scholarly journals C-Reactive protein and SOFA score as early predictors of critical care requirement in patients with COVID-19 pneumonia in Spain

2020 ◽  
Author(s):  
Luis Mario Vaquero-Roncero ◽  
Elisa Sánchez-Barrado ◽  
Daniel Escobar-Macias ◽  
Pilar Arribas-Pérez ◽  
Jose Ramón Gonzalez-Porras ◽  
...  
Keyword(s):  
Critical Care ◽  
Sofa Score ◽  
Care Group ◽  
C Reactive Protein ◽  
Regression Methods ◽  
Reactive Protein ◽  
Early Predictors ◽  
Multivariable Regression ◽  
Care Assistance ◽  
Care Requirement

AbstractBackgroundSome patients infected by SARS-CoV-2 in the recent pandemic have required critical care, becoming one of the main limitations of the health systems. Our objective has been to identify potential markers at admission predicting the need for critical care in patients with COVID-19 pneumonia.MethodsWe retrospectively collected and analyzed data from electronic medical records of patients with laboratory-confirmed SARS-CoV-19 infection by real-time RT-PCR. A comparison was made between patients staying in the hospitalization ward with those who required critical care. Univariable and multivariable logistic regression methods were used to identify risk factors predicting critical care need.FindingsBetween March 15 and April 15, 2020, 150 patients under the age of 75 were selected (all with laboratory confirmed SARS-CoV-19 infection), 75 patients requiring intensive care assistance and 75 remaining the regular hospitalization ward. Most patients requiring critical care were males, 76% compared with 60% in the non-critical care group (p<0.05). Multivariable regression showed increasing odds of in-hospital critical care associated with increased C-reactive protein (CRP) (odds ratio 1.052 (1.009-1.101); p=0.0043) and higher Sequential Organ Failure Assessment (SOFA) score (1.968 (1.389-2.590) p<0.0001) both at the time of hospital admission. The AUC-ROC for the combined model was 0.83 (0.76-0.90) (vs AUC-ROC SOFA p<0.05).InterpretationPatients COVID-19 positive presenting at admission with high SOFA score ≥2 combined with CRP ≥ 9,1 mg/mL could help clinicians to identify them as a group that will more likely require critical care so further actions might be implemented to improve their prognosis.

Evaluation of Microbiologic and Hematologic Parameters and E-Selectin as Early Predictors for Outcome of Neonatal Sepsis

2009 ◽  
Vol 133 (8) ◽  
pp. 1291-1296 ◽  
Author(s):  
Maysaa El Sayed Zaki ◽  
Hesham El Sayed
Keyword(s):  
Neonatal Sepsis ◽  
Neonatal Intensive Care ◽  
Newborn Infants ◽  
Prognostic Indicator ◽  
Diagnostic Value ◽  
Total Leukocyte Count ◽  
C Reactive Protein ◽  
Gram Negative ◽  
Reactive Protein ◽  
Early Predictors

Abstract Context.—Early diagnosis of neonatal sepsis is mandatory. Various markers are used to diagnose the condition. Objective.—To evaluate the diagnostic value of various clinical data and hematologic parameters, such as total leukocyte count, absolute neutrophil count, immature to total neutrophil ratio, and soluble E-selectin (sE-selectin) in identification and outcome of neonatal sepsis. Design.—Newborn infants with a clinical diagnosis of sepsis in the neonatal intensive care unit at Mansoura University Children's Hospital during the period between July 2007 and December 2007 were eligible for study. In addition, 30 healthy neonates were included in the study. Complete hematologic and microbiologic laboratory investigations were performed, and serum E-selectin was measured. Results.—Plasma sE-selectin levels were significantly higher (P &lt; .001) in infected infants (mean [SD], 156.9 [77.0] ng/mL) than in noninfected (mean [SD], 88.8 [47.1] ng/mL) and healthy infants (mean [SD], 8.67 [3.74] ng/ mL). Infants with gram-negative sepsis had higher sE-selectin levels than did those with gram-positive sepsis (P = .04). C-reactive protein was the best laboratory test for diagnosis of neonatal sepsis, with an overall sensitivity and specificity of 86% and 97%, respectively. Performing sE-selectin with C-reactive protein or immature to total ratio tests increased the specificity, but reduced the sensitivity, of the tests for the determination of neonatal sepsis. Plasma sE-selectin levels were higher in nonsurvivors than in survivors (P = .01) and were higher in those with hemodynamic dysfunction than in those without hemodynamic dysfunction (P &lt; .001). Conclusions.—We conclude that plasma sE-selectin levels are elevated in neonatal sepsis. Significant elevation was associated with gram-negative sepsis. Plasma sE-selectin had low diagnostic value when used alone or in combination with other tests; however, it can be used as a prognostic indicator for the outcome of neonatal sepsis.

scholarly journals The Role of C-Reactive Protein and the SOFA Score as Parameter for Clinical Decision Making in Surgical Patients during the Intensive Care Unit Course

PLoS ONE ◽  
2013 ◽  
Vol 8 (2) ◽  
pp. e55964 ◽  
Author(s):  
Zainna C. Meyer ◽  
Jennifer M. J. Schreinemakers ◽  
Paul G. H. Mulder ◽  
Ruud A. L. de Waal ◽  
Antonius A. M. Ermens ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Sofa Score ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Surgical Patients ◽  
C Reactive Protein ◽  
Reactive Protein

scholarly journals Mid-regional proadrenomedullin (MR-proADM), C-reactive protein (CRP) and other biomarkers in the early identification of disease progression in patients with COVID-19 in the acute NHS setting

