scholarly journals The Predictive Potential of Elevated Serum Inflammatory Markers in Determining the Need for Intubation in CoVID-19 Patients

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Samuel Windham ◽  
Kellen Hirsch ◽  
Ryan Peterson ◽  
David Douin ◽  
Lakshmi Chauhan ◽  
...  
Keyword(s):  
Lactate Dehydrogenase ◽  
Predictive Model ◽  
Inflammatory Markers ◽  
Elevated Serum ◽  
Area Under The Curve ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Diabetes Status ◽  
Time Of Admission ◽  
Serum Inflammatory Markers

Abstract Introduction The predictive potential of demographics, clinical characteristics, and inflammatory markers at admission to determine future intubation needs of hospitalised CoVID-19 patients is unknown. The study aimed to determine the predictive potential of elevated serum inflammatory markers in determining the need for intubation in CoVID-19 Patients. Methods In a retrospective cohort study of hospitalised SARS-CoV2 positive patients, single and multivariable regression analyses were used to determine covariate effects on intubation odds, and a minimax concave penalty regularised logistic regression was used to build a predictive model. A second prospective independent cohort tested the model. Results Systemic inflammatory markers obtained at admission were higher in patients that required subsequent intubation, and adjusted odds of intubation increased for every standard deviation above the mean for c-reactive protein (CRP) OR:2.8 (95% CI 1.8-4.5, p<0.001) and lactate dehydrogenase OR:2.1 (95% CI 1.33.3, p=0.002). A predictive model incorporating C-reactive protein, lactate dehydrogenase, and diabetes status at the time of admission predicted intubation status with an area under the curve (AUC) of 0.78 with corresponding sensitivity of 86%, specificity of 63%. This predictive model achieved an AUC of 0.83, 91% sensitivity, and 41% specificity on the validation cohort. Conclusion In patients hospitalised with CoVID-19, elevated serum inflammatory markers measured within the first twenty-four hours of admission are associated with an increased need for intubation. Additionally, a model of C-reactive protein, lactate dehydrogenase, and the presence of diabetes may play a predictive role in determining the future need for intubation.

Diagnostic accuracy of serum inflammatory markers in late fracture-related infection

2018 ◽  
Vol 100-B (12) ◽  
pp. 1542-1550 ◽  
Author(s):  
J. van den Kieboom ◽  
P. Bosch ◽  
J. D. J. Plate ◽  
F. F. A. IJpma ◽  
R. Kuehl ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Inflammatory Markers ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Mixed Effects Models ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Serum Inflammatory Markers

Aims To assess the diagnostic value of C-reactive protein (CRP), leucocyte count (LC), and erythrocyte sedimentation rate (ESR) in late fracture-related infection (FRI). Materials and Methods PubMed, Embase, and Cochrane databases were searched focusing on the diagnostic value of CRP, LC, and ESR in late FRI. Sensitivity and specificity combinations were extracted for each marker. Average estimates were obtained using bivariate mixed effects models. Results A total of 8284 articles were identified but only six were suitable for inclusion. Sensitivity of CRP ranged from 60.0% to 100.0% and specificity from 34.3% to 85.7% in all publications considered. Five articles were pooled for meta-analysis, showing a sensitivity and specificity of 77.0% and 67.9%, respectively. For LC, this was 22.9% to 72.6%, and 73.5% to 85.7%, respectively, in five articles. Four articles were pooled for meta-analysis, resulting in a 51.7% sensitivity and 67.1% specificity. For ESR, sensitivity and specificity ranged from 37.1% to 100.0% and 59.0% to 85.0%, respectively, in five articles. Three articles were pooled in meta-analysis, showing a 45.1% sensitivity and 79.3% specificity. Four articles analyzed the value of combined inflammatory markers, reporting an increased diagnostic accuracy. These results could not be pooled due to heterogeneity. Conclusion The serum inflammatory markers CRP, LC, and ESR are insufficiently accurate to diagnose late FRI, but they may be used as a suggestive sign in its diagnosis.

