diagnosed with lower respiratory tract infection were included in the study. 88 patients were COVID-19 negative (CAP) and 152 were positive. Plasma concentrations of D-dimer (µg/ml) were significantly higher in COVID-19 patients admitted to the ICU when compared with non-ICU COVID-19 admitted patients (Median [IQR]; 1.54 [0.9-3.25] Vs. 1.13 [0.69-1.69], p=0.005). The area under curve (AUC) ROC to predict ICU admission was 0.62 among COVID-19 patients. DeLong’s test p value was 0.24. Serum D-dimer an ICU admission Conclusion D-dimer seems to be a promising tool to identify COVID-19 patients with disease. However, this predicting capacity was not observed in CAP patients. Further studies are needed to identify the mechanisms underling the elevation of D-dimer in COVID-19 patients. Disclosures All Authors: No reported disclosures

Download Full-text

319. Presepsin as a Prognostic Biomarker for Mortality in COVID-19 Patients vs Community-Adquired Pneumonia (CAP) Patients

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.521 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S265-S265

Author(s):

Lina Morales-Cely ◽

Laura A Bravo-Castelo ◽

Ingrid G Bustos-Moya ◽

Yuli Fuentes ◽

Julian Lozada-Arciniegas ◽

...

Keyword(s):

At Risk ◽

Plasma Concentration ◽

Prognostic Biomarker ◽

Plasma Concentrations ◽

Area Under The Curve ◽

Roc Curves ◽

Community Acquired Pneumonia ◽

P Value ◽

Patients At Risk ◽

Tract Infections

Abstract Background Lower respiratory tract infections such as community-acquired pneumonia (CAP) and coronavirus disease 2019 (COVID-19) are the main current causes of mortality worldwide. Several scores and biomarkers have been proposed to identify patients at risk of dying, with unclear results. Presepsin is a glycoprotein expressed on the surface of the membrane of monocytes and macrophages and its utility has been proven in sepsis as a predictor of severity and treatment response. However, it is unknown the utility of this biomarker as a mortality predictor among COVID-19 and CAP patients. Thus, the aim of this study was to determine the utility of serum presepsin to identify patients at risk of dying due to COVID-19 and CAP. Methods A prospective observational study was conducted at Clinica Universidad de La Sabana, Colombia. We included 240 patients who required hospital admission due to CAP or COVID-19. Plasma samples were collected within 24 hours of admission. The presepsin concentration was quantified using the PATHFAST system. Afterwards, a two-tailed test was used to compare mortality rates among patients and their presepsin plasma concentration. Lastly, the ROC was calculated to determine presepsin’s sensibility as a mortality predictor. Results A total of 88 patients with CAP and 152 patients with COVID-19 were included in the study. The median [with IQR] in Presepsin plasma concentration was higher in all patients who died (920 [573 - 2340] vs 573 [307,5 - 1052,5], p-value< 0.0001). Furthermore, comparing to the study group, the median concentration of presepsin was higher in patients deceased by COVID-19 than those who survived. (1358 [642,8 - 2976,8] vs 570 [333,2 - 1007,5], p-value< 0.0001). In addition, the area under the curve (AUC) ROC of presepsin to predict risk of mortality was 0.769. DeLong’s test comparing ROC curves in COVID-19 and CAP patients had a p-value=0.073. Serum presepsin results Conclusion Plasma concentrations of presepsin plasma were higher among COVID-19 patients who died. Moreover, serum concentration of presepsin were not useful to identify CAP patients at risk of dying. However, practical use of Presepsin as a prognostic biomarker of severity is yet to be assessed as further studies are needed. Disclosures All Authors: No reported disclosures

Download Full-text

The prognostic role of inflammatory markers in COVID 19 patients – A retrospective analysis.

