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Correlation of patient profiles and biomarkers with outcomes in covid-19 icu patients: a retrospective analysis

Karthik Raman
Karthik Raman
, 
Deepak Kumar
Deepak Kumar
, 
Abhijit Kumar
Abhijit Kumar
, 
Kirti Nath Saxena
Kirti Nath Saxena
, 
Amit Kohli
Amit Kohli
 oraz 
Sonia Wadhawan
Sonia Wadhawan
   | 29 gru 2022
Romanian Journal of Anaesthesia and Intensive Care's Cover Image
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Article Category: Original Paper
Data publikacji: 29 gru 2022
Zakres stron: 71 - 79
DOI: https://doi.org/10.2478/rjaic-2021-0012
Słowa kluczowe
© 2021 Karthik Raman et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Serum ferritin, LDH, CRP, IL6, NLR, and D-dimer across 3 categories of ventilatory support i.e. none, non-invasive ventilation (NIV) or invasive ventilation (IV). One way ANOVA showed the medians of all biomarkers to significantly different across the three categories.
Serum ferritin, LDH, CRP, IL6, NLR, and D-dimer across 3 categories of ventilatory support i.e. none, non-invasive ventilation (NIV) or invasive ventilation (IV). One way ANOVA showed the medians of all biomarkers to significantly different across the three categories.

Figure 2

Receiver operating characteristic (ROC) curves for CRP, IL6, NLR, and D-dimers. A) ROC curves to predict need for mechanical ventilatory support (NIV or invasive ventilation). B) ROC curves to predict mortality.
Receiver operating characteristic (ROC) curves for CRP, IL6, NLR, and D-dimers. A) ROC curves to predict need for mechanical ventilatory support (NIV or invasive ventilation). B) ROC curves to predict mortality.

Figure 3

A) Comparison of the proportion of patients with levels of CRP, IL6, and D-dimers above the suggested cut-offs amongst recovered and expired patients. B) Comparison of the proportion of patients with levels of CRP, IL6, and D-dimers above the suggested cut-offs amongst patients who required invasive ventilation (IV), non-invasive ventilatory support (NIV), and those who did not require any mechanical ventilatory support (NO MVS).
A) Comparison of the proportion of patients with levels of CRP, IL6, and D-dimers above the suggested cut-offs amongst recovered and expired patients. B) Comparison of the proportion of patients with levels of CRP, IL6, and D-dimers above the suggested cut-offs amongst patients who required invasive ventilation (IV), non-invasive ventilatory support (NIV), and those who did not require any mechanical ventilatory support (NO MVS).

Outcome tabulation of receiver operating characteristic curve analysis of biomarkers.

Parameters, cut-off AUC (95% CI) Sensitivity, % Specificity, %
Prediction of Survival      
Serum CRP, 40mg/L 0.933 (0.879-0.987) 93.3 88.9
IL6, 32.5 pg/ml 0.821 (0.739-0.902) 82.2 70.4
NLR, 8.5 0.749 (0.648-0.851) 75.6 75.9
D-DIMER, 810 ng/ml 0.8 (0.711-0.889) 82.2 75.9
PFR, 106 0.886 (0.790-0.942) 88.9 80
Prediction of need for mechanical ventilatory support (NIV or IV)      
Serum CRP, 40mg/L 0.956 (0.915-0.996) 76.7 94.9
IL6, 32.5 pg/ml 0.843 (0.765-0.921) 73.3 76.9
NLR, 8.5 0.797 (0.695-0.899) 70 87.2
D-DIMER, 810 ng/ml 0.816 (0.726-0.905) 71.7 82.1
PFR, 106 0.840 (0.758-0.922) 94.9 66.7
Prediction of need for invasive mechanical ventilation      
Serum CRP, 40mg/L 0.895 (0.832-0.958) 91.9 77.4
IL6, 32.5 pg/ml 0.797 (0.709-0.884) 83.8 64.5
NLR, 8.5 0.768 (0.672-0.863) 78.4 71
D-DIMER, 810 ng/ml 0.773 (0.676-0.870) 81.1 67.7
PFR, 106 0.790 (0.696-0.885) 80.6 81.1

Clinico-demographics and laboratory parameters compared across survival groups.

