‘Immune-inflammatory markers & clinical characteristics for outcomes in hospitalized SARS-CoV-2 infected patients of Pakistan: a retrospective analysis’
ABSTRACTObjective Accumulating evidence suggests the role of immune-inflammatory markers in early risk stratification and prognostication of COVID-19 patients. We aimed to evaluate their association with severity and the development of diagnostic scores with optimal thresholds in critical patients.S...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Hematology |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/16078454.2023.2199629 |
| _version_ | 1797786225324589056 |
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| author | Atiqa Khalid Rao Faheem Aqeel Amber Nawaz Jehangir Ahmad Syeda Tatheer Fatima Samreen Shahid Aqsa Aqeel Rao Gulali Aktas Shaista Ijaz Muhammad Shehryar |
| author_facet | Atiqa Khalid Rao Faheem Aqeel Amber Nawaz Jehangir Ahmad Syeda Tatheer Fatima Samreen Shahid Aqsa Aqeel Rao Gulali Aktas Shaista Ijaz Muhammad Shehryar |
| author_sort | Atiqa Khalid |
| collection | DOAJ |
| description | ABSTRACTObjective Accumulating evidence suggests the role of immune-inflammatory markers in early risk stratification and prognostication of COVID-19 patients. We aimed to evaluate their association with severity and the development of diagnostic scores with optimal thresholds in critical patients.Setting and participants This retrospective case study includes hospitalized COVID-19 patients from March 2019 to March, 2022, in the developing area teaching hospital in Pakistan. Polymerase chain reaction (PCR) positive patients, n = 467 were investigated for clinical outcomes, comorbidities and disease prognosis. The plasma levels of Interleukin-6 (IL-6), Lactate dehydrogenase (LDH), C-reactive protein (CRP), Procalcitonin (PCT), ferritin and Complete blood count markers were measured.Results Majority were males (58.8%) and patients with comorbidities had more severe disease. Hypertension and diabetes mellitus were the commonest comorbidities. Shortness of breath, myalgia and cough were the main symptoms. The hematological markers NLR, as well as the plasma levels of immune-inflammatory variables, IL-6, LDH, Procalcitonin, Erythrocyte sedimentation rate, Ferritin were markedly raised in severe and critical patients (p < 0.0001 for these markers). ROC analysis supports IL-6 as the most accurate marker with high prognostic relevance with proposed cut-off threshold (43 pg/ml), determining >90% of patients in terms of COVID-19 severity (AUC = 0.93, 91.7%, se; 90.3%sp). Furthermore, positive correlation with all other markers including NLR with cut-off = 2.99 (AUC = 0.87, se = 89.8%, sp = 88.4%), CRP with cut-offs at 42.9 mg/l, (AUC = 0.883, se = 89.3% and sp = 78.6%), LDH cut-off at 267μg/L, evidenced in >80% patients (AUC = 0.834 se = 84% and sp = 80%). Additionally, ESR and ferritin have the corresponding AUC 0.81 and 0.813 with cut-off at 55 mm/hr and 370, respectively.Conclusion Investigating the immune-inflammatory markers can assist physicians in providing prompt treatment and ICU admission in terms of COVID-19 severity. As a result, which may reduce the overall mortality of COVID-19 patients. |
| first_indexed | 2024-03-13T01:04:51Z |
| format | Article |
| id | doaj.art-697c742f3003445b82359c41ffa234f9 |
| institution | Directory Open Access Journal |
| issn | 1607-8454 |
| language | English |
| last_indexed | 2024-03-13T01:04:51Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Hematology |
| spelling | doaj.art-697c742f3003445b82359c41ffa234f92023-07-06T06:57:45ZengTaylor & Francis GroupHematology1607-84542023-12-0128110.1080/16078454.2023.2199629‘Immune-inflammatory markers & clinical characteristics for outcomes in hospitalized SARS-CoV-2 infected patients of Pakistan: a retrospective analysis’Atiqa Khalid0Rao Faheem Aqeel1Amber Nawaz2Jehangir Ahmad3Syeda Tatheer Fatima4Samreen Shahid5Aqsa Aqeel Rao6Gulali Aktas7Shaista Ijaz8Muhammad Shehryar9MBBS, Sahiwal Medical College, Hospital, SahiwalPostgraduate Resident Pediatrician, Sahiwal Teaching Hospital, SahiwalPathology Department, Sahiwal Medical College, SahiwalDepartment of Medicine, Divisional Headquarters Teaching Hospital Mirpur AJKPost resident Gynaecology