Effects of Metformin-Single Therapy on the Level of Inflammatory Markers in Serum of Non-Obese T2DM Patients with NAFLD

2021 ◽  
Vol 21 ◽  
Author(s):  
Bojan Mitrovic ◽  
Zoran Gluvic ◽  
Djuro Macut ◽  
Milan Obradovic ◽  
Emina Sudar-Milovanovic ◽  
...  
Keyword(s):  
Fatty Liver ◽  
Inflammatory Markers ◽  
Liver Steatosis ◽  
Diagnostic Procedures ◽  
Abdominal Ultrasound ◽  
C Reactive Protein ◽  
Subsequent Increase ◽  
Alcoholic Fatty Liver ◽  
Reactive Protein ◽  
Serum Inflammatory Markers

Background and Objectives : Non-alcoholic fatty liver disease (NAFLD) is associated with inflammation and subsequent increase in cardiovascular risk. Because of its widespread presence and distribution, invasive diagnostic procedures (i.e., liver biopsy) are reserved for a limited number of subjects. With liver ultrasound, Fatty liver index (FLI) and fibrosis-4 (FIB-4) scores non-invasively assess liver steatosis and fibrosis. We aimed to evaluate the changes in inflammatory markers and FLI/FIB-4 scores in non-obese metformin-treated type 2 diabetes patients (T2DM) with NAFLD. Methods: All subjects underwent abdominal ultrasound aiming for NAFLD stratification (grade 1 to 3 according to its severity). Metabolic parameters (morning glycaemia, HbA1C, lipids, liver function tests) and serum inflammatory markers (C-reactive protein, ferritin, and nitric oxide), and FLI/FIB-4 are calculated. Results: FLI score and ultrasound NAFLD grades correlated (p<0.05). We observed a significant correlation between the levels of ferritin and C-reactive protein (CRP) (p<0.05), and the FLI (p<0.05). Body weight (BW) (p<0.05), waist circumference (WC) (p<0.05), the levels of HbA1c (p<0.05), transferrin (p<0.05), insulin (p<0.05), and FLI score (p<0.05) significantly differed between groups defined by the severity of NAFLD. Conclusion: This pilot study suggests that the serum inflammatory markers at the average normal values point to the sufficiency of metformin-single therapy in inflammation control in non-obese T2DM patients with NAFLD.

Baseline high-sensitivity C-reactive protein to predict progression-free survival in metastatic renal cell carcinoma patients treated with first-line sunitinib.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15527-e15527
Author(s):  
Ryuichi Mizuno ◽  
Go Kimura ◽  
Tsunenori Kondo ◽  
Takeshi Ueda ◽  
Hidehiko Hara ◽  
...  
Keyword(s):  
Interleukin 6 ◽  
Inflammatory Markers ◽  
Progression Free Survival ◽  
High Sensitivity ◽  
C Reactive Protein ◽  
First Line ◽  
Free Survival ◽  
Reactive Protein ◽  
Hs Crp ◽  
Serum Inflammatory Markers

e15527 Background: Predicting the efficacy of tyrosine kinase inhibitors (TKI) would be of clinical value in patients with metastatic renal cell carcinoma (mRCC). We tested the hypothesis that serum inflammatory markers are associated with clinical outcome in mRCC patients at favorable or intermediate prognostic risk treated with first-line sunitinib. Methods: Eighty-nine mRCC patients were prospectively monitored at baseline (day 0) during sunitinib treatment. Serum interleukin-6 and 8 levels were determined by CLEIA and ELISA, respectively. A high-sensitivity C-reactive protein (hs-CRP) levels were measured using laser nephelometry. Correlations between baseline interleukin-6, 8, hs-CRP levels and response to sunitinib, and progression-free survival (PFS) were examined. Results: Median PFS was 9.2 months. Clinical benefit rate (CBR; percent complete responses+partial responses +stable disease 24 weeks) was 57.3%. Baseline interleukin-8 (P=0.0240) and hs-CRP (P=0.0060) was associated with CBR. No association between baseline interleukin-6 and 8 with PFS was observed. However, baseline hs-CRP were associated with PFS (P=0.0016; unit risk 1.010; 95% CI 1.004 to 1.017). Conclusions: Baseline serum inflammatory markers could be of clinical interest in sunitinib-treated mRCC patiens to predict outcome. Baseline hs-CRP serum levels warrant further study. Clinical trial information: UMIN000009622.

scholarly journals Absolute Lymphocytes, Ferritin, C-Reactive Protein, and Lactate Dehydrogenase Predict Early Invasive Ventilation in Patients With COVID-19

