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

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 biomarkers in predicting prognosis of Coronavirus disease 2019 (COVID-19): A retrospective cross-sectional study: Perspective of a tertiary care hospital in India

World Journal of Advanced Research and Reviews ◽

10.30574/wjarr.2021.11.1.0300 ◽

2021 ◽

Vol 11 (1) ◽

pp. 081-090

Author(s):

Arushi Mohan ◽

Padmini SN ◽

Brunda MS ◽

Abhinaya Shekhar ◽

Paul Matthew ◽

...

Keyword(s):

Inflammatory Markers ◽

Cross Sectional Study ◽

Sectional Study ◽

C Reactive Protein ◽

Oxygen Requirement ◽

Cross Sectional ◽

Reactive Protein ◽

Significant Difference ◽

D Dimer

Background: COVID-19 is a novel disease triggered by the SARS-CoV-2 virus, a beta coronavirus similar to MERS-CoV and SARS CoV. Inflammatory markers have a vital role in the pathogenesis of nCOVID 19; understanding the importance of these inflammatory markers in determining disease status is essential given the impact of the disease on healthcare. Thus, being able to triage cases with minimal tests is momentous to capture, which we have investigated as per our study guidelines of the role of inflammatory markers such as D-dimer, CRP (C - reactive protein), Ferritin, LDH (Lactate Dehydrogenase) in patients with COVID 19. In addition, limited data is available comparing the utility of these inflammatory markers to predict the following parameters as the need for ICU, oxygen support requirement, and duration of in-hospital stay, which can help guide the management protocol. Aim: This study aims to determine markers associated with poor prognosis in patients with Coronavirus disease 2019 (COVID-19). Objectives: 1) To assess the inflammatory markers that are routinely investigated in COVID- 19 patients. 2) To determine the most probable factor to estimate severity in COVID- 19 and thus predict prognosis. Methods: This is a retrospective cross-sectional observational study of patients who tested SARS COV 2 positive by RT PCR. The laboratory inflammatory markers, namely Lactate Dehydrogenase, C reactive protein, D-dimer, Ferritin, were assessed in the selected patients, and their clinical data and demographic details were taken into account. The parameters considered for contributing to the severity included the number of days of stay in the hospital, oxygen requirement, and ICU needs. Analyses relied upon analysis of variance for cross-sectional study design and a P< 0.05 statistical significance criterion. Results: There was a statistically significant difference found between oxygen requirement and D dimer (p<0.001), LDH (p= 0.002), and CRP (p= 0.024). There was a statistically significant difference found between admission to ICU and D Dimer (p= 0.001). Conclusion: A statistically significant association between the increasing D-dimer levels and all the outcome measures considered was found. The D-dimer, LDH, and CRP help predict oxygen requirement, and all the inflammatory markers can predict the number of days of stay in the hospital.

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

The Journal of Laryngology & Otology ◽

10.1017/s0022215121001651 ◽

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.

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Association between the C-reactive protein/albumin ratio and prognosis in patients with oral squamous cell carcinoma

Scientific Reports ◽

10.1038/s41598-021-83362-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kenji Yamagata ◽

Satoshi Fukuzawa ◽

Naomi Ishibashi-Kanno ◽

Fumihiko Uchida ◽

Hiroki Bukawa

Keyword(s):

Squamous Cell Carcinoma ◽

Oral Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Prognostic Marker ◽

Squamous Cell ◽

Inflammatory Markers ◽

Outcome Variable ◽

C Reactive Protein ◽

Reactive Protein ◽

Significant Difference

AbstractThe systemic inflammatory response is known to be associated with poor outcomes in patients with various types of cancer. The C-reactive protein (CRP)/albumin (Alb) ratio (CAR) has been reported as a novel inflammation-based prognostic marker. We have evaluated the prognostic value of inflammatory markers for patients with oral squamous cell carcinoma (OSCC). The study population included 205 patients treated with OSCC between 2013 and 2018. The primary predictor variable was the inflammatory markers. The primary outcome variable was overall survival (OS). Univariate and multivariate analyses were performed using a Cox proportional hazards model to identify independent prognostic factors. The CAR had the highest area under the curve (AUC) values compared with other markers in the receiver operating characteristic (ROC) curve analysis. The cutoff value for CAR was 0.032 (AUC 0.693, P < 0.001). There was a significant difference in OS when patients were stratified according to CAR, with 79.1% for CAR < 0.032 and 35% for CAR ≥ 0.032 (P < 0.001). Cox multivariate analysis identified independent predictive factors for OS: age (hazard ratio [HR] 2.155, 95% confidence interval [CI] 1.262–3.682; P = 0.005), stage (HR 3.031, 95% CI 1.576–5.827; P = 0.001), and CAR (HR 2.859, 95% CI 1.667–4.904; P < 0.001). CAR (≥ 0.032 vs. < 0.032) is a good prognostic marker in patients with OSCC in terms of age and stage.