and obstetrics, Sir Ganga Raam Hospital, LahoreKing Edward Medical University, Lahore, PakistanAssistant Professor, Wateen Medical & Dental College, RawatAbant Izzet Baysal University, Bolu, TurkeyMBBS, YANGTZE University Medical School, Wuhan, ChinaPost resident Gynaecology and obstetrics, Sir Ganga Raam Hospital, LahoreABSTRACTObjective Accumulating evidence suggests the role of immune-inflammatory markers in early risk stratification and prognostication of COVID-19 patients. We aimed to evaluate their association with severity and the development of diagnostic scores with optimal thresholds in critical patients.Setting and participants This retrospective case study includes hospitalized COVID-19 patients from March 2019 to March, 2022, in the developing area teaching hospital in Pakistan. Polymerase chain reaction (PCR) positive patients, n = 467 were investigated for clinical outcomes, comorbidities and disease prognosis. The plasma levels of Interleukin-6 (IL-6), Lactate dehydrogenase (LDH), C-reactive protein (CRP), Procalcitonin (PCT), ferritin and Complete blood count markers were measured.Results Majority were males (58.8%) and patients with comorbidities had more severe disease. Hypertension and diabetes mellitus were the commonest comorbidities. Shortness of breath, myalgia and cough were the main symptoms. The hematological markers NLR, as well as the plasma levels of immune-inflammatory variables, IL-6, LDH, Procalcitonin, Erythrocyte sedimentation rate, Ferritin were markedly raised in severe and critical patients (p < 0.0001 for these markers). ROC analysis supports IL-6 as the most accurate marker with high prognostic relevance with proposed cut-off threshold (43 pg/ml), determining >90% of patients in terms of COVID-19 severity (AUC = 0.93, 91.7%, se; 90.3%sp). Furthermore, positive correlation with all other markers including NLR with cut-off = 2.99 (AUC = 0.87, se = 89.8%, sp = 88.4%), CRP with cut-offs at 42.9 mg/l, (AUC = 0.883, se = 89.3% and sp = 78.6%), LDH cut-off at 267μg/L, evidenced in >80% patients (AUC = 0.834 se = 84% and sp = 80%). Additionally, ESR and ferritin have the corresponding AUC 0.81 and 0.813 with cut-off at 55 mm/hr and 370, respectively.Conclusion Investigating the immune-inflammatory markers can assist physicians in providing prompt treatment and ICU admission in terms of COVID-19 severity. As a result, which may reduce the overall mortality of COVID-19 patients.https://www.tandfonline.com/doi/10.1080/16078454.2023.2199629COVID-19SARS-CoV-2immune-inflammatory markersdisease severitydiagnostic criteria |
| spellingShingle | Atiqa Khalid Rao Faheem Aqeel Amber Nawaz Jehangir Ahmad Syeda Tatheer Fatima Samreen Shahid Aqsa Aqeel Rao Gulali Aktas Shaista Ijaz Muhammad Shehryar ‘Immune-inflammatory markers & clinical characteristics for outcomes in hospitalized SARS-CoV-2 infected patients of Pakistan: a retrospective analysis’ Hematology COVID-19 SARS-CoV-2 immune-inflammatory markers disease severity diagnostic criteria |
| title | ‘Immune-inflammatory markers & clinical characteristics for outcomes in hospitalized SARS-CoV-2 infected patients of Pakistan: a retrospective analysis’ |
| title_full | ‘Immune-inflammatory markers & clinical characteristics for outcomes in hospitalized SARS-CoV-2 infected patients of Pakistan: a retrospective analysis’ |
| title_fullStr | ‘Immune-inflammatory markers & clinical characteristics for outcomes in hospitalized SARS-CoV-2 infected patients of Pakistan: a retrospective analysis’ |
| title_full_unstemmed | ‘Immune-inflammatory markers & clinical characteristics for outcomes in hospitalized SARS-CoV-2 infected patients of Pakistan: a retrospective analysis’ |
| title_short | ‘Immune-inflammatory markers & clinical characteristics for outcomes in hospitalized SARS-CoV-2 infected patients of Pakistan: a retrospective analysis’ |
| title_sort | immune inflammatory markers clinical characteristics for outcomes in hospitalized sars cov 2 infected patients of pakistan a retrospective analysis |
| topic | COVID-19 SARS-CoV-2 immune-inflammatory markers disease severity diagnostic criteria |
| url | https://www.tandfonline.com/doi/10.1080/16078454.2023.2199629 |
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