10.21203/rs.3.rs-1121729/v1 ◽

2021 ◽

Author(s):

Shivkumar Gopalakrishnan ◽

sangeetha kandasamy ◽

S.Malini ◽

S.Peer Mohamed ◽

k.velmurugan

Keyword(s):

Inflammatory Markers ◽

Severe Disease ◽

Radiation Hazard ◽

P Value ◽

Binary Logistic Regression Analysis ◽

Group Iii ◽

Group I ◽

Group Ii ◽

D Dimer

Abstract Background. Approximately 5% of COVID-19 patients suffer near fatal disease. Clinical and radiologic features may predict severe disease albeit with limited specificity and radiation hazard. Laboratory biomarkers are eyed as simple, specific and point of care triage tools to optimize management decisions.This study aimed to study the role of inflammatory markers in prognosticating COVID-19 patients.Methodology. A hospital based retrospective study was conducted on COVID-19 adult inpatients classified into three groups as mild disease-recovered [Group I], severe disease-recovered [Group II] and dead [Group III]. Categorical outcomes were compared using Chi square test. Univariate binary logistic regression analysis was performed to test the association between the explanatory and outcome variables. Unadjusted OR along with 95% CI was calculated. The utility of lab parameters (Ferritin, LDH, D dimer, N/L ratio and PLT/L ratio) in predicting severity of COVID-19 was assessed by Receiver Operative Curve (ROC) analysis. P value < 0.05 was considered statistically significant.Results. The mean age was 49.32 +/- 17.1 years. Among study population, 378 were Group I, 66 Group II, and 56 Group III. Median levels of Ferritin among the 3 groups were 62ng/mL, 388.50 ng/mL and 1199.50 ng/mL. Median value of LDH were 95U/L, 720 and 982.50(p <0.001). D-dimer values of 3 groups were 23.20ng/mL, 104.30 ng/mL and 197.10 ng/mL (p <0.001). CRP done qualitatively was positive in 2 (0.53%), 30 (45.45%) and 53 (94.64%) of patients. The odds of patients suffering severe COVID-19 rose with rising values of ferritin, LDH and D-dimer [unadjusted OR 1.007, 1.004 &1.020]Conclusion. One time measurement of serum ferritin, LDH, D-dimer and CRP is promising to predict outcomes for COVID 19 inpatients. Single qualitative CRP was equally good but more cost effective than quantitative CRP. The most specific combination was NLR, Lymphocyte percentage and D-dimer levels done between 7th – 10th day of symptoms.

Download Full-text

Clinical Characteristic of Thoracic Malignancy Patients with Coronavirus Disease 2019 Related to Mitigation Strategy in Dharmais National Cancer Center Hospital, Indonesia

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6525 ◽

2021 ◽

Vol 9 (B) ◽

pp. 692-697

Author(s):

Arif Hanafi ◽

Noorwati Soetandyo ◽

Achmad Mulawarman Jayusman ◽

Leovinna Widjaja ◽

Fifi Dwijayanti ◽

...

Keyword(s):

Cancer Patients ◽

Disease Severity ◽

Poor Prognosis ◽

Severe Disease ◽

Mitigation Strategy ◽

Cancer Center ◽

P Value ◽

Lymphocyte Ratio ◽

Thoracic Malignancy ◽

D Dimer

Aim: To describe the clinical data and disease severity of thoracic malignancy patients with COVID-19 and its relation to the mitigation process at the Dharmais National Cancer Center, Indonesia. Methods: Total 5256 cancer patients registered from May 2020 to March 2021. There were 681 cancer patients diagnosed with COVID-19. Forty-five thoracic malignancy patients were enrolled. Data from medical records were obtained at the Dharmais Cancer Hospital, then analyzed using SPSS version 25. Comparative result was considered significant, as p-value < 0.05. Results: There were 12.9% of total patients registered infected by COVID-19, which 6% with thoracic malignancy dominated by Non-small cell lung carcinoma (57.8%). Patients who have asymptomatic (31.1%), mild (13.3%), and moderate COVID-19 disease (8.9%) were alive. Patient with severe disease (46.7%) tend to deteriorate. Neutrophilia (mean 78.0%), lymphopenia (mean 13.0%), high neutrophil to lymphocyte ratio (mean 13.1), hyperuricemia (mean 31.6 mg/dL), high fibrinogen (mean 521.7 mg/dL), and high d-dimer (mean 3821.6 ng/mL) were significantly associated with disease severity (p-value < 0.05). Conclusions: Only small number of cancer patients affected by COVID-19 and mostly do not progress to severe disease, showing the strict mitigation strategy was successful. Severe disease patients have a poor prognosis, with neutrophilia, lymphopenia, high neutrophil to lymphocyte ratio, hyperuricemia, high fibrinogen, and high d-dimer may be valuable for predicting poor prognosis.

