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  • Prompt Predicting of Early Clinical Deterioration of Moderate-to-Severe COVID-19 Patients: Usefulness of a Combined Score Using IL-6 in a Preliminary Study #MMPMID32565226
  • Vultaggio A; Vivarelli E; Virgili G; Lucenteforte E; Bartoloni A; Nozzoli C; Morettini A; Berni A; Malandrino D; Rossi O; Nencini F; Pieralli F; Peris A; Lagi F; Scocchera G; Spinicci M; Trotta M; Mazzetti M; Parronchi P; Cosmi L; Liotta F; Fontanari P; Mazzoni A; Salvati L; Maggi E; Annunziato F; Almerigogna F; Matucci A
  • J Allergy Clin Immunol Pract 2020[Sep]; 8 (8): 2575-2581.e2 PMID32565226show ga
  • BACKGROUND: The early identification of patients at risk of clinical deterioration is of interest considering the timeline of COVID-19 after the onset of symptoms. OBJECTIVE: The aim of our study was to evaluate the usefulness of testing serum IL-6 and other serological and clinical biomarkers, to predict a short-term negative clinical course of patients with noncritical COVID-19. METHODS: A total of 208 patients with noncritical COVID-19 pneumonia at admission were consecutively enrolled. Clinical and laboratory findings obtained on admission were analyzed by using survival analysis and stepwise logistic regression for variable selection. Three-day worsening as outcome in a logistic model to generate a prognostic score was used. RESULTS: Clinical worsening occurred in 63 patients (16 = died; 39 = transferred to intensive care unit; 8 worsening of respiratory failure). Forty-five of them worsened within 3 days after admission. The risk of clinical worsening was progressively enhanced along with increasing quartiles of IL-6 levels. Multivariate analysis showed that IL-6 (P = .005), C-reactive protein (CRP) (P = .003), and SaO2/FiO2 (P = .014) were the best predictors for clinical deterioration in the first 3 days after admission. The combined score yielded an area under the curve = 0.88 (95% confidence interval: 0.83-0.93). A nomogram predicting the probability of 3-day worsening was generated. The score also showed good performance for 7-day and 14- or 21-day worsening and in predicting death occurring during all the follow-up. CONCLUSIONS: Combining IL-6, CRP, and SaO2/FiO2 in a score may help clinicians to identify on admission those patients with COVID-19 who are at high risk for a further 3-day clinical deterioration.
  • |*Clinical Deterioration[MESH]
  • |Adult[MESH]
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |Betacoronavirus[MESH]
  • |Biomarkers[MESH]
  • |C-Reactive Protein/analysis[MESH]
  • |Comorbidity[MESH]
  • |Coronavirus Infections/blood/*epidemiology/mortality/*physiopathology[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Interleukin-6/*blood[MESH]
  • |Kaplan-Meier Estimate[MESH]
  • |Length of Stay[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Oxygen/blood[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/blood/*epidemiology/mortality/*physiopathology[MESH]
  • |ROC Curve[MESH]
  • |Retrospective Studies[MESH]
  • |Time Factors[MESH]
  • |Young Adult[MESH]

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  • suck abstract from ncbi

    2575 8.8 2020