Novel markers of COVID-19 mortality-A comparative study with patients of acute coronary syndrome
Background: COVID-19 can cause severe pneumonia that can progress to multiple organ failure. It is believed that dysregulation of inflammation and cytokine storm, contributes to severe COVID-19. As inflammatory mediators play an important role in the pathogenesis of the severe disease, inflammatory...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2023-01-01
|
| Series: | Journal of Family Medicine and Primary Care |
| Subjects: | |
| Online Access: | http://www.jfmpc.com/article.asp?issn=2249-4863;year=2023;volume=12;issue=5;spage=962;epage=966;aulast=Sharma |
| _version_ | 1797773824217841664 |
|---|---|
| author | Yash Paul Sharma Atit A Gawalkar Akash Batta Yamasandi Siddegowda Shrimanth Pruthvi C Revaiah Pragya Karki Vikas Chaudhary Ganesh Kasinadhuni Krishna Santosh Dinakar Bootla Sanjeev Kumar Nitin Kumar J Patel Bharat Singh Sambyal Prashant Panda |
| author_facet | Yash Paul Sharma Atit A Gawalkar Akash Batta Yamasandi Siddegowda Shrimanth Pruthvi C Revaiah Pragya Karki Vikas Chaudhary Ganesh Kasinadhuni Krishna Santosh Dinakar Bootla Sanjeev Kumar Nitin Kumar J Patel Bharat Singh Sambyal Prashant Panda |
| author_sort | Yash Paul Sharma |
| collection | DOAJ |
| description | Background: COVID-19 can cause severe pneumonia that can progress to multiple organ failure. It is believed that dysregulation of inflammation and cytokine storm, contributes to severe COVID-19. As inflammatory mediators play an important role in the pathogenesis of the severe disease, inflammatory markers like fever, leucocytosis, and C-reactive protein are known to predict severe disease. Various other biomarkers have been known to have prognostic value in patients with COVID-19 infection. Inflammation, both local and systemic plays an important role in the pathogenesis of acute coronary syndrome (ACS). Thus in this study, we aimed to compare and describe the various biomarkers, and mortality between patients admitted with COVID-19 infection and ACS patients without COVID-19 infection. Methods: In a retrospective observational case-control study, a total of 108 patients admitted to our hospital during the month of May 2021 with COVID-19 were enrolled. Patients of the acute coronary syndrome (tested negative for COVID-19 infection) admitted during the same month were enrolled (including both the intensive care unit and ward) as controls. Results: The median age of patients with COVID was significantly lower than that of patients with acute coronary syndrome [49 years (IQR, 36-62 years) and 60 years (IQR, 52-66 years)]. Left ventricular ejection fraction was significantly higher among patients with COVID infection (58.5 ± 6.3% versus 36.9 ± 9.3%). The total leukocyte count was significantly higher among patients with COVID-19 compared to those with acute coronary syndrome [13200 per microliter (8625-17500) vs 9800 per microliter (8150-12150), P < 0.001]. The blood urea level was significantly higher among patients with COVID infection [52.5 (IQR, 34.7-81.5) versus 20 (IQR, 16-31)]. Levels of C-reactive protein were significantly higher among patients with COVID [39 (IQR, 7.7-100) versus 2 (1.4-3.5)]. The mortality of patients hospitalized with COVID was 4 times higher than those with acute coronary syndrome [25.9% (28) versus 6.1% (6)]. Survivors of COVID-19 had higher hemoglobin levels than those who did not [12.5 g/dLvs 11.5 g/dL, P = 0.03]. Conclusions: Elevated total leukocyte counts reflect underlying secondary bacterial infection among patients with COVID-19 and help initiate appropriate antibiotics. Depletion of intravascular volume reflected by an increased urea/creatinine ratio increases the risk of mortality and warrants aggressive measures of rehydration and albumin infusion. |
| first_indexed | 2024-03-12T22:11:51Z |
| format | Article |
| id | doaj.art-7efe21f9e50c4bfd958f9dd3fef5864e |
| institution | Directory Open Access Journal |
| issn | 2249-4863 |
| language | English |
| last_indexed | 2024-03-12T22:11:51Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Family Medicine and Primary Care |
| spelling | doaj.art-7efe21f9e50c4bfd958f9dd3fef5864e2023-07-23T11:32:08ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632023-01-0112596296610.4103/jfmpc.jfmpc_1629_22Novel markers of COVID-19 mortality-A comparative study with patients of acute coronary syndromeYash Paul SharmaAtit A GawalkarAkash BattaYamasandi Siddegowda ShrimanthPruthvi C RevaiahPragya KarkiVikas ChaudharyGanesh KasinadhuniKrishna SantoshDinakar BootlaSanjeev KumarNitin Kumar J PatelBharat Singh SambyalPrashant PandaBackground: COVID-19 can cause severe pneumonia that can progress to multiple organ failure. It is believed that dysregulation of inflammation and cytokine storm, contributes to severe COVID-19. As inflammatory mediators play an important role in the pathogenesis of the severe disease, inflammatory markers like fever, leucocytosis, and C-reactive protein are known to predict severe disease. Various other biomarkers have