Receiver operating characteristic (ROC) to determine cut-off points of clinical and biomolecular markers to discriminate mortality in severe COVID-19 living at high altitude
Abstract Background In 2020, Ecuador had one of the highest death rates because of COVID-19. The role of clinical and biomolecular markers in COVID disease prognosis, is still not well supported by available data. In order for these markers to have practical application in clinical decision-making r...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12890-023-02691-2 |
| _version_ | 1797578438460047360 |
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| author | Jorge Luis Vélez-Páez Lucy Baldeón-Rojas Cristina Cañadas Herrera Mario Patricio Montalvo Fernando Esteban Jara Santiago Aguayo-Moscoso Wendy Tercero-Martínez Lenin Saltos Glenda Jiménez-Alulima Verónica Guerrero Jorge Pérez-Galarza |
| author_facet | Jorge Luis Vélez-Páez Lucy Baldeón-Rojas Cristina Cañadas Herrera Mario Patricio Montalvo Fernando Esteban Jara Santiago Aguayo-Moscoso Wendy Tercero-Martínez Lenin Saltos Glenda Jiménez-Alulima Verónica Guerrero Jorge Pérez-Galarza |
| author_sort | Jorge Luis Vélez-Páez |
| collection | DOAJ |
| description | Abstract Background In 2020, Ecuador had one of the highest death rates because of COVID-19. The role of clinical and biomolecular markers in COVID disease prognosis, is still not well supported by available data. In order for these markers to have practical application in clinical decision-making regarding patient treatment and prognosis, it is necessary to know an optimal cut-off point, taking into consideration ethnic differences and geographic conditions. Aim To determine the value of clinical and biomolecular markers, to predict mortality of patients with severe COVID-19 living at high altitude. Methods In this study, receiver operating characteristic (ROC) curves, area under the curve (AUC) of ROC, sensitivity, specificity and likelihood ratios were calculated to determine levels of clinical and biomolecular markers that best differentiate survivors versus non-survivors in severe COVID subjects that live at a high altitude setting. Results Selected cut-off values for ferritin (≥ 1225 ng/dl, p = 0.026), IL-6 (≥ 11 pg/ml, p = 0.005) and NLR (≥ 22, p = 0.008) at 24 h, as well as PaFiO2 (≤ 164 mmHg, p = 0.015), NLR (≥ 16, p = p = 0.013) and SOFA (≥ 6, p = 0.031) at 72 h, appear to have good discriminating power to differentiate survivors versus non-survivors. Additionally, odds ratios for ferritin (OR = 3.38); IL-6 (OR = 17.07); PaFiO2 (OR = 4.61); NLR 24 h (OR = 4.95); NLR 72 h (OR = 4.46), and SOFA (OR = 3.77) indicate increased risk of mortality when cut-off points were taken into consideration. Conclusions We proposed a straightforward and understandable method to identify dichotomized levels of clinical and biomolecular markers that can discriminate between survivors and non-survivors patients with severe COVID-19 living at high altitudes. |
| first_indexed | 2024-03-10T22:21:54Z |
| format | Article |
| id | doaj.art-1820c227fae34a9897a947b4d96601e8 |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-03-10T22:21:54Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-1820c227fae34a9897a947b4d96601e82023-11-19T12:14:25ZengBMCBMC Pulmonary Medicine1471-24662023-10-0123111010.1186/s12890-023-02691-2Receiver operating characteristic (ROC) to determine cut-off points of clinical and biomolecular markers to discriminate mortality in severe COVID-19 living at high altitudeJorge Luis Vélez-Páez0Lucy Baldeón-Rojas1Cristina Cañadas Herrera2Mario Patricio Montalvo3Fernando Esteban Jara4Santiago Aguayo-Moscoso5Wendy Tercero-Martínez6Lenin Saltos7Glenda Jiménez-Alulima8Verónica Guerrero9Jorge Pérez-Galarza10Pablo Arturo Suarez Hospital, Intensive Care Unit, Clinical Research CenterFaculty of Medical Sciences, Central University of EcuadorResearch Institute of Biomedicine, Central University of EcuadorPablo Arturo Suarez Hospital, Intensive Care Unit, Clinical Research CenterPablo Arturo Suarez Hospital, Intensive Care Unit, Clinical Research CenterPablo Arturo Suarez Hospital, Intensive Care