Prognostic Biomarkers For Mortality In Severe COVID-19 Patients : The Worth of C-reactive Protein, Serum Ferritin and D-dimer

Background: Patients critically ill with coronavirus disease-2019 (COVID-19) feature hyperinflammation, and the associated biomarkers may be beneficial for risk stratification. We aimed to investigate the association between several biomarkers, including serum C-reactive protein (CRP), procalcitonin (PCT), D-dimer, and serum ferritin, and COVID-19 severity. Methods: We performed a comprehensive systematic literature search through electronic databases. The outcome of interest for this study was the composite poor outcome, which comprises mortality, acute respiratory distress syndrome, need for care in an intensive care unit, and severe COVID-19. Results: A total of 5350 patients were pooled from 25 studies. Elevated CRP was associated with an increased composite poor outcome [risk ratio (RR) 1.84 (1.45, 2.33), p < 0.001; I2: 96%] and its severe COVID-19 (RR 1.41; I2: 93%) subgroup. A CRP ⩾10 mg/L has a 51% sensitivity, 88% specificity, likelihood ratio (LR) + of 4.1, LR- of 0.5, and an area under curve (AUC) of 0.84. An elevated PCT was associated with an increased composite poor outcome [RR 3.92 (2.42, 6.35), p < 0.001; I2: 85%] and its mortality (RR 6.26; I2: 96%) and severe COVID-19 (RR 3.93; I2: 63%) subgroups. A PCT ⩾0.5 ng/ml has an 88% sensitivity, 68% specificity, LR+ of 2.7, LR- of 0.2, and an AUC of 0.88. An elevated D-dimer was associated with an increased composite poor outcome [RR 2.93 (2.14, 4.01), p < 0.001; I2: 77%], including its mortality (RR 4.15; I2: 83%) and severe COVID-19 (RR 2.42; I2: 58%) subgroups. A D-dimer >0.5 mg/L has a 58% sensitivity, 69% specificity, LR+ of 1.8, LR- of 0.6, and an AUC of 0.69. Patients with a composite poor outcome had a higher serum ferritin with a standardized mean difference of 0.90 (0.64, 1.15), p < 0.0001; I2: 76%. Conclusion: This meta-analysis showed that an elevated serum CRP, PCT, D-dimer, and ferritin were associated with a poor outcome in COVID-19. The reviews of this paper are available via the supplemental material section.

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The effect of remdesivir on selective biomarkers and its value in predicting the clinical outcome in patients with COVID-19

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i12.39164 ◽

2021 ◽

Vol 12 (12) ◽

pp. 3-8

Author(s):

Sanjana Rai ◽

Dyna Jones ◽

Chinnappa Anjanappa Jayashankar ◽

Venkata Bharat Kumar Pinnelli ◽

Eashwer Manpreeth ◽

...

Keyword(s):

Lactate Dehydrogenase ◽

Clinical Outcome ◽

Serum Ferritin ◽

Inflammatory Markers ◽

Complete Blood Count ◽

Group Versus ◽

C Reactive Protein ◽

Reactive Protein ◽

Significant Difference ◽

D Dimer

Background: To the best of our knowledge, there have been no studies to evaluate the effect of remdesivir on inflammatory markers. Aims and Objectives: To study the effect of Remdesivir on Selective biomarkers namely C-Reactive Protein (CRP), Lactate Dehydrogenase (LDH), Serum Ferritin and D-dimer and their value in predicting the clinical outcome in patients with COVID -19 infection. Materials and Methods: This is a retrospective observational study including 102 laboratory-confirmed COVID-19 patients of moderate and severe category who were subjected to complete blood count, liver function test, BUN, creatinine, C-reactive protein, lactate dehydrogenase, D-dimer, serum ferritin, ECG, and chest X-ray. The association was analyzed using independent sample t-test or Mann–Whitney U-test. Patients were divided into two groups. Both received corticosteroids and anticoagulants. Group A also received remdesivir. Results: Of the 102 patients, 90.2% of the patients in the non-remdesivir group and 94.1% in the remdesivir group were discharged. The mortality rate was 9.8% in the non-remdesivir group versus 5.9% in the remdesivir group (P=0.71). There was no statistically significant difference in the decrease of the inflammatory markers overtime in both the groups, irrespective of whether they received remdesivir or not. Conclusion: High values of the inflammatory markers were seen at the time of admission. A 5 days course of remdesivir failed to demonstrate a statistically significant difference in the decrease in the levels of the inflammatory markers. However, we have observed a possible clinical benefit of remdesivir among patients with moderate and severe COVID-19 disease, as there was a trend toward better clinical outcomes. Further studies are needed to evaluate this therapeutic strategy.

