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A Simple Prognostic Score for Critical COVID-19 Derived from Patients without Comorbidities Performs Well in Unselected Patients

Authors :
Vasiliki E. Georgakopoulou
Nikolaos I. Vlachogiannis
Dimitrios Basoulis
Irene Eliadi
Georgios Georgiopoulos
Georgios Karamanakos
Sotiria Makrodimitri
Stamatia Samara
Maria Triantafyllou
Pantazis M. Voutsinas
Fotinie Ntziora
Mina Psichogiou
Michael Samarkos
Petros P. Sfikakis
Nikolaos V. Sipsas
Source :
Journal of Clinical Medicine; Volume 11; Issue 7; Pages: 1810
Publication Year :
2022
Publisher :
MDPI AG, 2022.

Abstract

We aimed to search for laboratory predictors of critical COVID-19 in consecutive adults admitted in an academic center between 16 September 2020–20 December 2021. Patients were uniformly treated with low-molecular-weight heparin, and dexamethasone plus remdesivir when SpO2 < 94%. Among consecutive unvaccinated patients without underlying medical conditions (n = 241, 49 year-old median, 71% males), 22 (9.1%) developed critical disease and 2 died (0.8%). White-blood-cell counts, neutrophils, neutrophil-to-lymphocyte ratio, CRP, fibrinogen, ferritin, LDH and γ-GT at admission were each univariably associated with critical disease. ROC-defined cutoffs revealed that CRP > 61.8 mg/L, fibrinogen > 616.5 mg/dL and LDH > 380.5 U/L were each associated with critical disease development, independently of age, sex and days from symptom-onset. A score combining higher-than-cutoff CRP (0/2), LDH (0/1) and fibrinogen (0/1) predicted critical disease (AUC: 0.873, 95% CI: 0.820–0.926). This score performed well in an unselected patient cohort (n = 1228, 100% unvaccinated) predominantly infected by the alpha variant (AUC: 0.718, 95% CI: 0.683–0.753), as well as in a mixed cohort (n = 527, 65% unvaccinated) predominantly infected by the delta variant (AUC: 0.708, 95% CI: 0.656–0.760). Therefore, we propose that a combination of standard biomarkers of acute inflammatory response, cell death and hypercoagulability reflects the severity of COVID-19 per se independently of comorbidities, age and sex, being of value for risk stratification in unselected patients.

Details

ISSN :
20770383
Volume :
11
Database :
OpenAIRE
Journal :
Journal of Clinical Medicine
Accession number :
edsair.doi.dedup.....331d07ce6ad988e06478dd9b9d2ca62f
Full Text :
https://doi.org/10.3390/jcm11071810