tetano
Editor, Senior Moderator
Cell Rep Med
. 2020 Oct 29;100144.
doi: 10.1016/j.xcrm.2020.100144. Online ahead of print.
Inflammatory Biomarker Trends Predict Respiratory Decline in COVID-19 Patients
Alisa A Mueller[SUP] 1 2 [/SUP], Tomoyoshi Tamura[SUP] 2 3 [/SUP], Conor P Crowley[SUP] 3 [/SUP], Jeremy R DeGrado[SUP] 4 [/SUP], Hibah Haider[SUP] 3 [/SUP], Julia L Jezmir[SUP] 2 5 [/SUP], Gregory Keras[SUP] 1 [/SUP], Erin H Penn[SUP] 1 2 [/SUP], Anthony F Massaro[SUP] 2 3 [/SUP], Edy Y Kim[SUP] 2 3 [/SUP]
Affiliations
Abstract
In this single-center, retrospective cohort analysis of hospitalized coronavirus disease 2019 (COVID-19) patients, we investigate whether inflammatory biomarker levels predict respiratory decline in patients who initially present with stable disease. Examination of C-reactive protein (CRP) trends reveals that a rapid rise in CRP levels precedes respiratory deterioration and intubation, although CRP levels plateau in patients who remain stable. Increasing CRP during the first 48 h of hospitalization is a better predictor (with higher sensitivity) of respiratory decline than initial CRP levels or ROX indices (a physiological score of respiratory function). CRP, the proinflammatory cytokine interleukin-6 (IL-6), and physiological measures of hypoxemic respiratory failure are correlated, which suggests a mechanistic link. Our work shows that rising CRP predicts subsequent respiratory deterioration in COVID-19 and may suggest mechanistic insight and a potential role for targeted immunomodulation in a subset of patients early during hospitalization.
Keywords: COVID-19; CRP; D-dimer; IL-6; acute respiratory distress syndrome; cytokine storm; ferritin; inflammation; intensive care unit; intubation.
. 2020 Oct 29;100144.
doi: 10.1016/j.xcrm.2020.100144. Online ahead of print.
Inflammatory Biomarker Trends Predict Respiratory Decline in COVID-19 Patients
Alisa A Mueller[SUP] 1 2 [/SUP], Tomoyoshi Tamura[SUP] 2 3 [/SUP], Conor P Crowley[SUP] 3 [/SUP], Jeremy R DeGrado[SUP] 4 [/SUP], Hibah Haider[SUP] 3 [/SUP], Julia L Jezmir[SUP] 2 5 [/SUP], Gregory Keras[SUP] 1 [/SUP], Erin H Penn[SUP] 1 2 [/SUP], Anthony F Massaro[SUP] 2 3 [/SUP], Edy Y Kim[SUP] 2 3 [/SUP]
Affiliations
- PMID: 33163981
- PMCID: PMC7598305
- DOI: 10.1016/j.xcrm.2020.100144
Abstract
In this single-center, retrospective cohort analysis of hospitalized coronavirus disease 2019 (COVID-19) patients, we investigate whether inflammatory biomarker levels predict respiratory decline in patients who initially present with stable disease. Examination of C-reactive protein (CRP) trends reveals that a rapid rise in CRP levels precedes respiratory deterioration and intubation, although CRP levels plateau in patients who remain stable. Increasing CRP during the first 48 h of hospitalization is a better predictor (with higher sensitivity) of respiratory decline than initial CRP levels or ROX indices (a physiological score of respiratory function). CRP, the proinflammatory cytokine interleukin-6 (IL-6), and physiological measures of hypoxemic respiratory failure are correlated, which suggests a mechanistic link. Our work shows that rising CRP predicts subsequent respiratory deterioration in COVID-19 and may suggest mechanistic insight and a potential role for targeted immunomodulation in a subset of patients early during hospitalization.
Keywords: COVID-19; CRP; D-dimer; IL-6; acute respiratory distress syndrome; cytokine storm; ferritin; inflammation; intensive care unit; intubation.