Download Full-text

Ambulant erworbene Pneumonie: Die Mortalität nachhaltig senken

Karger Kompass Pneumologie ◽

10.1159/000510837 ◽

2020 ◽

Vol 8 (5) ◽

pp. 252-253

Author(s):

Stefan Krüger

Keyword(s):

Operating Characteristic ◽

Distress Syndrome ◽

Area Under The Curve ◽

Scoring Systems ◽

Roc Curves ◽

Community Acquired Pneumonia ◽

Ambulant Erworbene Pneumonie ◽

Icu Admission ◽

Failure Assessment

Background: The study aimed to investigate the predictive value of the quick sequential organ failure assessment (qSOFA) for clinical outcomes in emergency patients with community-acquired pneumonia (CAP). Methods: A total of 742 CAP cases from the emergency department (ED) were enrolled in this study. The scoring systems including the qSOFA, SOFA and CURB-65 (confusion, urea, respiratory rate, blood pressure and age) were used to predict the prognostic outcomes of CAP in ICU-admission, acute respiratory distress syndrome (ARDS) and 28-day mortality. According to the area under the curve (AUC) of the receiver operating characteristic (ROC) curves, the accuracies of prediction of the scoring systems were analyzed among CAP patients. Results: The AUC values of the qSOFA, SOFA and CURB-65 scores for ICU-admission among CAP patients were 0.712 (95%CI: 0.678–0.745, P < 0.001), 0.744 (95%CI: 0.711–0.775, P < 0.001) and 0.705 (95%CI: 0.671–0.738, P < 0.001), respectively. For ARDS, the AUC values of the qSOFA, SOFA and CURB-65 scores were 0.730 (95%CI: 0.697–0.762, P < 0.001), 0.724 (95%CI: 0.690–0.756, P < 0.001) and 0.749 (95%CI: 0.716–0.780, P < 0.001), respectively. After 28 days of follow-up, the AUC values of the qSOFA, SOFA and CURB-65 scores for 28-day mortality were 0.602 (95%CI: 0.566–0.638, P < 0.001), 0.587 (95%CI: 0.551–0.623, P < 0.001) and 0.614 (95%CI: 0.577–0.649, P < 0.001) in turn. There were no statistical differences between qSOFA and SOFA scores for predicting ICU-admission (Z = 1.482, P = 0.138), ARDS (Z = 0.321, P = 0.748) and 28-day mortality (Z = 0.573, P = 0.567). Moreover, we found no differences to predict the ICU-admission (Z = 0.370, P = 0.712), ARDS (Z = 0.900, P = 0.368) and 28-day mortality (Z = 0.768, P = 0.442) using qSOFA or CURB-65 scores. Conclusion: qSOFA was not inferior to SOFA or CURB-65 scores in predicting the ICU-admission, ARDS and 28-day mortality of patients presenting in the ED with CAP.

Download Full-text

Lack of Association Between 25-Hydroxyvitamin D Level and Outcomes in Hospitalized Indian Patients With COVID-19

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.563 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A277-A278

Author(s):

Ganesh Jevalikar ◽

Rutuja Sharma ◽

Khalid J Farooqui ◽

Anshu Singh ◽

Sandeep Budhiraja ◽

...

Keyword(s):