Clinical & Demographic Characteristics Total (N=99) Expired (N=45) Recovered (N=54) p-value
AGE (yrs) 57 (45.0-65.0) 57 (45.0-65.0) 54 (45.0-65.5) 0.898
≥60 YEARS, (N,%) 46, 46.5 22, 48.9 24, 44.4 0.659
MALES, (N,%) 62, 62.6 33, 73.3 29, 53.7 0.044
FEMALES, (N,%) 37, 37.4 12, 26.7 25, 46.7  
HYPERTENSION, (N,%) 48, 48.5 22, 48.9 26, 48.1 0.941
TYPE II DIABETES MELLITUS, (N,%) 44, 44.4 25, 55.6 19, 35.2 0.042
CHRONIC KIDNEY DISEASE, (N,%) 15, 15.2 8, 17.8 7, 13 0.506
CORONARY HEART DISEASE, (N,%) 13, 13.1 9, 20 4, 7.4 0.065
ANEMIA, (N,%) 24, 24.2 10, 22.2 14, 25.9 0.669
Arterial oxygenation and biomarkers        
SERUM FERRITIN, ng/ml 352 (184-674) 449 (225-852) 277.5 (123.7-484.7) 0.004
SERUM LDH, U/L 544 (340-724) 679 (458-865) 418 (275.7-591.7) 0.001
Serum CRP, mg/L 37 (12-88) 88 (68-106) 12.5 (8-23.2) <0.001
IL6, pg/ml 38 (11-121) 88 (42-245.5) 14 (2-43.2) <0.001
NLR 8 (5-15) 14 (8.5-17) 5.5 (4-8.2) <0.001
D-DIMER, ng/ml 845 (340-2100) 1447 (937-4609) 426.5 (254.5-817.7) <0.001
PFR 118 (80-220) 80 (70-102.5) 192 (122.5-281.5) <0.001

Clinico-demographics and laboratory parameters compared across groups of escalating ventilatory support.

Parameters NO MVS (N=39) MVS (NIV + IV)(N=60)
 p-value
NIV (N=23) IV (N=37)
AGE (yrs) 59 (43-67) 57 (50-65) 54 (44-65) 0.895
MALES, (N,%) 19, 48.7 16, 69.6 27, 73 0.068
  43, 71.6   0.021
HYPERTENSION, (N,%) 17, 43.6 15, 65.2 16, 43.2 0.186
TYPE II DIABETES MELLITUS, (N,%) 12, 30.8 14, 60.9 18, 48.6 0.057
  32, 53.3   0.027
CHRONIC KIDNEY DISEASE, (N,%) 5, 12.8 5, 21.7 5, 13.5 0.601
CORONARY ARTERY DISEASE, (N,%) 3, 7.7 1, 4.3 9, 24.3 0.051
4, 6.4     0.015
ANEMIA, (N,%) 13, 33.3 3, 13 8, 21.6 0.177
SERUM FERRITIN, ng/ml 273 (112-421) 394 (165-663) 464 (233-940) 0.001
SERUM LDH, U/L 356 (254-551) 550 (330-689) 679 (446-893) 0.001
Serum CRP, mg/L 11 (7-14) 56 (23-77) 92 (71.5-114) <0.001
IL6, pg/ml 10 (2-32) 45 (14-152) 90 (44.5-245.5) 0.028
NLR 5 (4-7) 9 (6.5-16) 15 (9.5-17.5) 0.001
D-DIMER, ng/ml 339 (224-670) 946 (524-1560) 1953 (937-5000) <0.001
PFR 214 (146-298) 110 (72-160) 82 (72-102.5) <0.001
eISSN:
2502-0307
Język:
Angielski
Częstotliwość wydawania:
2 razy w roku
Dziedziny czasopisma:
Medicine, Clinical Medicine, other, Surgery, Anaesthesiology, Emergency Medicine and Intensive-Care Medicine
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