tetano
Editor, Senior Moderator
Clin Biochem
. 2021 May 19;S0009-9120(21)00149-1.
doi: 10.1016/j.clinbiochem.2021.05.008. Online ahead of print.
Biochemistry tests in hospitalized COVID-19 patients: Experience from a canadian tertiary care centre
Angela C Rutledge[SUP] 1 [/SUP], Yun-Hee Choi[SUP] 2 [/SUP], Igor Karp[SUP] 2 [/SUP], Vipin Bhayana[SUP] 1 [/SUP], Ivan Stevic[SUP] 3 [/SUP]
Affiliations
Abstract
Background: Coronavirus Disease 2019 (COVID-19) has variable clinical presentation, from asymptomatic to severe disease leading to death. Biochemical markers may help with management and prognostication of COVID-19 patients; however, their utility is still under investigation.
Methods: A retrospective study was conducted to evaluate alanine aminotransferase, C-reactive protein (CRP), ferritin, lactate, and high sensitivity troponin T (TnT) levels in 67 patients who were admitted to a Canadian tertiary care centre for management of COVID-19. Logistic, cause-specific Cox proportional-hazards, and accelerated failure-time regression modelling were performed to assess the associations of initial analyte concentrations with in-hospital death and length of stay in hospital; joint modelling was performed to assess the associations of the concentrations over the course of the hospital stay with in-hospital death.
Results: Initial TnT and CRP concentrations were associated with length of stay in hospital. Eighteen patients died (27%), and the median initial TnT concentration was higher in patients who died (55 ng/L) than those who lived (16 ng/L; P<0.0001). There were no survivors with an initial TnT concentration >64 ng/L. While the initial TnT concentration was predictive of death, later measurements were not. Only CRP had prognostic value with both the initial and subsequent measurements: a 20% increase in the initial CRP concentration was associated with a 14% (95% confidence interval (CI): 1-29%) increase in the odds of death, and the hazard of death increased 14% (95% CI: 5-25%) for each 20% increase in the current CRP value. While the initial lactate concentration was not predictive of death, subsequent measurements were.
Conclusion: CRP, lactate and TnT were associated with poorer outcomes and appear to be useful biochemical markers for monitoring COVID-19 patients.
Keywords: ALT; Biochemical markers; COVID-19; CRP; Ferritin; Lactate; Troponin.
. 2021 May 19;S0009-9120(21)00149-1.
doi: 10.1016/j.clinbiochem.2021.05.008. Online ahead of print.
Biochemistry tests in hospitalized COVID-19 patients: Experience from a canadian tertiary care centre
Angela C Rutledge[SUP] 1 [/SUP], Yun-Hee Choi[SUP] 2 [/SUP], Igor Karp[SUP] 2 [/SUP], Vipin Bhayana[SUP] 1 [/SUP], Ivan Stevic[SUP] 3 [/SUP]
Affiliations
- PMID: 34022172
- DOI: 10.1016/j.clinbiochem.2021.05.008
Abstract
Background: Coronavirus Disease 2019 (COVID-19) has variable clinical presentation, from asymptomatic to severe disease leading to death. Biochemical markers may help with management and prognostication of COVID-19 patients; however, their utility is still under investigation.
Methods: A retrospective study was conducted to evaluate alanine aminotransferase, C-reactive protein (CRP), ferritin, lactate, and high sensitivity troponin T (TnT) levels in 67 patients who were admitted to a Canadian tertiary care centre for management of COVID-19. Logistic, cause-specific Cox proportional-hazards, and accelerated failure-time regression modelling were performed to assess the associations of initial analyte concentrations with in-hospital death and length of stay in hospital; joint modelling was performed to assess the associations of the concentrations over the course of the hospital stay with in-hospital death.
Results: Initial TnT and CRP concentrations were associated with length of stay in hospital. Eighteen patients died (27%), and the median initial TnT concentration was higher in patients who died (55 ng/L) than those who lived (16 ng/L; P<0.0001). There were no survivors with an initial TnT concentration >64 ng/L. While the initial TnT concentration was predictive of death, later measurements were not. Only CRP had prognostic value with both the initial and subsequent measurements: a 20% increase in the initial CRP concentration was associated with a 14% (95% confidence interval (CI): 1-29%) increase in the odds of death, and the hazard of death increased 14% (95% CI: 5-25%) for each 20% increase in the current CRP value. While the initial lactate concentration was not predictive of death, subsequent measurements were.
Conclusion: CRP, lactate and TnT were associated with poorer outcomes and appear to be useful biochemical markers for monitoring COVID-19 patients.
Keywords: ALT; Biochemical markers; COVID-19; CRP; Ferritin; Lactate; Troponin.