Association of Inflammatory Markers with Mortality in COVID-19 Infection
| Autor: | Imran Khan, Khurram Shahzad, Muhammad Jawad Aslam, Abdul Rehman Arshad, Murad Arshad, Syed Jarrar Haider |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Cross-sectional study Disease Gastroenterology Severity of Illness Index chemistry.chemical_compound Risk Factors Lactate dehydrogenase Internal medicine Severity of illness medicine Humans Pakistan Pandemics Inflammation biology Receiver operating characteristic business.industry SARS-CoV-2 COVID-19 General Medicine Confidence interval Ferritin Survival Rate C-Reactive Protein Cross-Sectional Studies chemistry biology.protein Female business Viral load Biomarkers |
| Zdroj: | Journal of the College of Physicians and Surgeons--Pakistan : JCPSP. 30(10) |
| ISSN: | 1681-7168 |
| Popis: | OBJECTIVE: To evaluate the association of serum ferritin, lactate dehydrogenase, and C-reactive protein at admission with in-hospital mortality in COVID-19 infection; and to determine best predictive cut-offs. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Department of Medicine, Combined Military Hospital, Peshawar Cantt; Pakistan from March to June 2020. METHODOLOGY: Admitted patients with SARS-CoV-2 detectable by polymerase chain reaction (PCR) were included. Patients with suggestive radiological findings but negative PCR for SARS-CoV-2, those with incomplete data or those leaving against medical advice were excluded. Serum C-reactive protein, ferritin and LDH levels were tested on admission. SARS-CoV-2 viral load was checked on nasopharyngeal samples. Disease severity was assessed using World Health Organization guidelines. RESULTS: There were 238 patients, aged 41.18 ± 16.74 years. Disease was mild in 157 (65.97%), moderate in 36 (15.13%), and severe in 45 (18.91%) cases. Twenty-two (9.24%) patients died in the hospital. Serum C-reactive protein, ferritin and lactate dehydrogenase levels were elevated in 122 (51.26%), 83 (34.87%) and 184 (77.31%) patients, respectively; more frequently amongst patients with moderate/severe disease or mortality. Areas under receiver operating characteristic curves and 95% confidence intervals for serum C-reactive protein, ferritin and LDH were 0.909 (0.854-0.964), 0.915 (0.835-0.995) and 0.863 (0.785-0.942), respectively. C-reactive protein ≥45.5 mg/L had sensitivity 86.36% and specificity 88.89%; serum ferritin ≥723 ng/ml had sensitivity 95.45% and specificity 86.57%, and lactate dehydrogenase ≥428.5 U/L had sensitivity 90.91% and specificity 80.56% for predicting mortality. CONCLUSION: Levels of the three inflammatory markers at admission can predict mortality in COVID-19 infection. Key Words: Coronavirus, Inflammation, Mortality, Outcome, Pakistan. |
| Databáze: | OpenAIRE |
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