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The role of IL-6 receptor inhibitor treatment in critical patient monitoring with COVID-19

10.22514/sv.2021.068 ◽

2021 ◽

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Lactate Dehydrogenase ◽

Critically Ill ◽

Critically Ill Patients ◽

C Reactive Protein ◽

Reactive Protein ◽

Group 2 ◽

D Dimer

Objectives: The COVID-19 disease can manifest itself with acute respiratory distress syndrome, renal failure, and septic shock in critically ill patients. There are opinions that there is a correlation between high IL-6 levels and disease severity. In our intensive care unit, we evaluated the changes in the laboratory data and radiological involvement severity of our patients who underwent tocilizumab treatment and examined the appropriate laboratory parameter in the treatment follow-up and its effect on survival. Methods: In the critical patient follow-up of COVID-19, 17 of the 23 patients treated with tocilizumab had a mortal course (Group 1) and the remaining 6 (Group 2) were. The C-reactive protein, lactate dehydrogenase, IL-6, D-dimer, procalcitonin, albumin, and ferritin values, which were routinely screened in our clinic on the day of tocilizumab treatment and the 5th day after, were recorded. Both the change between the two groups and the change between days 1 and 5 were analyzed. Results: A total of 23 patients (55.35 ± 13.31 years) were included in the study. The computed tomography severity score assessed at the intensive care unit admission was statistically significantly higher in Group 2. The procalcitonin and lactate dehydrogenase values measured on day 5 after tocilizumab were significantly lower in Group 2. On the 5th day after treatment, the levels of C-reactive protein, ferritin, chest X-rays, IL-6 and D-dimer statistically significantly changed compared to the first day of the treatment. In correlation with the decrease in PCT as of the 5th day after tocilizumab administration, an increasing tendency was observed in 28-day survival. Conclusion: This study demonstrated that tocilizumab treatment may positively contribute to the treatment by decreasing cytokine levels. PCT and LDH follow-up before and after treatment in critically ill patients who are receiving tocilizumab treatment can give an idea about survival.

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Regression Correction Equation to Adjust Serum Iron and Ferritin Concentrations Based on C-Reactive Protein and Albumin in Patients Receiving Primary and Secondary Care

Journal of Nutrition ◽

10.1093/jn/nxz008 ◽

2019 ◽

Vol 149 (5) ◽

pp. 877-883 ◽

Cited By ~ 3

Author(s):

Stephen T McSorley ◽

Alexander Tham ◽

Iain Jones ◽

Dinesh Talwar ◽

Donald C McMillan

Keyword(s):

Iron Deficiency ◽

Linear Regression ◽

Serum Ferritin ◽

Secondary Care ◽

Serum Iron ◽

C Reactive Protein ◽

Reactive Protein ◽

Iron Deficient ◽

Significant Difference ◽

Low Levels

ABSTRACT Background Systemic inflammation, even at low levels, can greatly interfere with measures of iron status, making diagnosis of iron deficiency difficult. The objective of the present study was to create linear regression correction equations to adjust serum ferritin and iron concentrations based on measurements of the acute-phase proteins C-reactive protein (CRP) and albumin. Methods Data from a cohort (1) of patients (n = 7226) in primary and secondary care who had serum ferritin, iron, CRP, and albumin measured at the same time point were examined. Linear regression coefficients were calculated for CRP and albumin with serum iron and ferritin as the outcome variables. Patients with ferritin <15 µg/L or serum iron <10 µmol/L were categorized as iron deficient. The equation was then applied to a cohort (2) of patients with colorectal cancer who had ferritin and iron measured preoperatively ( n = 356). Results In cohort 1 there was a significant difference in the proportions of patients with serum ferritin <15 µg/L and serum iron <10 µmol/L, respectively, when the unadjusted (7% and 55%), adjusted based on CRP alone (13% and 26%), adjusted based on albumin alone (11% and 37%), and adjusted based on both CRP and albumin (24% and 15%) values were compared (both P < 0.001). In cohort 2 there was a significant difference in the proportions of patients with serum ferritin <15 µg/L and serum iron <10 µmol/L, respectively, when the unadjusted (28% and 66%), adjusted based on CRP alone (39% and 57%), adjusted based on albumin alone (39% and 59%), and adjusted based on both CRP and albumin (46% and 44%) values were compared (P < 0.001 and P < 0.004). Conclusions In both cohorts the greatest increase in the proportion of patients meeting definitions of iron deficiency was found when adjustment was made for both CRP and albumin together. Even low levels of inflammation had a significant effect on serum iron and ferritin values.

