Prediction of Cytokine Storm and Mortality in Patients with COVID-19 Admitted to ICU: Do Markers Tell the Story?

Autor: Rashid Nadeem, Ashraf Mahmoud Elhoufi, Naheed Elahi Iqbal, Zainab Abdulameer Obaida, Doaa Mohamed Elgohary, Mukesh Kumar Singh, Shymaa Farouk Zoraey, Rami M. Abdalla, Sara Yousif Eltayeb, Crystal Sharon Danthi, Nouha Azaza, Waleed Mohamed Ahmed, Muzammil Hafeez, Maryam AlSada, Fatima Farid Mir
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Dubai Medical Journal, Pp 1-9 (2021)
Druh dokumentu: article
ISSN: 2571-726X
DOI: 10.1159/000514406
Popis: Introduction: COVID-19 has caused approximately one million deaths worldwide as of November 24, 2020. Markers of disease activity like ferritin, C-reactive protein (CRP), and D-dimers are frequently monitored to detect the best opportunity for intensive treatment. Methods: All patients of >18 years of age were included. The primary variables of interest, ferritin, CRP, and D-dimers, for each patient throughout hospitalization were recorded. Primary clinical outcomes of length of stay in ICU and survival were recorded. Demographics: age, gender, BMI, and nationality. Ferritin, CRP, and D-dimers were recorded daily if available for the whole ICU stay, and all other variables were recorded on admission day to ICU. Results: The sample includes 235 records. More than 95% of patients have all markers on the day of admission to ICU were ferritin (median 1,278; IQR 1,424), D-dimer 1.21 (3.4), and CRP 129.5 (121). Daily average levels of markers were different from their admission day level: ferritin 1,395 (1,331), D-dimer 3.11 (5.52), and CRP 107 (75.8). Multiple logistic regression analysis determined that average CRP during the stay was the only predictor of survival. Discussion: Data on markers utilization to detect the acute phase of inflammation help clinicians focus on the opportunity window for intensive treatment. Conclusion: Average CRP during the stay in ICU is higher than CRP on admission. Average CRP is the only factor that predicts survival.
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