Procalcitonin Levels in COVID-19 Patients Are Strongly Associated with Mortality and ICU Acceptance in an Underserved, Inner City Population
| Autor: | Mohamd Nakeshbandi, Kyra Doumlele, Lillian Chow, Kanza Zahid, Osato Ukponmwan, Alecia James, Seth White, Wendy Twardzik, Theresa Feng, Zeeshan Sattar, Robert F. Foronjy |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Medicine (General) Population Intensivist intensivist Article Procalcitonin law.invention R5-920 law Internal medicine medicine Humans education Aged Retrospective Studies education.field_of_study SARS-CoV-2 business.industry biomarkers COVID-19 General Medicine Odds ratio Middle Aged Prognosis Intensive care unit mortality Confidence interval Intensive Care Units Quartile ARDS business Cohort study |
| Zdroj: | Medicina Volume 57 Issue 10 Medicina, Vol 57, Iss 1070, p 1070 (2021) |
| ISSN: | 1648-9144 |
| DOI: | 10.3390/medicina57101070 |
| Popis: | Background and Objectives: This study aimed to identify demographic and clinical factors at the time of critical care consultation associated with mortality or intensive care unit acceptance in a predominantly Afro-Caribbean population during the first wave of the COVID19 pandemic. Materials and Methods: This retrospective, single-center observational cohort study included 271 COVID19 patients who received a critical care consult between March 11 and April 30, 2020 during the first wave of the COVID19 pandemic at State University of New York Downstate Health Sciences University. Results: Of the 271 patients with critical care consults, 33% survived and 67% expired. At the bivariate level, age, blood urea nitrogen, and blood neutrophil percentage were significantly associated with mortality (mean age: survivors, 61.62 ± 1.50 vs. non-survivors, 68.98 ± 0.85, p < 0.001). There was also a significant association between neutrophil% and mortality in the univariate logistic regression model (quartile 4 vs. quartile 1: odd ratio 2.73, 95% confidence interval (1.28–5.82), p trend = 0.044). In the multivariate analyses, increasing levels of procalcitonin and C-reactive protein were significantly associated with mortality, adjusting for age, sex, and race/ethnicity (for procalcitonin quartile 4 vs. quartile 1: odds ratio 5.65, 95% confidence interval (2.14–14.9), p trend < 0.001). In contrast, higher platelet levels correlated with significantly decreased odds of mortality (quartile 4 vs. quartile 1, odds ratio 0.47, 95% CI (0.22–0.998), p trend = 0.010). Of these factors, only elevated procalcitonin levels were associated with intensive care unit acceptance. Conclusions: Procalcitonin showed the greatest magnitude of association with both death and likelihood of intensive care unit acceptance at the bivariate level. Our data suggests that procalcitonin reflects pneumonia severity during COVID-19 infection. Thus, it may help the intensivist identify those COVID19 patients who require intensive care unit level care. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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