2020 ◽  
Author(s):  
Salvador Payán-Pernía ◽  
Lucía Gómez Pérez ◽  
Ángel F Remacha Sevilla ◽  
Jordi Sierra Gil ◽  
Silvana Novelli Canales
Keyword(s):  
Lactate Dehydrogenase ◽  
Classification Tree ◽  
Surrogate Marker ◽  
Area Under The Curve ◽  
Absolute Lymphocyte Count ◽  
Limited Resources ◽  
Invasive Ventilation ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
A Value

Abstract Objective Early detection of patients with COVID-19 who will need mechanical invasive ventilation (MIV) may aid in delivering proper care and optimizing the use of limited resources. Methods In this single-center retrospective observational study, we aimed to identify simple laboratory parameters that in combination with ferritin (a surrogate marker of severe inflammation) may help predict early (first 48 hours) MIV. A total of 160 patients with COVID-19 in whom serum ferritin, absolute lymphocyte count (ALC), platelet count, C-reactive protein (CRP), and lactate dehydrogenase (LDH) had been analyzed at admission were included. Results We found that ferritin, LDH, ALC, and CRP predicted with 88% accuracy the probability of early MIV. Results indicated that LDH showed the greater area under the curve (AUC), with a value of 89.1%. Using the AUC, we established cutoff values for clinical application. Finally, we developed a classification tree based on LDH for its clinical use. Conclusion Ferritin, LDH, ALC, and CRP predict with 88% accuracy the probability of early MIV.

scholarly journals Inferior performance of established and novel serum inflammatory markers in diagnosing periprosthetic joint infections

2020 ◽  
Author(s):  
Irene Katharina Sigmund ◽  
Johannes Holinka ◽  
Kevin Staats ◽  
Florian Sevelda ◽  
Richard Lass ◽  
...  
Keyword(s):  
Platelet Count ◽  
Inflammatory Markers ◽  
Volume Ratio ◽  
Diagnostic Value ◽  
C Reactive Protein ◽  
Platelet Volume ◽  
Reactive Protein ◽  
Joint Infections ◽  
Serum Crp ◽  
Serum Inflammatory Markers

Abstract Purpose Besides other diagnostic test methods, established serum inflammatory markers such as serum C-reactive protein or leukocyte count are widely used preoperatively to aid in diagnosing periprosthetic joint infections (PJI). Although low accuracies were reported, these parameters are easily accessible and routinely available. Novel biomarkers with promising results in diagnosing PJI (platelet count to mean platelet volume ratio) or other infectious conditions (percentage of neutrophils, neutrophils to lymphocytes ratio) were described. The purpose of this study was to investigate the diagnostic value of established and novel serum inflammatory biomarkers for the diagnosis of PJI so as to compare the results to find the serum inflammatory marker with the best performance. Methods In 177 patients with a previous total hip (n = 91) or knee (n = 86) arthroplasty and indicated revision surgery, the diagnostic value of the routinely available serum inflammatory markers C-reactive protein (CRP), white blood cell count (WBC), percentage of neutrophils (%N), neutrophils to lymphocytes ratio (NLR), fibrinogen and platelet count to mean platelet volume ratio (PC/mPV) were examined retrospectively via receiver operating characteristic curve analysis (AUC). The curves were compared using the z-test. Results Sensitivities of serum CRP, WBC, %N, NLR, fibrinogen and PC/mPV were calculated with 68%, 36%, 66%, 63%, 69% and 43%, respectively. Specificities were 87%, 89%, 67%, 73%, 89% and 81%, respectively. Serum CRP (0.78) and fibrinogen (0.79) showed significantly better AUCs compared with serum WBC (0.63), %N (0.67), NLR (0.68) and PC/mPV (0.62) (p < 0.0001). Patients with PJI caused by a low-virulent microorganism (median CRP: 17.6 mg/L) obtained lower CRP levels compared with infections caused by high-virulent microorganisms (median CRP: 49.2 mg/L; p = 0.044). The combination of CRP and fibrinogen showed a better sensitivity (77%) with similar specificity (83%) than one method alone but not at a significant level (CRP (p = 0.200); fibrinogen (p = 0.437)). Conclusion Serum CRP and fibrinogen showed the best accuracies among these widely available serum inflammatory parameters. However, due to the insufficient performance, these biomarkers can only be recommended as suggestive criteria in diagnosing PJI. The preoperative workup should always be complemented by more specific tests such as synovial fluid analysis.

scholarly journals Systemic inflammatory markers and psychophysical olfactory scores in coronavirus disease 2019 patients: is there any correlation?

