Can we predict critical care mortality with non-conventional inflammatory markers in SARS-CoV-2 infected patients?

IF 2.1 4区医学 Q3 HEMATOLOGY

Clinical hemorheology and microcirculation Pub Date : 2023-01-01 DOI:10.3233/CH-231697

Martin Rozanovic, Kamilla Domokos, Gergő Márovics, Mirtill Rohonczi, Csaba Csontos, Lajos Bogár, Szilárd Rendeki, Tamás Kiss, Melánia Nacira Rozanovic, Csaba Loibl

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引用次数: 1

Abstract

Background: Severe COVID-19 disease is associated with multiple organ involvement,then failure and often fatal outcomes.In addition,inflammatory mechanisms and cytokine storms,documented in many COVID-19 patients,are responsible for the progression of the disease and high mortality rates.Inflammatory parameters,such as procalcitonin(PCT) and C-reactive protein(CRP), are widely used in clinical practice.

Objective: To evaluate the predictive power of non-conventional inflammatory markers regarding mortality risk.

Methods: In our prospective study 52 patients were followed for 5 days after admission to an intensive care unit immediately with severe SARS-CoV-2 infection.We compared leukocyte-,platelet antisedimentation rate (LAR, PAR),neutrophil lymphocyte ratio(NLR), CRP, PCT levels.

Results: In non-surviving(NSU) patients LAR remained largely constant from D1 to D4 with a statistically significant drop(p < 0.05) only seen on D5.The NSU group showed statistically significant(p < 0.05) elevated LAR medians on D4 and D5, compared to the SU group.NLR values were continually higher in the non-survivor group.The difference between the SU and NSU groups were statistically significant on every examined day.PAR, CRP and PCT levels didn't show any significant differences between the SU and NSU groups.

Conclusions: In conclusion, this study suggests that LAR and NLR are especially worthy of further investigation as prognostic markers.LAR might be of particular relevance as it is not routinely obtained in current clinical practice.It would seem beneficial to include LAR in data sets to train prognostic artificial intelligence.

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我们可以用非常规炎症标志物预测SARS-CoV-2感染患者的重症监护死亡率吗?

背景:严重的COVID-19疾病与多器官受累，然后衰竭和通常致命的结局相关。此外，在许多COVID-19患者中记录的炎症机制和细胞因子风暴是导致疾病进展和高死亡率的原因。炎症参数如降钙素原(PCT)和c反应蛋白(CRP)在临床中被广泛使用。目的:评价非传统炎症标志物对死亡风险的预测能力。方法:在我们的前瞻性研究中，52例重症SARS-CoV-2感染患者入院后立即随访5天。我们比较了白细胞，血小板抗沉降率(LAR, PAR)，中性粒细胞淋巴细胞比率(NLR)， CRP, PCT水平。结果:在非存活(NSU)患者中，LAR从D1到D4基本保持不变，并有统计学意义的下降(p)。结论:总之，本研究表明LAR和NLR作为预后指标特别值得进一步研究。LAR可能是特别相关的，因为它不是在目前的临床实践常规获得。将LAR纳入数据集以训练预测人工智能似乎是有益的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical hemorheology and microcirculation 医学-外周血管病

CiteScore

4.30

自引率

33.30%

发文量

170

期刊介绍： Clinical Hemorheology and Microcirculation, a peer-reviewed international scientific journal, serves as an aid to understanding the flow properties of blood and the relationship to normal and abnormal physiology. The rapidly expanding science of hemorheology concerns blood, its components and the blood vessels with which blood interacts. It includes perihemorheology, i.e., the rheology of fluid and structures in the perivascular and interstitial spaces as well as the lymphatic system. The clinical aspects include pathogenesis, symptomatology and diagnostic methods, and the fields of prophylaxis and therapy in all branches of medicine and surgery, pharmacology and drug research. The endeavour of the Editors-in-Chief and publishers of Clinical Hemorheology and Microcirculation is to bring together contributions from those working in various fields related to blood flow all over the world. The editors of Clinical Hemorheology and Microcirculation are from those countries in Europe, Asia, Australia and America where appreciable work in clinical hemorheology and microcirculation is being carried out. Each editor takes responsibility to decide on the acceptance of a manuscript. He is required to have the manuscript appraised by two referees and may be one of them himself. The executive editorial office, to which the manuscripts have been submitted, is responsible for rapid handling of the reviewing process. Clinical Hemorheology and Microcirculation accepts original papers, brief communications, mini-reports and letters to the Editors-in-Chief. Review articles, providing general views and new insights into related subjects, are regularly invited by the Editors-in-Chief. Proceedings of international and national conferences on clinical hemorheology (in original form or as abstracts) complete the range of editorial features.