Clinical Outcomes ◽

Inflammatory Markers ◽

Severe Disease ◽

Laboratory Data ◽

Ordinal Scale ◽

Nasopharyngeal Swab ◽

Icu Admission ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

D Dimer

Abstract Vitamin D deficiency (VDD) is thought to play a role in determining the outcomes of COVID-19. India has a high prevalence of VDD. We hypothesized that VDD as measured by serum 25-hydroxyvitamin D (25OHD) <20 ng/mL is associated with severe COVID-19 infection. Outcomes were assessed by the WHO ordinal scale for clinical improvement (OSCI)1, the need for oxygen therapy, admission to an intensive care unit (ICU), and inflammatory markers. The diagnosis of COVID-19 was proven by RT-PCR on the nasopharyngeal swab for SARS-CoV2. Serum 25OHD and PTH were measured in addition to the standard protocol for COVID-19. Clinical and laboratory data were extracted from electronic medical records and analyzed using SPSS v22.0. Patients with OSCI score < 5 were classified as mild and ≥5 as severe disease. The study was approved by the Institutional Ethics Committee. A total of 410 patients (127 females, 9 pediatric, 17 asymptomatic) were included with a median age of 54 years (6–92 years) with 272(66.3%) having at least one co-morbid condition, including diabetes (190, 46.3%) and hypertension (164,40%). Patients with VDD (197,48%) were significantly younger (46.7±17.1 vs. 57.8±14.7 years) and had lesser prevalence of diabetes and hypertension (39.1% vs 52.4%, 29.4% vs 49.5%). Proportion of severe cases (26,13.2% vs. 31,14.6%), mortality (4, 2% vs. 11, 5.2%), oxygen requirement (68,34.5% vs.92,43.4), ICU admission (29, 14.7% vs. 42, 19.8%), need for inotropes (7,3.6% vs.12,5.7%) was not significantly different between patients with VDD and those with normal 25OHD level. The proportion of severe cases was similar across all 25OHD categories. There was no significant correlation between 25OHD levels and outcome OSCI, inflammatory markers (CRP, IL-6, D-dimer, ferritin, LDH). PTH levels positively correlated with D-dimer (r 0.117, p- 0.019), ferritin (r 0.132, p-0.010) and LDH (r0.124, p-0.018). Amongst VDD patients, 128(64.9%) were treated with cholecalciferol with a median dose of 60000 IU. The proportion of severe cases, oxygen, or ICU admission was not significantly different in the treated vs. untreated group. In conclusion, baseline levels of 25OHD did not determine the severe clinical outcomes of COVID-19 or levels of inflammatory markers. Treatment with cholecalciferol did not make any difference to the clinical outcomes of those with VDD. Reference:1WHO R&D Blueprint, novel Coronavirus. Retrieved from: https://www.who.int/blueprint/priority-diseases/key-action/COVID-19_Treatment_Trial_Design_Master_Protocol_synopsis_Final_18022020.pdf

Download Full-text

The Age-AST-D Dimer (AAD) Regression Model Predicts Severe COVID-19 Disease

Disease Markers ◽

10.1155/2021/6658270 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Fátima Higuera-de-la-Tijera ◽

Alfredo Servín-Caamaño ◽

Daniel Reyes-Herrera ◽

Argelia Flores-López ◽

Enrique J. A. Robiou-Vivero ◽

...

Keyword(s):

