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. 2021 Aug;34(4):308-314.
doi: 10.37201/req/141.2020. Epub 2021 May 31.

Prognostic value of static and dynamic biomarkers in COVID-19 patients: a prospective cohort study

M Hormanstorfer  1 , H Borodowski, K Nelson, M J Patrosso, I Kolland, L Italiano, V I Casali, P V Barrios, L F Hernández Sepulveda, M E Tanaro, C Aldana Petraglia, A D Aguzezko, C Luna, C Mouse, I Gandino, J L Presas, F Paulin
Affiliations

Prognostic value of static and dynamic biomarkers in COVID-19 patients: a prospective cohort study

M Hormanstorfer et al. Rev Esp Quimioter. 2021 Aug.

Abstract
in English, Spanish

Objective: The aim of this study was to analyze in a prospective cohort of hospitalized COVID-19 patients the relationship between biomarkers levels and their variation within the first 4 days since admission, and prognosis.

Methods: Prospective cohort study. Individuals with confirmed diagnosis of covid-19 admitted in our hospital were included. Blood samples were obtained systematically on days 1 and 4 of hospitalization. Levels of RCP, LDH, Ferritin and D-dimer, together with platelets, lymphocytes and neutrophils counts were measured. A combined outcome that included ICU admission and death was considered the primary outcome. Logistic regression analysis was performed.

Results: We included 335 patients with confirmed COVID-19. During their hospitalization, 23 (6.8%) needed ICU admission, and 10 (2.9%) died. In the multivariate analysis, a value of RCP greater than 10 mg/dl (OR 8.69, CI95% 1.45-52), an increase in RCP greater than 20% (OR 26.08, CI 95% 3.21-211.3), an increase in LDH greater than 20% (OR 6.29, CI 95% 1.84-21.44), a count of lymphocytes lower than 1500/mm3 (OR 2.74, CI 95% 1.04-7.23), a D-dimer value greater than 550 ng/ml (OR 9.8, CI 95% 1.78-53.9) and a neutrophil/lymphocyte index greater than 3(OR 4.5, CI 95% 1.43-14.19) were all associated with the primary outcome.

Conclusions: Our study shows that the utilization of static and dynamic biomarkers may represent an important tool to assess prognosis of COVID-19 patients.

Objetivo: El objetivo de este estudio es analizar en una cohorte prospectiva de pacientes internados por COVID-19, el valor pronóstico de los niveles de biomarcadores y su variación en los primeros cuatro días de internación.

Material y métodos: Estudio de cohorte prospectivo. Se incluyeron individuos con diagnóstico confirmado de COVID-19 ingresados en nuestro hospital. Se obtuvieron muestras de sangre de forma sistemática los días 1 y 4 de internación. Se midieron los niveles de PCR, LDH, ferritina y dímero-D, junto con recuento de plaquetas, linfocitos y neutrófilos. Una variable de desenlace combinada que incluía la admisión a la UCI y la muerte se consideró como resultado primario. Se realizó un análisis de regresión logística.

Resultados: Se incluyeron 335 pacientes con COVID-19 confirmado. Durante su internación, 23 (6,8%) necesitaron ingreso en UCI y 10 (2,9%) fallecieron. En el análisis multivariado, un valor de PCR superior a 10 mg/dl (OR 8,69, IC 95% 1,45-52), un aumento de PCR superior al 20% (OR 26,08, IC 95% 3,21-211,3), un aumento de LDH superior al 20% (OR 6,29, IC 95% 1,84-21,44), un recuento de linfocitos inferior a 1500/mm3 (OR 2,74, IC 95% 1,04-7,23), un valor de dímero-D superior a 550 ng/ml (OR 9,8, IC 95% 1,78-53,9) y un índice de neutrófilos/linfocitos superior a 3 (OR 4,5, IC 95% 1,43-14,19) se asociaron con el resultado primario.

Conclusión: Nuestro estudio muestra que la utilización de biomarcadores estáticos y dinámicos puede representar una herramienta importante para evaluar el pronóstico de los pacientes con COVID-19.

Keywords: COVID-19; biomarkers; inflammation.

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Conflict of interest statement

All the authors state that they have no conflicts of interest.

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