Prognostic value of sTREM-1 in COVID-19 patients: a biomarker for disease severity and mortality (original) (raw)
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Viruses
Uncontrolled inflammatory responses play a critical role in coronavirus disease (COVID-19). In this context, because the triggering-receptor expressed on myeloid cells-1 (TREM-1) is considered an intrinsic amplifier of inflammatory signals, this study investigated the role of soluble TREM-1 (sTREM-1) as a biomarker of the severity and mortality of COVID-19. Based on their clinical scores, we enrolled COVID-19 positive patients (n = 237) classified into mild, moderate, severe, and critical groups. Clinical data and patient characteristics were obtained from medical records, and their plasma inflammatory mediator profiles were evaluated with immunoassays. Plasma levels of sTREM-1 were significantly higher among patients with severe disease compared to all other groups. Additionally, levels of sTREM-1 showed a significant positive correlation with other inflammatory parameters, such as IL-6, IL-10, IL-8, and neutrophil counts, and a significant negative correlation was observed with ly...
Bioscience Reports
Patients with sepsis display increased concentrations of sTREM-1 (soluble Triggering Receptor Expressed on Myeloid cells 1), and a phase II clinical trial focusing on TREM-1 modulation is ongoing. We investigated whether sTREM-1 circulating concentrations are associated with the outcome of patients with coronavirus disease 2019 (COVID-19) to assess the role of this pathway in COVID-19. This observational study was performed in two independent cohorts of patients with COVID-19. Plasma concentrations of sTREM-1 were assessed after ICU admission (pilot cohort) or after COVID-19 diagnosis (validation cohort). Routine laboratory and clinical parameters were collected from electronic patient files. Results showed sTREM-1 plasma concentrations were significantly elevated in patients with COVID-19 (161 [129–196] pg/ml) compared to healthy controls (104 [75–124] pg/ml; P<0.001). Patients with severe COVID-19 needing ICU admission displayed even higher sTREM-1 concentrations compared to le...
Biomarker Insights
Background: The current knowledge about novel coronavirus-2019 (COVID-19) indicates that the immune system and inflammatory response play a crucial role in the severity and prognosis of the disease. In this study, we aimed to investigate prognostic value of systemic inflammatory biomarkers including C-reactive protein/albumin ratio (CAR), prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) in patients with severe COVID-19. Methods: This single-center, retrospective study included a total of 223 patients diagnosed with severe COVID-19. Primary outcome measure was mortality during hospitalization. Multivariate logistic regression analyses were performed to identify independent predictors associated with mortality in patients with severe COVID-19. Receiver operating characteristic (ROC) curve was used to determine cut-offs, and area under the curve (AUC) values were used to demonstrate disc...
Assessment of Inflammatory Biomarkers as Predictor of Mortality in COVID-19 Patients
Pakistan Journal of Medical and Health Sciences
Background: In individuals with coronavirus, a cytokine storm is an important cause of illness and demise. The purpose of the study was to assess whether pro-inflammatory cytokines had an impact on progression and risk of mortality in patients with COVID-19. Study Design: Retrospective study Place and Duration of Study: Intensive Care Unit (ICU) and Medical Wards, Bahria Town International Hospital from 21st August 2020 to 17th September 2021. Methodology: One hundred and thirty-six patients of confirmed cases of COVID-19 disease were enrolled. Their demographic, blood and biochemical parameters were collected within 48 hours after admission from the medical record of patients. Patients were divided into two groups according to the final outcome, the survivors and non survivors. The data were investigated to assess the prognostic importance of the blood marker and inflammatory variables for the prognostic importance. Results: The mean age and body mass index (BMI) were statistically...
Association of Inflammatory Markers with Disease Severity and Outcome in Covid-19 Patients
PRILOZI
Objectives: The coronavirus pandemic was associated with a high mortality rate in the Republic of North Macedonia. Finding early markers of the disease’s severity may predict outcomes and guide the treatment of the disease. The aim of our study was to evaluate the role of inflammatory markers in predicting the outcome of COVID-19 in hospitalized patients. Methods: The study included 104 PCR-confirmed COVID-19 patients who underwent hospital treatment at the Institute of Lung Diseases and Tuberculosis in Skopje, North Macedonia, between November 2020 and May 2021. Inflammatory markers were assessed in all patients and correlated with the disease severity and outcome in terms of survival or death. Results: IL-6 and LDH at admission were significantly elevated in patients with a severe or critical form of the disease and among non-survivors. In addition, IL-6 showed 87.9% of sensitivity and 61.8% of specificity for distinguishing non-survivors from survivors with a cut-off value of 21....
The Severity of COVID-19 and its Correlation with Inflammation Biomarkers
Open Access Macedonian Journal of Medical Sciences
Introduction: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov2) or Covid-19 has been spread quickly and caused 5 million deaths until February 2022. Severe symptoms of the infection may lead to death that prompt appropriate clinical diagnosis and adequate treatment going to be necessary. Covid-19 shows a severe inflammatory response which causes an imbalance in the immune response. Therefore, circulating biomarkers that can represent inflammation and immune status are potential predictors for the prognosis of COVID-19 patients. This study aims to know the role of Neutrophil-Lymphocyte Ratio (NLR), Neutrophil Monocyte Ratio (NMR), and Lymphocyte-monocyte Ratio (LMR) as inflammatory biomarkers for the severity of Covid-19. Methodology: This study is a single-center retrospective cohort study. The sample of this study was taken by consecutive sampling with complete clinical data from 893 Covid-19 patients from Andalas University Teaching Hospital from April 2020 to September ...
