Association of Inflammatory Markers with Mortality in COVID-19 Infection

Arshad, Abdul Rehman; Khan, Imran Mahmood; Shahzad, Khurram; Arshad, M. A.; Haider, Syed Jarrar; Aslam, Muhammad Jawad

doi:10.29271/jcpsp.2020.supp2.s158

Cited by 19 publications

(17 citation statements)

References 4 publications

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“…6 Similarly, different biomarkers are being proposed including high serum CRP level and LDH due to cytokine storm associated with COVID pneumonia. 7 We noticed in our patients, who had normal or near normal serum albumin level on arrival in ICU, developed hypoalbuminemia within four days in ICU due to cytokine storm. The objective of the study was to evaluate the sudden decrease in serum albumin level in four days just after shifting in ICU as a consequence of cytokine storm and its association with respiratory failure and death.…”

Section: Introductionmentioning

confidence: 54%

Serum albumin levels monitoring in ICU in early days and mortality risk association in patients with moderate to severe COVID-19 pneumonia

Baig¹,

Raza²,

Baig³

2022

Pak J Med Sci

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Objective: To establish correlation between serum albumin during early days of ICU admission and risk of death in COVID-19 pneumonia. Methods: In this retrospective study, we included 76 patients hospitalized in ICU, who stayed for at least four days with COVID-19 pneumonia, from May 1, 2020 to June 30, 2020 in Lahore Health Care Hospital and Al-Shafi Hospital. Patients were labelled as COVID-19 pneumonia on radiological basis as bilateral ‘ground-glass opacity’ in lower zones and RT-PCR positive result in nasopharyngeal swab. All patients were oxygen dependent, either on high flow oxygen via non rebreathing mask or invasive positive pressure ventilation support. Serum albumin levels were measured daily from first day to fourth day of ICU admission. The data was analyzed using SPSS version 26 and Microsoft excel 2016. Results: Out of 76 patients of COVID-19 pneumonia admitted in ICU who stayed for more than four days, 38 patients expired. The mean age of all the patients was 58.9±12.56 years, 38(50%) of the patients were ≥60 years and 49 (62%) of them were male. On day four of ICU admission, mean serum albumin of discharged patients was 3.83±0.22 g/dl while mean serum albumin level of expired patients was 2.96±0.46 g/dl. Strong negative correlation (r = -767) was found between decrease in serum albumin level and increase number of deaths from COVID-19 pneumonia. Weak correlation was observed between increase in serum CRP and increase number of deaths in the same patients. Conclusion: Daily monitoring of serum albumin level of COVID-19 pneumonia patients can be used as a biological marker for monitoring of cytokine storm and risk of death in COVID-19 pneumonia. doi: https://doi.org/10.12669/pjms.38.3.4154 How to cite this:Baig MA, Raza MM, Baig M, Baig MU. Serum albumin levels monitoring in ICU in early days and mortality risk association in patients with moderate to severe COVID-19 pneumonia. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4154 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Introductionmentioning

confidence: 54%

Serum albumin levels monitoring in ICU in early days and mortality risk association in patients with moderate to severe COVID-19 pneumonia

Baig¹,

Raza²,

Baig³

2022

Pak J Med Sci

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“…The collected analytical parameters were complete blood count including hemoglobin (Hb), platelet count (PTC) and white blood cell (WBC) count, biochemistry parameters including serum glucose, creatinine, urea and triglycerides (TG), and those related to coagulation. As inflammatory markers they were included the ultrasensitive C-reactive protein (US-CRP), procalcitonin, IL-6, lactate dehydrogenase (LDH), fibrinogen and ferritin [20][21][22].…”

Section: Laboratory Variablesmentioning

confidence: 99%

Assessment of oxidative stress markers in elderly patients with SARS-CoV-2 infection and potential prognostic implications. An observational study