2022 ◽  
pp. jclinpath-2021-207750
Author(s):  
Nathan Moore ◽  
Rebecca Williams ◽  
Matilde Mori ◽  
Beatrice Bertolusso ◽  
Gabrielle Vernet ◽  
...  
Keyword(s):  
Critical Care ◽  
Disease Progression ◽  
Cox Regression ◽  
White Cell Count ◽  
Tertiary Care ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Non Invasive Ventilation ◽  
Increased Risk ◽  
Critical Care Admission

AimsThere is a lack of biomarkers validated for assessing clinical deterioration in patients with COVID-19 on presentation to secondary or tertiary care. This evaluation looked at the potential clinical application of C reactive protein (CRP), procalcitonin, mid-regional proadrenomedullin (MR-proADM) and white cell count to support prediction of clinical outcomes.Methods135 patients presenting to Hampshire Hospitals NHS Foundation Trust between April and June 2020 confirmed to have COVID-19 via reverse-transcription-qPCR were included. Biomarkers from within 24 hours of presentation were used to predict disease progression by Cox regression and area under the receiver operating characteristic curves. The endpoints assessed were 30-day all-cause mortality, intubation and ventilation, critical care admission and non-invasive ventilation (NIV) use.ResultsElevated MR-proADM was shown to have the greatest ability to predict 30-day mortality adjusting for age, cardiovascular disease, renal disease and neurological disease. A significant association was also noted between raised MR-proADM and CRP concentrations and the requirement for critical care admission and NIV.ConclusionsThe measurement of MR-proADM and CRP in patients with confirmed COVID-19 infection on admission shows significant potential to support clinicians in identifying those at increased risk of disease progression and need for higher level care, subsequently enabling prompt escalation in clinical interventions.

Abstract 067: Predictors of High-sensitivity C-reactive Protein Elevation Among Patients With Myocardial Infarction: Insights From VIRGO and TRIUMPH

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Mohammed Qintar ◽  
Puza P Sharma ◽  
Yuanyuan Tang ◽  
Philip Jones ◽  
Yashashwi Pokharel ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
High Sensitivity ◽  
Peripheral Vascular ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
History Of ◽  
Multivariable Regression ◽  
Hs Crp

Background: Elevated hs-CRP is associated with worse cardiovascular outcomes in patients with acute myocardial infarction (AMI), but little is known about predictors of elevated hs-CRP after AMI. Methods: TRIUMPH and VIRGO are prospective AMI registries that assessed hs-CRP levels 30 days after AMI. TRIUMPH assessed hs-CRP levels at 6 months. Multivariable regression analysis was conducted to examine predictors of elevated hs-CRP [≥2.0 mg/L] at 30 days and at 6 months after an AMI (TRIUMPH only). Results: Of 3410 patients in both registries, 58.6% had elevated hs-CRP 30 days post AMI. Patients with elevated hs-CRP were more likely to be female, black, obese, smokers, to have had higher LDL-C at the time of their AMI, with more peripheral vascular disease and history of heart failure, and were less likely to have had a prior PCI (Table). In TRIUMPH, baseline hs-CRP ≥2 mg/L (n=1301) was significantly associated with elevated hs-CRP at 6 months (p<0.001). Patients with elevated hs-CRP at 6 months (n=407) were more likely to be black, obese, smokers, have peripheral vascular disease and have higher baseline hs-CRP. Conclusions: hs-CRP remains elevated in a large proportion of patients following AMI. We identified several predictors of elevated hs-CRP at 1 and 6 months post AMI. Further studies are needed to validate the findings and understand the utility of routine screening of hs-CRP in post AMI patients.

Procalcitonin and C-Reactive Protein as Early Predictors of Anastomotic Leak in Colorectal Surgery

2013 ◽  
Vol 56 (4) ◽  
pp. 475-483 ◽  
Author(s):  
Alvaro Garcia-Granero ◽  
Matteo Frasson ◽  
Blas Flor-Lorente ◽  
Francisco Blanco ◽  
Ramon Puga ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leak ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Early Predictors

scholarly journals C-reactive protein is not a useful indicator for infection in surgical intensive care units

2009 ◽  
Vol 127 (6) ◽  
pp. 350-354 ◽  
Author(s):  
Domingos Dias Cicarelli ◽  
Joaquim Edson Vieira ◽  
Fábio Ely Martins Benseñor
Keyword(s):  
Septic Shock ◽  
Intensive Care ◽  
Postoperative Period ◽  
Sofa Score ◽  
Early Postoperative Period ◽  
Surgical Intensive Care Unit ◽  
C Reactive Protein ◽  
Surgical Intensive Care ◽  
Reactive Protein ◽  
Lactate Levels

CONTEXT AND OBJECTIVE: C-reactive protein (CRP) is commonly used as a marker for inflammatory states and for early identification of infection. This study aimed to investigate CRP as a marker for infection in patients with postoperative septic shock. DESIGN AND SETTING: Prospective, single-center study, developed in a surgical intensive care unit at Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo. METHODS: This study evaluated 54 patients in the postoperative period, of whom 29 had septic shock (SS group) and 25 had systemic inflammatory response syndrome (SIRS group). All of the patients were monitored over a seven-day period using the Sequential Organ Failure Assessment (SOFA) score and daily CRP and lactate measurements. RESULTS: The daily CRP measurements did not differ between the groups. There was no correlation between CRP and lactate levels and the SOFA score in the groups. We observed that the plasma CRP concentrations were high in almost all of the patients. The patients presented an inflammatory state postoperatively in response to surgical aggression. This could explain the elevated CRP measurements, regardless of whether the patient was infected or not. CONCLUSIONS: This study did not show any correlation between CRP and infection among patients with SIRS and septic shock during the early postoperative period.

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