TY - JOUR

T1 - Association between biomarkers and COVID-19 severity and mortality

T2 - A nationwide Danish cohortstudy

AU - Hodges, Gethin

AU - Pallisgaard, Jannik

AU - Schjerning Olsen, Anne Marie

AU - McGettigan, Patricia

AU - Andersen, Mikkel

AU - Krogager, Maria

AU - Kragholm, Kristian

AU - Køber, Lars

AU - Gislason, Gunnar Hilmar

AU - Torp-Pedersen, Christian

AU - Bang, Casper N.

PY - 2020

Y1 - 2020

N2 - Objective To evaluate the association between common biomarkers, death and intensive care unit(ICU) admission in patients with COVID-19. Design Retrospective cohort study. From electronic national registry data, we used Cox analysis and bootstrapping to evaluate associations between baselinelevels of biomarkers and standardised absolute risks of death/ICU admission, adjusted for age and gender. Setting All hospitals in Denmark. Participants 1310 patients aged ≥18 years admitted to hospital with COVID-19 from 27th of February to 1st of May 2020, with available biochemistry data. Main outcome measures A composite of death/ICU admission occurring within 30 days. Results Of the 1310 patients admitted to hospital (54.6% men; median age 73.6 years), 352 (26.9%) experienced the composite endpoint and 263 (20.1%) died. For the composite endpoint, the absolute risks for moderately and severely elevated C reactive protein (CRP) were significantly higher, 21.5% and 39.2%, respectively, compared with 5.0% for those with normal CRP. Moderately and severely elevated leucocytes were significantly higher, 34.5% and 46.6% risk, respectively, compared with 23.2% for those with normal leucocytes. Moderately and severely decreased estimated glomerular filtration rates (eGFR) were significantly higher, 41.5% and 45.9% risk, respectively, compared with 30.4% for those with normal/mildly decreased eGFR. Normal and elevated ureas were significantly higher, 22.3% and 40.6% risk, respectively, compared with 7.3% for those with low urea. Elevated D-dimer was significantly higher, 31.8% risk, compared with 17.5% for those with normal D-dimer. Moderately and severely elevatedtroponins were significantly higher, 27.7% and 57.3% risk, respectively, compared with 9.4% for those with normal troponin. Elevated procalcitonin was significantly higher, 52.1% risk, compared with28.0% for those with normal procalcitonin. Conclusion In this nationwide study of patients admittedwith COVID-19, elevated levels of CRP, leucocytes, procalcitonin, urea, troponins and D-dimer, and low levels of eGFR were associated with higher standardised absolute risk of death/ICU admission within 30 days.

AB - Objective To evaluate the association between common biomarkers, death and intensive care unit(ICU) admission in patients with COVID-19. Design Retrospective cohort study. From electronic national registry data, we used Cox analysis and bootstrapping to evaluate associations between baselinelevels of biomarkers and standardised absolute risks of death/ICU admission, adjusted for age and gender. Setting All hospitals in Denmark. Participants 1310 patients aged ≥18 years admitted to hospital with COVID-19 from 27th of February to 1st of May 2020, with available biochemistry data. Main outcome measures A composite of death/ICU admission occurring within 30 days. Results Of the 1310 patients admitted to hospital (54.6% men; median age 73.6 years), 352 (26.9%) experienced the composite endpoint and 263 (20.1%) died. For the composite endpoint, the absolute risks for moderately and severely elevated C reactive protein (CRP) were significantly higher, 21.5% and 39.2%, respectively, compared with 5.0% for those with normal CRP. Moderately and severely elevated leucocytes were significantly higher, 34.5% and 46.6% risk, respectively, compared with 23.2% for those with normal leucocytes. Moderately and severely decreased estimated glomerular filtration rates (eGFR) were significantly higher, 41.5% and 45.9% risk, respectively, compared with 30.4% for those with normal/mildly decreased eGFR. Normal and elevated ureas were significantly higher, 22.3% and 40.6% risk, respectively, compared with 7.3% for those with low urea. Elevated D-dimer was significantly higher, 31.8% risk, compared with 17.5% for those with normal D-dimer. Moderately and severely elevatedtroponins were significantly higher, 27.7% and 57.3% risk, respectively, compared with 9.4% for those with normal troponin. Elevated procalcitonin was significantly higher, 52.1% risk, compared with28.0% for those with normal procalcitonin. Conclusion In this nationwide study of patients admittedwith COVID-19, elevated levels of CRP, leucocytes, procalcitonin, urea, troponins and D-dimer, and low levels of eGFR were associated with higher standardised absolute risk of death/ICU admission within 30 days.

KW - adult intensive & critical care

KW - general medicine (see internal medicine)

KW - infectious diseases

U2 - 10.1136/bmjopen-2020-041295

DO - 10.1136/bmjopen-2020-041295

M3 - Journal article

C2 - 33268425

AN - SCOPUS:85097123325

VL - 10

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 12

M1 - e041295

ER -