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Diagnostic value of inflammatory markers (complete blood count, erythrocyte sedimentation rate, and C-reactive protein) in children with acute appendicitis

Annals of Pediatric Surgery ◽

10.1097/01.xps.0000445131.82852.44 ◽

2014 ◽

Vol 10 (2) ◽

pp. 39-41

Author(s):

Omid Amanollahi ◽

Javad Salimi ◽

Diana Noemi Diaz

Keyword(s):

Acute Appendicitis ◽

Erythrocyte Sedimentation Rate ◽

Sedimentation Rate ◽

Inflammatory Markers ◽

Blood Count ◽

Complete Blood Count ◽

Diagnostic Value ◽

C Reactive Protein ◽

Reactive Protein ◽

Erythrocyte Sedimentation

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Evolution of the Use of Corticosteroids for the Treatment of Hospitalised COVID-19 Patients in Spain between March and November 2020: SEMI-COVID National Registry

Journal of Clinical Medicine ◽

10.3390/jcm10194610 ◽

2021 ◽

Vol 10 (19) ◽

pp. 4610

Author(s):

David Balaz ◽

Philip Erick Wikman-Jorgensen ◽

Vicente Giner Galvañ ◽

Manuel Rubio-Rivas ◽

Borja de Miguel Campo ◽

...

Keyword(s):

Observational Study ◽

Oxygen Saturation ◽

Inflammatory Markers ◽

National Registry ◽

Mortality Benefit ◽

C Reactive Protein ◽

Potential Influence ◽

Reactive Protein ◽

Higher Doses ◽

D Dimer

Objectives: Since the results of the RECOVERY trial, WHO recommendations about the use of corticosteroids (CTs) in COVID-19 have changed. The aim of the study is to analyse the evolutive use of CTs in Spain during the pandemic to assess the potential influence of new recommendations. Material and methods: A retrospective, descriptive, and observational study was conducted on adults hospitalised due to COVID-19 in Spain who were included in the SEMI-COVID-19 Registry from March to November 2020. Results: CTs were used in 6053 (36.21%) of the included patients. The patients were older (mean (SD)) (69.6 (14.6) vs. 66.0 (16.8) years; p < 0.001), with hypertension (57.0% vs. 47.7%; p < 0.001), obesity (26.4% vs. 19.3%; p < 0.0001), and multimorbidity prevalence (20.6% vs. 16.1%; p < 0.001). These patients had higher values (mean (95% CI)) of C-reactive protein (CRP) (86 (32.7–160) vs. 49.3 (16–109) mg/dL; p < 0.001), ferritin (791 (393–1534) vs. 470 (236–996) µg/dL; p < 0.001), D dimer (750 (430–1400) vs. 617 (345–1180) µg/dL; p < 0.001), and lower Sp02/Fi02 (266 (91.1) vs. 301 (101); p < 0.001). Since June 2020, there was an increment in the use of CTs (March vs. September; p < 0.001). Overall, 20% did not receive steroids, and 40% received less than 200 mg accumulated prednisone equivalent dose (APED). Severe patients are treated with higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%. Conclusions: Patients with greater comorbidity, severity, and inflammatory markers were those treated with CTs. In severe patients, there is a trend towards the use of higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%.

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The Inflammatory Markers of Multisystem Inflammatory Syndrome in children (MIS-C) and Adolescents During the COVID-19 Pandemic: A Meta-Analysis

10.21203/rs.3.rs-127768/v1 ◽

2021 ◽

Author(s):

Yan Zhao ◽

Li-juan Yin ◽

Jenil Patel ◽

Lei Tang ◽

Ying Huang

Keyword(s):

Inflammatory Markers ◽

Meta Analysis ◽

Absolute Lymphocyte Count ◽

Older Children ◽

C Reactive Protein ◽

Reactive Protein ◽

Erythrocyte Sedimentation ◽

Quality Check ◽

Inflammatory Syndrome ◽

D Dimer

Abstract As per the indicated need in literature, we conducted a systematic review and meta-analysis to characterize inflammatory markers of MIS-C patients with COVID-19, Kawasaki disease (KD), and coronary artery abnormalities. We searched nine databases for studies on inflammatory markers of MIS-C. After quality check, data were pooled using a fixed- or random-effects model. Inflammatory markers included white blood cell count (WBC) or leukocytes, absolute lymphocyte count (ALC), absolute neutrophil count (ANC), platelet count (PLT), C-reactive protein (CRP), procalcitonin (PCT), ferritin, D-dimer, lactate dehydrogenase (LDH), fibrinogen and erythrocyte sedimentation rate (ESR) for comparisons by severity and age. Twenty studies with 2,990 participants yielded 684 MIS-C patients. Compared to non-severe COVID-19 patients, MIS-C patients had lower ALC and higher ANC, CRP and D-dimer levels. Compared to severe COVID-19 patients, MIS-C patients had lower LDH and PLT counts and higher ESR levels. Compared to KD patients, MIS-C patients had lower ALC and PLT, and higher CRP and ferritin levels. Severe MIS-C patients had higher levels of WBC, CRP, D-dimer and ferritin. For MIS-C, younger children had lower CRP and ferritin levels than medium-aged/older children. Measurement of inflammatory markers might assist clinicians in accurate evaluation and diagnosis of MIS-C and the associated disorders.

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