Abstract
This study analyzed the levels at admission of biomarkers for their association with and ability to predict risk of severe outcomes, including admission to the ICU, need for invasive mechanical ventilation (IMV), need for vasopressor use (VU), and in-hospital mortality (IHM) in 700 patients hospitalized with COVID-19. Biomarker data split by outcomes was compared using Mann-Whitney U tests; frequencies of biomarker values were compared using Chi-square tests and multivariable logistic regression analysis was performed to look at the impact of biomarkers by outcome. Patients that suffered IHM were more likely to have reduced platelet numbers and high blood urea nitrogen (BUN) levels among patients admitted to the ICU. Risk factors for mortality were related to hyper-coagulability (low platelet count and increased D-dimer) and decreased respiratory (PaO 2 /FiO 2 ratio) and kidney function (BUN). Association with risks of other severe outcomes were as follows: ICU with hyper-inflammation (IL-6) and decreased respiratory function; IMV with low platelet count, abnormal neutrophil-lymphocyte ratio with reduced respiratory function, VU with inflammatory markers (IL-6), and low platelet count with respiratory function. Our studies confirmed the association of biomarkers of hematological, inflammatory, coagulation, pulmonary and kidney functions with disease severity. Whether these biomarkers have any mechanistic or causal role in the disease progress requires further investigation.
Keywords: COVID-19; Critical care; Cytokines and inflammatory mediators; Growth factors; Inflammation; Intensive care; Mechanical ventilation.
【저자키워드】 COVID-19, Inflammation, Critical care, intensive care, mechanical ventilation, Cytokines and inflammatory mediators, Growth factors, 【초록키워드】 Biomarker, Biomarkers, Risk factors, Cytokines, Critical care, Mortality, intensive care, mechanical ventilation, IL-6, Kidney function, Respiratory function, disease severity, Ventilation, inflammatory markers, risk, D-dimer, outcome, ICU, Coagulation, Growth factors, outcomes, Patient, Platelet, hyper-inflammation, Inflammatory marker, respiratory, Admission, predict, in-hospital mortality, Platelet count, association, Inflammatory mediators, Invasive mechanical ventilation, Frequency, Analysis, Inflammatory, nitrogen, urea, chi-square tests, Blood urea nitrogen, Factor, frequencies, multivariable logistic regression, hematological, Multivariable logistic regression analysis, Chi-square, Mann-Whitney U, IMV, analyzed, the disease, was performed, reduced, suffered, Mechanical, PaO, patients hospitalized, with COVID-19, 【제목키워드】 Biomarker, SARS-COV-2 infection, outcome, Predictive, hospitalized patient,