D-dimer, Troponin, and Urea Level at Presentation With COVID-19 can Predict ICU Admission: A Single Centered Study

Background: Identifying clinical-features or a scoring-system to predict a benefit from hospital admission for patients with COVID-19 can be of great value for the decision-makers in the health sector. We aimed to identify differences in patients' demographic, clinical, laboratory, and radiolog...

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Main Authors: Mahmood Y. Hachim, Ibrahim Y. Hachim, Kashif Bin Naeem, Haifa Hannawi, Issa Al Salmi, Suad Hannawi
Format: Article
Language:English
Published: Frontiers Media S.A. 2020-12-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2020.585003/full
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author Mahmood Y. Hachim
Ibrahim Y. Hachim
Kashif Bin Naeem
Haifa Hannawi
Issa Al Salmi
Suad Hannawi
author_facet Mahmood Y. Hachim
Ibrahim Y. Hachim
Kashif Bin Naeem
Haifa Hannawi
Issa Al Salmi
Suad Hannawi
author_sort Mahmood Y. Hachim
collection DOAJ
description Background: Identifying clinical-features or a scoring-system to predict a benefit from hospital admission for patients with COVID-19 can be of great value for the decision-makers in the health sector. We aimed to identify differences in patients' demographic, clinical, laboratory, and radiological findings of COVID-19 positive cases to develop and validate a diagnostic-model predicting who will develop severe-form and who will need critical-care in the future.Methods: In this observational retrospective study, COVID-19 positive cases (total 417) diagnosed in Al Kuwait Hospital, Dubai, UAE were recruited, and their prognosis in terms of admission to the hospital and the need for intensive care was reviewed until their tests turned negative. Patients were classified according to their clinical state into mild, moderate, severe, and critical. We retrieved all the baseline clinical data, laboratory, and radiological results and used them to identify parameters that can predict admission to the intensive care unit (ICU).Results: Patients with ICU admission showed a distinct clinical, demographic as well as laboratory features when compared to patients who did not need ICU admission. This includes the elder age group, male gender, and presence of comorbidities like diabetes and history of hypertension. ROC and Precision-Recall curves showed that among all variables, D dimers (>1.5 mg/dl), Urea (>6.5 mmol/L), and Troponin (>13.5 ng/ml) could positively predict the admission to ICU in patients with COVID-19. On the other hand, decreased Lymphocyte count and albumin can predict admission to ICU in patients with COVID-19 with acceptable sensitivity (59.32, 95% CI [49.89–68.27]) and specificity (79.31, 95% CI [72.53–85.07]).Conclusion: Using these three predictors with their cut of values can identify patients who are at risk of developing critical COVID-19 and might need aggressive intervention earlier in the course of the disease.
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spelling doaj.art-7eea04dd7ef240f2bf624cb444a0ff9e2022-12-21T18:12:44ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2020-12-01710.3389/fmed.2020.585003585003D-dimer, Troponin, and Urea Level at Presentation With COVID-19 can Predict ICU Admission: A Single Centered StudyMahmood Y. Hachim0Ibrahim Y. Hachim1Kashif Bin Naeem2Haifa Hannawi3Issa Al Salmi4Suad Hannawi5College of Medicine, Mohammed bin Rashid University of Medicine and Health Sciences, Dubai, United Arab EmiratesClinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, United Arab EmiratesMinistry of Health and Prevention (MOHAP), Dubai, United Arab EmiratesMinistry of Health and Prevention (MOHAP), Dubai, United Arab EmiratesThe Royal Hospital, Muscat, OmanMinistry of Health and Prevention (MOHAP), Dubai, United Arab EmiratesBackground: Identifying clinical-features or a scoring-system to predict a benefit from hospital admission for patients with COVID-19 can be of great value for the decision-makers in the health sector. We aimed to identify differences in patients' demographic, clinical, laboratory, and radiological findings of COVID-19 positive cases to develop and validate a diagnostic-model predicting who will develop severe-form and who will need critical-care in the future.Methods: In this observational retrospective study, COVID-19 positive cases (total 417) diagnosed in Al Kuwait Hospital, Dubai, UAE were recruited, and their prognosis in terms of admission to the hospital and the need for intensive care was reviewed until their tests turned negative. Patients were classified according to their clinical state into mild, moderate, severe, and critical. We retrieved all the baseline clinical data, laboratory, and radiological results and used them to identify parameters that can predict admission to the intensive care unit (ICU).Results: Patients with ICU admission showed a distinct clinical, demographic as well as laboratory features when compared to patients who did not need ICU admission. This includes the elder age group, male gender, and presence of comorbidities like diabetes and history of hypertension. ROC and Precision-Recall curves showed that among all variables, D dimers (>1.5 mg/dl), Urea (>6.5 mmol/L), and Troponin (>13.5 ng/ml) could positively predict the admission to ICU in patients with COVID-19. On the other hand, decreased Lymphocyte count and albumin can predict admission to ICU in patients with COVID-19 with acceptable sensitivity (59.32, 95% CI [49.89–68.27]) and specificity (79.31, 95% CI [72.53–85.07]).Conclusion: Using these three predictors with their cut of values can identify patients who are at risk of developing critical COVID-19 and might need aggressive intervention earlier in the course of the disease.https://www.frontiersin.org/articles/10.3389/fmed.2020.585003/fullCOVID-19severe COVID-19 predictionrisk stratificationICU - Intensive care unitSARS-CoV-2
spellingShingle Mahmood Y. Hachim
Ibrahim Y. Hachim
Kashif Bin Naeem
Haifa Hannawi
Issa Al Salmi
Suad Hannawi
D-dimer, Troponin, and Urea Level at Presentation With COVID-19 can Predict ICU Admission: A Single Centered Study
Frontiers in Medicine
COVID-19
severe COVID-19 prediction
risk stratification
ICU - Intensive care unit
SARS-CoV-2
title D-dimer, Troponin, and Urea Level at Presentation With COVID-19 can Predict ICU Admission: A Single Centered Study
title_full D-dimer, Troponin, and Urea Level at Presentation With COVID-19 can Predict ICU Admission: A Single Centered Study
title_fullStr D-dimer, Troponin, and Urea Level at Presentation With COVID-19 can Predict ICU Admission: A Single Centered Study
title_full_unstemmed D-dimer, Troponin, and Urea Level at Presentation With COVID-19 can Predict ICU Admission: A Single Centered Study
title_short D-dimer, Troponin, and Urea Level at Presentation With COVID-19 can Predict ICU Admission: A Single Centered Study
title_sort d dimer troponin and urea level at presentation with covid 19 can predict icu admission a single centered study
topic COVID-19
severe COVID-19 prediction
risk stratification
ICU - Intensive care unit
SARS-CoV-2
url https://www.frontiersin.org/articles/10.3389/fmed.2020.585003/full
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