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. 2024 Apr 8;14(1):8220.
doi: 10.1038/s41598-024-58727-y.

The laboratory parameters-derived CoLab score as an indicator of the host response in ICU COVID-19 patients decreases over time: a prospective cohort study

Tom Schoenmakers  1   2   3 , Mathie P G Leers  4   5   6 , Stefan H M Gorissen  7 , Inge H M van Loo  8   9 , Frank van Rosmalen  10   11 , Eda Aydeniz  10 , Joep Schellens  10 , Marielle Driessen  10 , Ruben Deneer  4 , Wilhelmine P H G Verboeket-van de Venne  4 , Petra F G Wolffs  8   9 , Walther N K A van Mook  10   12 , Bas C T van Bussel  10   9   11 ; CoLaIC-consortium
Collaborators, Affiliations

The laboratory parameters-derived CoLab score as an indicator of the host response in ICU COVID-19 patients decreases over time: a prospective cohort study

Tom Schoenmakers et al. Sci Rep. .

Abstract

The CoLab score was developed and externally validated to rule out COVID-19 among suspected patients presenting at the emergency department. We hypothesized a within-patient decrease in the CoLab score over time in an intensive care unit (ICU) cohort. Such a decrease would create the opportunity to potentially rule out the need for isolation when the infection is overcome. Using linear mixed-effects models, data from the Maastricht Intensive Care COVID (MaastrICCht) cohort were used to investigate the association between time and the CoLab score. Models were adjusted for sex, APACHE II score, ICU mortality, and daily SOFA score. The CoLab score decreased by 0.30 points per day (95% CI - 0.33 to - 0.27), independent of sex, APACHE II, and Mortality. With increasing SOFA score over time, the CoLab score decreased more strongly (- 0.01 (95% CI - 0.01 to - 0.01) additional decrease per one-point increase in SOFA score.) The CoLab score decreased in ICU patients on mechanical ventilation for COVID-19, with a one-point reduction per three days, independent of sex, APACHE II, and ICU mortality, and somewhat stronger with increasing multi-organ failure over time. This suggests that the CoLab score would decrease below a threshold where COVID-19 can be excluded.

Keywords: COVID-19; CoLab score; Linear mixed-effects models; SARS-CoV-2.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Inclusion flow chart. ICU intensive care unit, APACHE Acute Physiology and Chronic Health Evaluation.
Figure 2
Figure 2
Scatter plot of the CoLab score. The CoLab score was measured daily from the start of intubation. A general downward trend can be observed. The red dotted line is the CoLab score threshold that the emergency department uses for excluding active SARS-CoV-2 infection (COVID-19 is highly unlikely below the red dotted line for the threshold that the emergency department uses). (A) The CoLab score over time of the total population. (B) The CoLab score over time of the survivor population. (C) The CoLab score over time of the non-survivor population.
Figure 3
Figure 3
Line plot of the mixed model results. Result of the linear mixed-effects model analyses of the MaastrICCht cohort. (A) A blue line indicates a patient who survived the intensive care stay. An orange line indicates a patient who did not survive the intensive care stay. Results of model 1 are shown. (B) A blue line indicates a patient who survived the intensive care stay. An orange line indicates a patient who did not survive the intensive care stay. Results of Model 5 [adjusted for sex, APACHE II, and SOFA (predictor and interaction term)] are shown. (C) Results of Model 1 are shown with a heatmap related to the SOFA score (the purple color indicates a low SOFA score, while the orange color indicates a high SOFA score). (D) Results of Model 5 are shown with a heatmap related to the SOFA score (the purple color indicates a low SOFA score, while the orange color indicates a high SOFA score).
See this image and copyright information in PMC

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