Abstract
In this single-center, retrospective cohort analysis of hospitalized coronavirus disease 2019 (COVID-19) patients, we investigate whether inflammatory biomarker levels predict respiratory decline in patients who initially present with stable disease. Examination of C-reactive protein (CRP) trends reveals that a rapid rise in CRP levels precedes respiratory deterioration and intubation, although CRP levels plateau in patients who remain stable. Increasing CRP during the first 48 h of hospitalization is a better predictor (with higher sensitivity) of respiratory decline than initial CRP levels or ROX indices (a physiological score of respiratory function). CRP, the proinflammatory cytokine interleukin-6 (IL-6), and physiological measures of hypoxemic respiratory failure are correlated, which suggests a mechanistic link. Our work shows that rising CRP predicts subsequent respiratory deterioration in COVID-19 and may suggest mechanistic insight and a potential role for targeted immunomodulation in a subset of patients early during hospitalization.
Keywords: COVID-19; CRP; D-dimer; IL-6; acute respiratory distress syndrome; cytokine storm; ferritin; inflammation; intensive care unit; intubation.
【저자키워드】 COVID-19, Inflammation, Cytokine storm, acute respiratory distress syndrome, IL-6, intensive care unit, intubation, CRP, D-dimer, ferritin, 【초록키워드】 coronavirus disease, Coronavirus disease 2019, Cytokine storm, Hospitalized, Respiratory failure, intensive care, acute respiratory distress syndrome, Hospitalization, IL-6, Respiratory function, intensive care unit, interleukin-6, intubation, C-reactive protein, D-dimer, ferritin, cytokine, sensitivity, Deterioration, Patient, respiratory, disease, patients, predict, acute respiratory distress, Hypoxemic respiratory failure, Analysis, physiological, respiratory distress, C-reactive protein (CRP, respiratory function), Proinflammatory cytokine, examination, CRP levels, measure, single-center, CRP level, retrospective cohort, plateau, hypoxemic, ROX, inflammatory biomarker levels, initial, subsequent, correlated, reveal, subset, Increasing, rising, inflammatory biomarker level, 【제목키워드】 respiratory, trend, Decline,