Prognostic Value of Inflammatory Markers in Hospitalized COVID-19 Patients
Canadian Journal of General Internal Medicine
It is unclear whether D-dimer is a disease-specific marker for COVID-19 or part of the general inflammatory response alongside C-reactive protein (CRP) and other acute-phase reactants. We extracted data of patients hos-pitalized with COVID-19 for demographics, comorbidities, biochemical data, and outcomes. Using multivari-able logistic regression, the value of D-dimer in predicting intensive care unit (ICU) admission or mortality was measured. Of 1175 patients, 263 were admitted to the ICU and 226 died. CRP predicted both ICU admission and mortality [Odds ratios (ORs) with 95% confidence interval 1.01 (1.01–1.01) and 1.00 (1.00–1.01), respectively] but D-dimer was not predictive of either outcome [ORs 1.02 (0.97–1.06) and 0.99 (0.93–1.06)]. This suggests D-dimer levels are not independently predictive of COVID-19 severity or mortality. Our results confirm find-ings from smaller cohorts and demonstrate the inflammatory characteristics of COVID in the Canadian context. RésuméOn ne sai...
Dynamics of Inflammatory Markers in Predicting Mortality in COVID-19
Cureus, 2021
Introduction A cytokine storm is an important cause of morbidity and mortality in patients with coronavirus disease 2019 (COVID-19). The objective of the study was to determine the prognostic significance of pro-inflammatory cytokines with the overall final outcome of patients with COVID-19. Methods We conducted a retrospective study of 142 patients admitted with COVID-19 in the Department of Medicine at All India Institute of Medical Sciences, New Delhi, from May 2021 to June 2021. We obtained their demographic, clinical, and biochemical characteristics at baseline and 48-72 hours prior to the terminal event (survival/death). The data were analyzed to determine the prognostic significance of these markers on the final outcome. Results Higher levels of inflammatory markers were associated with a worse final outcome (ferritin p-value <0.001, c-reactive protein (CRP) p-value <0.001, interleukin 6 (IL-6) p-value 0.007, procalcitonin p-value 0.005, and lactic acid p-value 0.004). Optimal probability cutoffs for these markers for predicting mortality were:
Co-relation between inflammatory biomarkers and COVID-19 progression
International Journal of Health Sciences (IJHS), 2022
Background & Objective:-Coronavirus Disease-19 (COVID-19) disease has caused considerable morbidity and mortality worldwide. The present study aims to investigate the prognostic significance of the inflammatory markers and to augment our present knowledge of these biomarkers to help in risk stratification. Methodology-The proposed study is a retrospective observational study on COVID-19 positive patients admitted in the ICU of Hospital of Government Doon Medical College, Dehradun, India from November 2020 to January 2021. Patients were categorized in to three groups moderate, severe and critical as per the criteria mentioned in methodology section in detail. Statistical Analysis-To explore the risk factors associated with illness severity of COVID-19, we categorized the patients into two groups, and one is moderate and severe and second is critical. Potential predictive variables included the following case characteristics on admission: demographic features and, comorbidity, clinical signs and symptoms and laboratory findings. Results-Sixty-two patients were enrolled in this study with mean age of 63.24±20.12 of which 44(70.96%) were males and 18(29.03%) were females. Multiple number of patients had comorbidities with diabetes 36(58.06%) patients, followed by hypertension in 24(38.70%). Conclusion-Single prognostic inflammatory marker indicating the progression to disease severity early in disease timeline is the Creactive protein. Neutrophil (NEU)-to-lymphocyte (LYM) ratio (NLR) with CRP together can have a good predictability of disease outcome.
Internal and Emergency Medicine
Inflammatory biomarkers may be associated with disease severity and increased mortality in COVID-19 patients but have not been studied in North American populations. We sought to determine whether a set of commonly ordered inflammatory biomarkers can predict 28-day mortality. We analyzed a multi-centered (four) COVID-19 registry cohort from March 4th to December 7th, 2020. This cohort included COVID-19-positive patients admitted to medical wards or intensive care units. Patients presenting to the emergency department for COVID-19 symptoms and then subsequently discharged were also included. We performed Cox-regression analysis to measure whether commonly used biomarkers were associated with an increased 28-day mortality. Of 336 COVID-19-positive patients, 267 required hospital admission, and 69 were seen in the emergency room and discharged. The median age was 63 years (IQR 80-50) and the female-to-male ratio was 49:51. Derivation of internally validated cutoffs suggested that C-reactive protein ≥ 78.4 mg/L, neutrophil-to-lymphocyte ratio ≥ 6.1, lymphocyte-to-white blood cell ratio < 0.127, and a modified Glasgow prognostic score equal to 2 vs. 1 or 0 were associated with the highest increased risk of 28-day mortality. We provide early estimates of cutoff values for inflammatory biomarkers and indices measured at the time of admission that may be useful to clinicians for predicting 28-day mortality in North American COVID-19 patients.