been known to have prognostic value in patients with COVID-19 infection. Inflammation, both local and systemic plays an important role in the pathogenesis of acute coronary syndrome (ACS). Thus in this study, we aimed to compare and describe the various biomarkers, and mortality between patients admitted with COVID-19 infection and ACS patients without COVID-19 infection. Methods: In a retrospective observational case-control study, a total of 108 patients admitted to our hospital during the month of May 2021 with COVID-19 were enrolled. Patients of the acute coronary syndrome (tested negative for COVID-19 infection) admitted during the same month were enrolled (including both the intensive care unit and ward) as controls. Results: The median age of patients with COVID was significantly lower than that of patients with acute coronary syndrome [49 years (IQR, 36-62 years) and 60 years (IQR, 52-66 years)]. Left ventricular ejection fraction was significantly higher among patients with COVID infection (58.5 ± 6.3% versus 36.9 ± 9.3%). The total leukocyte count was significantly higher among patients with COVID-19 compared to those with acute coronary syndrome [13200 per microliter (8625-17500) vs 9800 per microliter (8150-12150), P < 0.001]. The blood urea level was significantly higher among patients with COVID infection [52.5 (IQR, 34.7-81.5) versus 20 (IQR, 16-31)]. Levels of C-reactive protein were significantly higher among patients with COVID [39 (IQR, 7.7-100) versus 2 (1.4-3.5)]. The mortality of patients hospitalized with COVID was 4 times higher than those with acute coronary syndrome [25.9% (28) versus 6.1% (6)]. Survivors of COVID-19 had higher hemoglobin levels than those who did not [12.5 g/dLvs 11.5 g/dL, P = 0.03]. Conclusions: Elevated total leukocyte counts reflect underlying secondary bacterial infection among patients with COVID-19 and help initiate appropriate antibiotics. Depletion of intravascular volume reflected by an increased urea/creatinine ratio increases the risk of mortality and warrants aggressive measures of rehydration and albumin infusion.http://www.jfmpc.com/article.asp?issn=2249-4863;year=2023;volume=12;issue=5;spage=962;epage=966;aulast=Sharmaacute coronary syndromebiomarkerscovid-19total leukocyte count |
| spellingShingle | Yash Paul Sharma Atit A Gawalkar Akash Batta Yamasandi Siddegowda Shrimanth Pruthvi C Revaiah Pragya Karki Vikas Chaudhary Ganesh Kasinadhuni Krishna Santosh Dinakar Bootla Sanjeev Kumar Nitin Kumar J Patel Bharat Singh Sambyal Prashant Panda Novel markers of COVID-19 mortality-A comparative study with patients of acute coronary syndrome Journal of Family Medicine and Primary Care acute coronary syndrome biomarkers covid-19 total leukocyte count |
| title | Novel markers of COVID-19 mortality-A comparative study with patients of acute coronary syndrome |
| title_full | Novel markers of COVID-19 mortality-A comparative study with patients of acute coronary syndrome |
| title_fullStr | Novel markers of COVID-19 mortality-A comparative study with patients of acute coronary syndrome |
| title_full_unstemmed | Novel markers of COVID-19 mortality-A comparative study with patients of acute coronary syndrome |
| title_short | Novel markers of COVID-19 mortality-A comparative study with patients of acute coronary syndrome |
| title_sort | novel markers of covid 19 mortality a comparative study with patients of acute coronary syndrome |
| topic | acute coronary syndrome biomarkers covid-19 total leukocyte count |
| url | http://www.jfmpc.com/article.asp?issn=2249-4863;year=2023;volume=12;issue=5;spage=962;epage=966;aulast=Sharma |
| work_keys_str_mv | AT yashpaulsharma novelmarkersofcovid19mortalityacomparativestudywithpatientsofacutecoronarysyndrome AT atitagawalkar novelmarkersofcovid19mortalityacomparativestudywithpatientsofacutecoronarysyndrome AT akashbatta novelmarkersofcovid19mortalityacomparativestudywithpatientsofacutecoronarysyndrome AT yamasandisiddegowdashrimanth novelmarkersofcovid19mortalityacomparativestudywithpatientsofacutecoronarysyndrome AT pruthvicrevaiah novelmarkersofcovid19mortalityacomparativestudywithpatientsofacutecoronarysyndrome AT pragyakarki novelmarkersofcovid19mortalityacomparativestudywithpatientsofacutecoronarysyndrome AT vikaschaudhary novelmarkersofcovid19mortalityacomparativestudywithpatientsofacutecoronarysyndrome AT ganeshkasinadhuni novelmarkersofcovid19mortalityacomparativestudywithpatientsofacutecoronarysyndrome AT krishnasantosh novelmarkersofcovid19mortalityacomparativestudywithpatientsofacutecoronarysyndrome AT dinakarbootla novelmarkersofcovid19mortalityacomparativestudywithpatientsofacutecoronarysyndrome AT sanjeevkumar novelmarkersofcovid19mortalityacomparativestudywithpatientsofacutecoronarysyndrome AT nitinkumarjpatel novelmarkersofcovid19mortalityacomparativestudywithpatientsofacutecoronarysyndrome AT bharatsinghsambyal novelmarkersofcovid19mortalityacomparativestudywithpatientsofacutecoronarysyndrome AT prashantpanda novelmarkersofcovid19mortalityacomparativestudywithpatientsofacutecoronarysyndrome |