Intensive Care ◽

Liver Injury ◽

Clinical Course ◽

Severe Disease ◽

Lactic Dehydrogenase ◽

Icu Patients ◽

Derivation Cohort ◽

Icu Admission ◽

Admission Time ◽

D Dimer

Aim. Coronavirus disease (COVID-19) ranges from mild clinical phenotypes to life-threatening conditions like severe acute respiratory syndrome (SARS). It has been suggested that early liver injury in these patients could be a risk factor for poor outcome. We aimed to identify early biochemical predictive factors related to severe disease development with intensive care requirements in patients with COVID-19. Methods. Data from COVID-19 patients were collected at admission time to our hospital. Differential biochemical factors were identified between seriously ill patients requiring intensive care unit (ICU) admission (ICU patients) versus stable patients without the need for ICU admission (non-ICU patients). Multiple linear regression was applied, then a predictive model of severity called Age-AST-D dimer (AAD) was constructed ( n = 166 ) and validated ( n = 170 ). Results. Derivation cohort: from 166 patients included, there were 27 (16.3%) ICU patients that showed higher levels of liver injury markers ( P < 0.01 ) compared with non-ICU patients: alanine aminotrasnferase (ALT) 225.4 ± 341.2 vs. 41.3 ± 41.1 , aspartate aminotransferase (AST) 325.3 ± 382.4 vs. 52.8 ± 47.1 , lactic dehydrogenase (LDH) 764.6 ± 401.9 vs. 461.0 ± 185.6 , D-dimer (DD) 7765 ± 9109 vs. 1871 ± 4146 , and age 58.6 ± 12.7 vs. 49.1 ± 12.8 . With these finding, a model called Age-AST-DD (AAD), with a cut-point of <2.75 ( sensitivity = 0.797 and specificity = 0.391 , c − statistic = 0.74 ; 95%IC: 0.62-0.86, P < 0.001 ), to predict the risk of need admission to ICU ( OR = 5.8 ; 95% CI: 2.2-15.4, P = 0.001 ), was constructed. Validation cohort: in 170 different patients, the AAD model < 2.75 ( c − statistic = 0.80 (95% CI: 0.70-0.91, P < 0.001 ) adequately predicted the risk ( OR = 8.8 , 95% CI: 3.4-22.6, P < 0.001 ) to be admitted in the ICU (27 patients, 15.95%). Conclusions. The elevation of AST (a possible marker of early liver injury) along with DD and age efficiently predict early (at admission time) probability of ICU admission during the clinical course of COVID-19. The AAD model can improve the comprehensive management of COVID-19 patients, and it could be useful as a triage tool to early classify patients with a high risk of developing a severe clinical course of the disease.

Download Full-text

4221 Lower Serum TWEAK Concentration is a Biomarker for Mortality in Community Acquired Pneumonia

Journal of Clinical and Translational Science ◽

10.1017/cts.2020.411 ◽

2020 ◽

Vol 4 (s1) ◽

pp. 139-139

Author(s):

Daniela Parra ◽

Manuela Sáenz-Valcárcel ◽

Laura Claverias ◽

Sandra Trefler ◽

María Bodí ◽

...

Keyword(s):

Serum Concentration ◽

Length Of Hospital Stay ◽

Community Acquired Pneumonia ◽

University Hospitals ◽

Underdeveloped Countries ◽

Icu Admission ◽

Inflammatory Processes ◽

Study Population ◽

The Relationship

OBJECTIVES/GOALS: To determine the relationship among serum concentration of tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) and mortality in community-acquired pneumonia (CAP) patients. METHODS/STUDY POPULATION: This is a multicenter 2-year cohort study in Spain, designed to better understand the role of sTWEAK concentrations in CAP patients. CAP patients were prospectively enrolled in two University hospitals and sTWEAK was measured within the first 24 hours of ICU admission. Samples were collected and stored for laboratory analyses. To detect sTWEAK in human samples, we used a commercially available ELISA kit following manufacturer’s instructions. Demographic patients’ characteristics and ICU mortality were prospectively collected. Descriptive statistics and logistical regressions were used to assess the proposed aims. RESULTS/ANTICIPATED RESULTS: A total of forty-three patients were included in the study (10 healthy users, 10 uninfected controls and 23 CAP patients). In comparison to healthy volunteers, patients admitted to the hospital (both, infected and non-infected) had lower level of sTWEAK. During hospital admission, 7 (17%) patients died. Patients whom died during ICU stay due to CAP, had significantly lower levels of sTWEAK when comparing with patients whom survived (Median [IQR]; 509.35 [357.49, 953.92] Vs 1103.03 [716.93, 1663.16]; p = 0.015). In contrast, patients that developed shock did not have different concentrations of sTWEAK (Median [IQR]; 1008.04 [531.87, 1390.80] Vs 1062.29 [575.24, 1598.83], p = 0.84). DISCUSSION/SIGNIFICANCE OF IMPACT: Community-acquired pneumonia (CAP) is the first cause of death in underdeveloped countries. CAP is a pulmonary infection that creates a proinflammatory environment not just locally but also systemically, secondary to upregulation of molecular cascades with a wide variety of proteins being released perpetuating this inflammation and tissue damage. Several of these molecules have been described and linked to a greater risk of inhospital complications, longer length of hospital stay and mortality. TNF-like weak inducer of apoptosis (TWEAK) is a member of the TNF-alpha superfamily, involved in immune response, cell growth, angiogenesis, NF-kB activation and apoptosis induction in tumor cells. It is known that serum-TWEAK plays a role in inflammatory processes, however, its behavior is unknown in patients with CAP. Therefore, this study aims to identify whether there is a relationship between serum concentration of TWEAK and prognosis in CAP patients. To our knowledge, this is the first study to shown that concentration of sTWEAK within the first 24 hours of ICU admission is lower in patients with CAP. Moreover, patients whom died during ICU admission due to CAP, have lower sTWEAK levels. This biomarker may identify patients at higher risk of dying due to CAP and may represent severe CAP. However, further studies are needed to confirm these findings.