Vazquez-Agra

Marques-Afonso

Cruces-Sande

et al. 2022

Preprint

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The aim of the study was to evaluate the correlation of plasma levels of thiobarbituric acid reactive substances (TBARS) and reduced thiols with morbidity, mortality and immune response in SARS-CoV-2 infection. This was an observational study that included inpatients with SARS-CoV-2 infection greater than 65 years old. Individuals were followed up until 12 months after hospital discharge. Demographic, clinical and laboratory variables were collected. Plasma levels of TBARS and reduced thiols were quantified as a measure of lipid and protein oxidation, respectively. Events of interest (fatal and non-fatal) were quantified at hospital discharge, third, sixth and twelfth-month post-discharge. The outcomes were differences in oxidative stress markers between groups of interest and time to a negative RT-qPCR and to significant anti-SARS-CoV-2 IgM titers. There were 61 patients (57% women) with a mean age of 83 years old. Patients with higher levels of TBARS and lower levels of reduced thiols had more risk of fatal and non-fatal events between admission and the first 12 months post-discharge. The presence of any event (fatal or non-fatal) at the end of the first 12 months post-discharge was correlated with TBARS levels, anti-SARS-CoV-2 IgM titers, lactate dehydrogenase, platelet count and neutrophil and lymphocyte count. We found a correlation between plasma reduced thiols and time to achieve significant anti-SARS-CoV-2 IgM titers. Assessment of some parameters related to oxidative stress could help to identify groups of patients with a higher risk of morbidity and mortality during and after SARS-CoV-2 infection.

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“…In the early stage of viral infection, the stimulation of the lungs leads to the recruitment and activation of a variety of inflammatory cells, and a large number of cytokines and inflammatory chemokines are released. In the early stage of stimulation, "early reactive cytokines" such as tumor necrosis factor-a (TNF-a) and interleukin-1b (IL-1b) are secreted rapidly and reach a peak within a few hours; then, anti-inflammatory cytokines are secreted to regulate the degree of the inflammatory response so that the body can not only remove harmful stimuli but also maintain cellular homeostasis (25)(26)(27). However, when the inflammatory balance is destroyed, early reactive cytokines can further trigger the activation and release of a series of cytokines, such as interleukin-2 (IL-2), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-12 (IL-12), macrophage inflammatory protein-1a (MIP-1a), MIP-1b and others, resulting in an uncontrolled inflammatory response (28,29).…”

Section: Mechanism Of Inflammatory Stormsmentioning

confidence: 99%

Regulation of Inflammatory Cytokine Storms by Mesenchymal Stem Cells

Wang

et al. 2021

Front. Immunol.

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Mesenchymal stem cells (MSCs) have been widely used in preclinical and clinical trials for various diseases and have shown great potential in the treatment of sepsis and coronavirus disease (COVID-19). Inflammatory factors play vital roles in the pathogenesis of diseases. The interaction between inflammatory factors is extremely complex. Once the dynamics of inflammatory factors are unbalanced, inflammatory responses and cytokine storm syndrome develop, leading to disease exacerbation and even death. Stem cells have become ideal candidates for the treatment of such diseases due to their immunosuppressive and anti-inflammatory properties. However, the mechanisms by which stem cells affect inflammation and immune regulation are still unclear. This article discusses the therapeutic mechanism and potential value of MSCs in the treatment of sepsis and the novel COVID-19, outlines how MSCs mediate innate and acquired immunity at both the cellular and molecular levels, and described the anti-inflammatory mechanisms and related molecular pathways. Finally, we review the safety and efficacy of stem cell therapy in these two diseases at the preclinical and clinical levels.

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Association of Inflammatory Markers with Mortality in COVID-19 Infection

Abstract: Objective: To evaluate the association of serum ferritin, lactate dehydrogenase, and C-reactive protein at admission with inhospital mortality in COVID-19 infection; and to determine best predictive cut-offs.

Cited by 19 publications

References 4 publications

Serum albumin levels monitoring in ICU in early days and mortality risk association in patients with moderate to severe COVID-19 pneumonia

Serum albumin levels monitoring in ICU in early days and mortality risk association in patients with moderate to severe COVID-19 pneumonia

Assessment of oxidative stress markers in elderly patients with SARS-CoV-2 infection and potential prognostic implications. An observational study

Regulation of Inflammatory Cytokine Storms by Mesenchymal Stem Cells

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