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Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 BMJ+Open 2020 ; 10 (12): e041295 Nephropedia Template TP
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Association between biomarkers and COVID-19 severity and mortality: a nationwide Danish cohort study #MMPMID33268425
Hodges G; Pallisgaard J; Schjerning Olsen AM; McGettigan P; Andersen M; Krogager M; Kragholm K; Kober L; Gislason GH; Torp-Pedersen C; Bang CN
BMJ Open 2020[Dec]; 10 (12): e041295 PMID33268425show ga
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 baseline levels 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 elevated troponins 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 with 28.0% for those with normal procalcitonin. CONCLUSION: In this nationwide study of patients admitted with 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.
|*Severity of Illness Index[MESH]
|Aged[MESH]
|Aged, 80 and over[MESH]
|Biomarkers/blood[MESH]
|COVID-19/*blood/*mortality[MESH]
|Comorbidity[MESH]
|Denmark[MESH]
|Female[MESH]
|Humans[MESH]
|Intensive Care Units/*statistics & numerical data[MESH]