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Role of C-reactive protein, serum ferritin, albumin, and lactate dehydrogenase in hospitalized coronavirus disease-19 infected patients - A study in tertiary care coronavirus disease-19 center in Eastern India

National Journal of Physiology Pharmacy and Pharmacology ◽

10.5455/njppp.2021.11.02050202114022021 ◽

2021 ◽

pp. 1

Author(s):

Santasmita Pal ◽

Suvendu Sengupta ◽

Manish Osta

Keyword(s):

Lactate Dehydrogenase ◽

Serum Ferritin ◽

Tertiary Care ◽

Eastern India ◽

C Reactive Protein ◽

Reactive Protein ◽

Protein Serum

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CORRELATION BETWEEN INTERLEUKIN-6 AND C-REACTIVE PROTEIN SERUM LEVEL IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS

10.26226/morressier.56e174d5d462b8028d88a9cf ◽

2016 ◽

Author(s):

Awalia Awalia

Keyword(s):

Systemic Lupus Erythematosus ◽

Serum Level ◽

Lupus Erythematosus ◽

Interleukin 6 ◽

C Reactive Protein ◽

Systemic Lupus ◽

Reactive Protein ◽

Protein Serum

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DOES ELEVATED 72-HOUR PEAK POST OPERATIVE C-REACTIVE PROTEIN SERUM CONCENTRATION PREDICT POSTOPERATIVE COMPLICATIONS IN MAJOR HEAD AND NECK CANCER OPERATIONS?

10.26226/morressier.578e3b4dd462b80292381e1b ◽

2016 ◽

Author(s):

Sarah Touyz

Keyword(s):

Head And Neck Cancer ◽

Postoperative Complications ◽

Serum Concentration ◽

Head And Neck ◽

Neck Cancer ◽

C Reactive Protein ◽

Reactive Protein ◽

Protein Serum

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Efficacy of Tocilizumab Therapy in Different Subtypes of COVID-19 Cytokine Storm Syndrome

Viruses ◽

10.3390/v13061067 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1067

Author(s):

Oleksandr Oliynyk ◽

Wojciech Barg ◽

Anna Slifirczyk ◽

Yanina Oliynyk ◽

Vitaliy Gurianov ◽

...

Keyword(s):

Macrophage Activation Syndrome ◽

Macrophage Activation ◽

Cytokine Storm ◽

Cytokine Release ◽

Cytokine Release Syndrome ◽

C Reactive Protein ◽

Treatment Results ◽

Reactive Protein ◽

Median Serum ◽

D Dimer

Background: Cytokine storm in COVID-19 is heterogenous. There are at least three subtypes: cytokine release syndrome (CRS), macrophage activation syndrome (MAS), and sepsis. Methods: A retrospective study comprising 276 patients with SARS-CoV-2 pneumonia. All patients were tested for ferritin, interleukin-6, D-Dimer, fibrinogen, calcitonin, and C-reactive protein. According to the diagnostic criteria, three groups of patients with different subtypes of cytokine storm syndrome were identified: MAS, CRS or sepsis. In the MAS and CRS groups, treatment results were assessed depending on whether or not tocilizumab was used. Results: MAS was diagnosed in 9.1% of the patients examined, CRS in 81.8%, and sepsis in 9.1%. Median serum ferritin in patients with MAS was significantly higher (5894 vs. 984 vs. 957 ng/mL, p < 0.001) than in those with CRS or sepsis. Hypofibrinogenemia and pancytopenia were also observed in MAS patients. In CRS patients, a higher mortality rate was observed among those who received tocilizumab, 21 vs. 10 patients (p = 0.043), RR = 2.1 (95% CI 1.0–4.3). In MAS patients, tocilizumab decreased the mortality, 13 vs. 6 patients (p = 0.013), RR = 0.50 (95% CI 0.25–0.99). Сonclusions: Tocilizumab therapy in patients with COVID-19 and CRS was associated with increased mortality, while in MAS patients, it contributed to reduced mortality.

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