Unit, Clinical Research CenterPablo Arturo Suarez Hospital, Intensive Care Unit, Clinical Research CenterPablo Arturo Suarez Hospital, Intensive Care Unit, Clinical Research CenterPablo Arturo Suarez Hospital, Intensive Care Unit, Clinical Research CenterPablo Arturo Suarez Hospital, Intensive Care Unit, Clinical Research CenterFaculty of Medical Sciences, Central University of EcuadorAbstract Background In 2020, Ecuador had one of the highest death rates because of COVID-19. The role of clinical and biomolecular markers in COVID disease prognosis, is still not well supported by available data. In order for these markers to have practical application in clinical decision-making regarding patient treatment and prognosis, it is necessary to know an optimal cut-off point, taking into consideration ethnic differences and geographic conditions. Aim To determine the value of clinical and biomolecular markers, to predict mortality of patients with severe COVID-19 living at high altitude. Methods In this study, receiver operating characteristic (ROC) curves, area under the curve (AUC) of ROC, sensitivity, specificity and likelihood ratios were calculated to determine levels of clinical and biomolecular markers that best differentiate survivors versus non-survivors in severe COVID subjects that live at a high altitude setting. Results Selected cut-off values for ferritin (≥ 1225 ng/dl, p = 0.026), IL-6 (≥ 11 pg/ml, p = 0.005) and NLR (≥ 22, p = 0.008) at 24 h, as well as PaFiO2 (≤ 164 mmHg, p = 0.015), NLR (≥ 16, p = p = 0.013) and SOFA (≥ 6, p = 0.031) at 72 h, appear to have good discriminating power to differentiate survivors versus non-survivors. Additionally, odds ratios for ferritin (OR = 3.38); IL-6 (OR = 17.07); PaFiO2 (OR = 4.61); NLR 24 h (OR = 4.95); NLR 72 h (OR = 4.46), and SOFA (OR = 3.77) indicate increased risk of mortality when cut-off points were taken into consideration. Conclusions We proposed a straightforward and understandable method to identify dichotomized levels of clinical and biomolecular markers that can discriminate between survivors and non-survivors patients with severe COVID-19 living at high altitudes.https://doi.org/10.1186/s12890-023-02691-2ROC curveCut-offOdds ratioSevere COVID-19Inflammatory markersHigh altitude |
| spellingShingle | Jorge Luis Vélez-Páez Lucy Baldeón-Rojas Cristina Cañadas Herrera Mario Patricio Montalvo Fernando Esteban Jara Santiago Aguayo-Moscoso Wendy Tercero-Martínez Lenin Saltos Glenda Jiménez-Alulima Verónica Guerrero Jorge Pérez-Galarza Receiver operating characteristic (ROC) to determine cut-off points of clinical and biomolecular markers to discriminate mortality in severe COVID-19 living at high altitude BMC Pulmonary Medicine ROC curve Cut-off Odds ratio Severe COVID-19 Inflammatory markers High altitude |
| title | Receiver operating characteristic (ROC) to determine cut-off points of clinical and biomolecular markers to discriminate mortality in severe COVID-19 living at high altitude |
| title_full | Receiver operating characteristic (ROC) to determine cut-off points of clinical and biomolecular markers to discriminate mortality in severe COVID-19 living at high altitude |
| title_fullStr | Receiver operating characteristic (ROC) to determine cut-off points of clinical and biomolecular markers to discriminate mortality in severe COVID-19 living at high altitude |
| title_full_unstemmed | Receiver operating characteristic (ROC) to determine cut-off points of clinical and biomolecular markers to discriminate mortality in severe COVID-19 living at high altitude |
| title_short | Receiver operating characteristic (ROC) to determine cut-off points of clinical and biomolecular markers to discriminate mortality in severe COVID-19 living at high altitude |
| title_sort | receiver operating characteristic roc to determine cut off points of clinical and biomolecular markers to discriminate mortality in severe covid 19 living at high altitude |
| topic | ROC curve Cut-off Odds ratio Severe COVID-19 Inflammatory markers High altitude |
| url | https://doi.org/10.1186/s12890-023-02691-2 |
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