Download Full-text

A Composite study of Coagulation Milieu in Covid-19: Experience from a Tertiary Care Centre from India

Cardiovascular & Haematological Disorders - Drug Targets ◽

10.2174/1871529x21666211201110007 ◽

2021 ◽

Vol 21 ◽

Author(s):

Gopal Krishana Bohra ◽

Abhishek Purohit ◽

Deepak Kumar ◽

Mahendra Kumar Garg ◽

Naresh Kumar Midha ◽

...

Keyword(s):

Factor Viii ◽

Disease Severity ◽

Inflammatory Markers ◽

Severe Disease ◽

Advanced Age ◽

P Value ◽

Coagulation Parameters ◽

Inflammatory Parameters ◽

Hs Crp ◽

D Dimer

Background:: The understanding of pathogenesis is necessary for the development of effective treatment for COVID-19. Various studies have postulated that there is a complex interplay of mediators of coagulation and inflammation responsible for the pathogenesis of COVID-19. We did this study on coagulation parameters and inflammatory markers and their effect on outcome in patients with COVID-19. Methods: This was a single centre observational cross-sectional study. Procoagulants [Prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer, lupus anticoagulant (LA), fibrinogen, factor-VIII (F-VIII)]; anticoagulants [protein-C (PC), protein-S (PS), antithrombin] and inflammatory markers [interleukin-6 (IL-6) and highly sensitive – C-reactive protein (hs-CRP)] were measured at the time of hospitalization and correlated with the severity of the disease. Results: A total of 230 patients were enrolled, of which 61.3%, 20.0%, and 18.7% had asymptomatic/ mild, moderate, or severe disease, respectively. COVID-19 disease severity was associated with rising trends with coagulation parameters (PT, APTT, D-Dimer; p value 0.01, <0.0001, <0.0001, respectively). Falling trends of anticoagulant (PC, Antithrombin; p value <0.0001, 0.003 respectively) and rising trends of procoagulant (fibrinogen, F-VIII; p value 0.004, <0.0001 respectively) were observed with increasing COVID-19 disease severity. Multivariate logistic regression analysis found that advanced age, D-Dimer, and hs-CRP (p value 0.035, 0.018, <0.0001 respectively) were independent predictors of mortality in COVID-19. Procoagulant parameters (D-dimer, APTT, Factor VIII) were positively correlated with anticoagulant parameters (PC and PS) and inflammatory parameters (hs-CRP). Conclusions: This study revealed increased levels of coagulation and inflammatory parameters, which correlated with the severity of COVID-19. Age, D-dimer, IL-6, hs-CRP, APTT, fibrinogen, and Factor VIII were significantly higher in patients with moderate and severe disease as compared to asymptomatic/mild disease. Advanced age, D dimer, and hs-CRP were significantly associated with poor outcomes.

Download Full-text

1335. High Serum Levels of Interleukin-10 as a Predictor Factor of In-Hospital Mortality in COVID-19 Patients

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.1527 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S755-S756

Author(s):

Salome Gomez-Duque ◽

Enrique Gamboa-Silva ◽

Ingrid G Bustos-Moya ◽

Yuli Fuentes ◽

Julian Lozada-Arciniegas ◽

...