2021 ◽  
pp. 1-6
Author(s):  
L A Vaira ◽  
A De Vito ◽  
G Deiana ◽  
C Pes ◽  
F Giovanditto ◽  
...  
Keyword(s):  
Lactate Dehydrogenase ◽  
Clinical Research ◽  
Inflammatory Markers ◽  
Serum Levels ◽  
Neutrophil To Lymphocyte Ratio ◽  
C Reactive Protein ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Clinical Research Center ◽  
D Dimer

Abstract Objective To analyse the correlations between olfactory psychophysical scores and the serum levels of D-dimer, C-reactive protein, ferritin, lactate dehydrogenase, procalcitonin and neutrophil-to-lymphocyte ratio in coronavirus disease 2019 patients. Methods Patients underwent psychophysical olfactory assessment with the Connecticut Chemosensory Clinical Research Center test, and determination of blood serum levels of the inflammatory markers D-dimer, C-reactive protein, ferritin, lactate dehydrogenase, procalcitonin and neutrophil-to-lymphocyte ratio within 10 days of the clinical onset of coronavirus disease 2019 and 60 days after. Results Seventy-seven patients were included in this study. D-dimer, procalcitonin, ferritin and neutrophil-to-lymphocyte ratio correlated significantly with severe coronavirus disease 2019. No significant correlations were found between baseline and 60-day Connecticut Chemosensory Clinical Research Center test scores and the inflammatory markers assessed. Conclusion Olfactory disturbances appear to have little prognostic value in predicting the severity of coronavirus disease 2019 compared to D-dimer, ferritin, procalcitonin and neutrophil-to-lymphocyte ratio. The lack of correlation between the severity and duration of olfactory disturbances and serum levels of inflammatory markers seems to further suggest that the pathogenetic mechanisms underlying the loss of smell in coronavirus disease 2019 patients are related to local rather than systemic inflammatory factors.

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

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.

Lymphocyte C-reactive protein ratio: A new biomarker to predict early complications after gastrointestinal oncologic surgery

2021 ◽  
pp. 1-9
Author(s):  
Murat Yildirim ◽  
Bulent Koca
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Inflammatory Markers ◽  
Operation Time ◽  
C Reactive Protein ◽  
Oncologic Surgery ◽  
Protein Ratio ◽  
Colorectal Cancer Surgery ◽  
Neutrophil Lymphocyte Ratio ◽  
Reactive Protein

BACKGROUND: Lymphocyte-to-C-reactive protein ratio (LCR) has been used as a post-surgical prognostic biomarker in patients with gastric and colorectal cancer. However, its relationship with early postoperative complications in these patients is unknown. In this study, we aimed to reveal the relationship between LCR and postoperative complications. METHODS: Eighty-one patients operated for stomach and colorectal cancer between January 2020 and August 2020 were prospectively analyzed. On preoperative and postoperative days 1, 3 and 5, other inflammatory parameters, mainly LCR, neutrophil lymphocyte ratio (NLR), were recorded. The patients were divided into two groups according to Clavien-Dindo classification as stage III and higher complications major, stage I-II/non-complication minor. RESULTS: Fifty seven patients were operated for colorectal cancer, 24 patients for gastric cancer. The mean age of the patients was 65.6 ± 12.6, 34.6% of them was women. Age, operation time and hospital stay were significantly different between the groups (p= 0.004, p= 0.002, p< 0.001). Major complications developed in 18 patients. On postoperative day 5, LCR found superior diagnostic accuracy in predicting major postoperative complications compared to other inflammatory markers. On the postoperative 5th day, the cut-off value of LCR was 0.0034, 88.8% (71.9–94.8) sensitivity, and 85.7% (73.6–95.4) selectivity. CONCLUSION: Among different inflammatory markers, postoperative LCR is a safe and effective predictor of postoperative complications, especially after gastric and colorectal cancer surgery on day 5.

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