The Predictive Potential of Elevated Serum Inflammatory Markers in Determining the Need for Intubation in CoVID-19 Patients.
CoVID-19
SARS-CoV-2
inflammatory markers
intubation
Journal
Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures)
ISSN: 2393-1809
Titre abrégé: J Crit Care Med (Targu Mures)
Pays: Poland
ID NLM: 101706934
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
received:
15
12
2020
accepted:
31
08
2021
entrez:
11
3
2022
pubmed:
12
3
2022
medline:
12
3
2022
Statut:
epublish
Résumé
The predictive potential of demographics, clinical characteristics, and inflammatory markers at admission to determine future intubation needs of hospitalised CoVID-19 patients is unknown. The study aimed to determine the predictive potential of elevated serum inflammatory markers in determining the need for intubation in CoVID-19 Patients. In a retrospective cohort study of hospitalised SARS-CoV2 positive patients, single and multivariable regression analyses were used to determine covariate effects on intubation odds, and a minimax concave penalty regularised logistic regression was used to build a predictive model. A second prospective independent cohort tested the model. Systemic inflammatory markers obtained at admission were higher in patients that required subsequent intubation, and adjusted odds of intubation increased for every standard deviation above the mean for c-reactive protein (CRP) OR:2.8 (95% CI 1.8-4.5, p<0.001) and lactate dehydrogenase OR:2.1 (95% CI 1.33.3, p=0.002). A predictive model incorporating C-reactive protein, lactate dehydrogenase, and diabetes status at the time of admission predicted intubation status with an area under the curve (AUC) of 0.78 with corresponding sensitivity of 86%, specificity of 63%. This predictive model achieved an AUC of 0.83, 91% sensitivity, and 41% specificity on the validation cohort. In patients hospitalised with CoVID-19, elevated serum inflammatory markers measured within the first twenty-four hours of admission are associated with an increased need for intubation. Additionally, a model of C-reactive protein, lactate dehydrogenase, and the presence of diabetes may play a predictive role in determining the future need for intubation.
Identifiants
pubmed: 35274051
doi: 10.2478/jccm-2021-0035
pii: jccm-2021-0035
pmc: PMC8852285
doi:
Types de publication
Journal Article
Langues
eng
Pagination
14-22Subventions
Organisme : NIA NIH HHS
ID : R01 AG054366
Pays : United States
Organisme : NIGMS NIH HHS
ID : T32 GM135169
Pays : United States
Informations de copyright
© 2022 Samuel Windham, Kellen Hirsch, Ryan Peterson, David Douin, Lakshmi Chauhan, Lauren Heery, Connor Fling, Nemanja Vukovic, Fernando Holguin, Shanta Zimmer, Kristine Erlandson, published by Sciendo.
Déclaration de conflit d'intérêts
Conflict of interest None to declare.
Références
N Engl J Med. 2020 Apr 30;382(18):1708-1720
pubmed: 32109013
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
Am J Emerg Med. 2021 Aug;46:595-598
pubmed: 33280969
Radiology. 2021 Jan;298(1):E46-E54
pubmed: 32787701
Dig Dis. 2020;38(5):373-379
pubmed: 32599601
JAMA. 2012 Jun 20;307(23):2526-33
pubmed: 22797452
N Engl J Med. 2020 May 21;382(21):1973-1975
pubmed: 32202721
Clin Infect Dis. 2020 Sep 12;71(6):1393-1399
pubmed: 32271369
Int J Environ Res Public Health. 2020 Jan 19;17(2):
pubmed: 31963947
JAMA. 2020 Mar 17;323(11):1061-1069
pubmed: 32031570
JAMA Cardiol. 2020 Jul 1;5(7):811-818
pubmed: 32219356
Intern Emerg Med. 2020 Aug;15(5):857-859
pubmed: 32303970
Clin Infect Dis. 2020 Jul 28;71(15):762-768
pubmed: 32161940
JAMA Intern Med. 2020 Jul 1;180(7):934-943
pubmed: 32167524
Ann Appl Stat. 2011 Jan 1;5(1):232-253
pubmed: 22081779
Allergy. 2020 Jul;75(7):1730-1741
pubmed: 32077115