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oai:repisalud.isciii.es:20.500.12105/232192024-11-28T20:14:38Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967

00925njm 22002777a 4500 dc García-Gasalla, Mercedes author Ferrer, Juana M author Fraile-Ribot, Pablo A author Ferré Beltrán, Adrián author Rodríguez, Adrián author Martinez Pomar, Natalia author Ramon-Clar, Luisa author Iglesias, Amanda author Losada-López, Inés author Fanjul, Francisco author Pou, Joan author Llompart Alabern, Isabel author Toledo Pons, Nuria author Pons De Ves, Jaime author Oliver, Antonio author Riera, Melchor author Murillas Angoiti, Javier author 2021 Background. Early identification of COVID-19 patients at risk of critical illness is a challenging endeavor for clinicians. We aimed to establish immunological, virological, and routine laboratory markers, which, in combination with clinical information, may allow identifying such patients. Methods. Blood tests to measure neutrophil/lymphocyte ratio (NLR) and levels of ferritin, CRP, D-dimer, complement components (C3 and C4), cytokines, and lymphocyte subsets, as well as SARS-Cov-2 RT-PCR tests, were performed in COVID-19-confirmed cases within 48 hours of admission. RT-PCR cycle threshold (Ct) values from oropharyngeal or nasopharyngeal swabs were determined on the day of admission. Symptom severity was categorized as mild (grade 1), severe (grade 2), or critical (grade 3). Results. of 120 patients who were included, 49 had mild, 32 severe, and 39 critical COVID-19. Levels of ferritin >370 ng/mL (OR 16.4, 95% CI 5.3-50.8), D-dimer >440 ng/mL (OR 5.45, 95% CI 2.36-12.61), CRP >7.65 mg/dL (OR 11.54, 95% CI 4.3-30.8), NLR >3.77 (OR 13.4, 95% CI 4.3-41.1), IL-6 >142.5 pg/mL (OR 8.76, 95% CI 3.56-21.54), IL-10 >10.8 pg/mL (OR 16.45, 95% CI 5.32-50.81), sIL-2r alpha (sCD25) >804.5 pg/mL (OR 14.06, 95% CI 4.56-43.28), IL-1Ra >88.4 pg/mL (OR 4.54, 95% CI 2.03-10.17), and IL-18 >144 pg/mL (OR 17.85, 95% CI 6.54-48.78) were associated with critical COVID-19 in the univariate age-adjusted analysis. This association was confirmed in the multivariate age-adjusted analysis only for ferritin, CRP, NLR, IL-10, sIL-2r alpha, and IL-18. T, B, and NK cells were significantly decreased in critical patients. SARS-CoV-2 was not detected in blood except in 3 patients who had indeterminate results. RT-PCR Ct values from oropharyngeal or nasopharyngeal swabs on admission were not related to symptom severity. Conclusion. Ferritin, D-dimer, CRP, NLR, cytokine (IL-18 and IL-10), and cytokine receptor (IL-6, IL1-Ra, and sCD25) test results combined with clinical data can contribute to the early identification of critical COVID-19 patients. García-Gasalla M, Ferrer JM, Fraile-Ribot PA, Ferre-Beltrán A, Rodríguez A, Martínez-Pomar N, et al. Predictive Immunological, Virological, and Routine Laboratory Markers for Critical COVID-19 on Admission. Gragnani L, editor. Can J Infect Dis Med Microbiol. 2021 Aug 2;2021:1-8. 10.1155/2021/9965850 1918-1493 1712-9532 The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale http://hdl.handle.net/20.500.13003/18190 34422145 L2014274155 2-s2.0-85113816017 https://hdl.handle.net/20.500.12105/23219 687414800001 Predictive Immunological, Virological, and Routine Laboratory Markers for Critical COVID-19 on Admission