Keyword(s):

Hospital Mortality ◽

Roc Curves ◽

Serum Levels ◽

Interleukin 10 ◽

Community Acquired Pneumonia ◽

High Serum ◽

P Value ◽

Serum Samples ◽

Luminex Technology ◽

Patients At Risk

Abstract Background Since the spread of SARS-CoV-2 worldwide, there has been the need for scores and biomarkers to identify patients at risk of died or requiring admission to the intensive care units (ICU) admission. Interleukin-10 (IL-10) is released as a response to the infection, stimulating inflammatory pathways in the acute phase response. Thus, previous studies have shown that high serum concentrations IL-10 can be identify patients with severe community acquired pneumonia (CAP). Nevertheless, there is a lack of information regarding the capacity of IL-10 to identify severe COVID-19. Thus, the aim of this study was to determine the capacity of IL-10 as a prediction factor for mortality in hospital admitted patients with COVID-19 compared with CAP patients. Methods A prospective observational study was carried out at the Clinica Universidad de La Sabana, Colombia. Patients older than 18 years and old, hospitalized due to COVID 19 or CAP, were included. Patients were stratified into COVID-19 and non-COVID-19 patients. IL-10 levels were quantified in serum samples using the LUMINEX technology. Serum samples were collected within the first 24 hours of hospital admission. Afterward, concentrations of interleukinwere statistically compared among groups. ROC curves were calculated. Results A total of 88 patients with CAP and 152 patients with COVID-19 were enrolled in the study. The median [with IQR] serum concentration of IL-10 were higher in those patients who died (81.1 [30.7-148.9] vs 18.8 [8.3-48.4] p-value < 0.0001). Then, comparing the study group, the median concentration of IL-10 levels among patients deceased by COVID-19 were higher than patients those who survived (85.1 [40-149.8] vs 32.4 [13.9-56.7] p-value < 0.001). In addition, IL-10 levels were higher in patients who survived COVID-19 compared with those who survived CAP (32.4 [13.9-56.7] vs 10.6 [4.9-18] p-value < 0.0001). The area under curve (AUC) ROC of IL-10 to predict mortality risk was 0.754 for all cohort. DeLong′s test comparing ROC curves in COVID-19 and CAP patients had a p= 0.744. Conclusion High serum levels of IL-10 are a good predictor of in-hospital mortality among COVID-19 patients. However, this risk association was not observed in CAP patients. Further studies are needed. Disclosures All Authors: No reported disclosures

Download Full-text

The impact of smoking on severity and outcome in patients with COVID-19 infection in Mosul city

10.22541/au.162505077.77351781/v1 ◽

2021 ◽

Author(s):

Mohammad Alsaaty ◽

Abdullah alyyouzbaki ◽

wael thanoon

Keyword(s):

Inflammatory Markers ◽

Statistical Difference ◽

P Value ◽

The Novel ◽

Ibn Sina ◽

Icu Admission ◽

Function Test ◽

Novel Coronavirus ◽

The Impact ◽

D Dimer

Background: The novel coronavirus ( SARS CoV 19) is responsible for the pandemic infection after starting in 2019 in Wuhan city /China, several small studies were done since then to determine the effects of smoking on the severity, outcome & mortality of patients with COVID-19 but the results were inconclusive, this study aims to assess the impact of active smoking on severity and outcome in patients with COVID-19 infection in Mosul city/Iraq. Methods: A prospective cohort study was conducted on 160 patients ( 80 patients were active smokers & 80 non-smoker patients) who have been diagnosed with COVID-19 infection by using real-time PCR, the study was done at Ibn-Sina teaching hospital in Mosul city/Iraq from May 2020 until December 2020. A detailed history was taken from the patients, full clinical examination & blood tests were done. The following parameters were recorded & compared between the 2 groups: severity of symptoms, inflammatory markers, D dimer, liver function test (LFT), oxygen use, hospitalization & outcome. Results: the symptoms of COVID-19 were more severe in the non smokers group (34.4%) compared to the smokers (25%) & it was statistically significant (p-value = 0.016), the inflammatory markers were also higher in the non-smokers (31.9%) compared to the smokers (20.0%) ( p-value = 0.011) , D dimer & LFT were also higher in the non-smoker group ( p-value = 0.01 & 0.008 respectively). There was no statistical difference regarding oxygen use, hospitalization, ICU admission, mortality, or post-recovery complications. Conclusion: severe symptomatic COVID-19 infection was more common in the non-smoker group, the inflammatory markers, D-dimer & LFT were higher in the non-smokers compared to the smokers. No statistical difference was found regarding O2 use, hospitalization, ICU admission, mortality & residual complications.

Download Full-text