Inflammatory biomarkers at hospital discharge are associated with readmission and death in patients hospitalized for COVID-19

Slim, Marleen A.; Appelman, Brent; Müller, Marcella C.A.; Brouwer, Matthijs C.; Vlaar, Alexander P. J.; Wiersinga, W. Joost; Vught, Lonneke A. van

doi:10.1007/s10096-021-04355-7

Cited by 2 publications

(1 citation statement)

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“…Based on their experience with 26 discharge-ready COVID-19 patients, Fuglebjerj et al had proposed that the six-minute walk test (6MWT) could be used potentially as a tool for the assessment of patients before discharge [ 6 ]. Elevated levels of laboratory markers such as d-dimer, interleukin-6 (IL-6), and IL-10, and lower levels of peripheral lymphocytes at discharge may be associated with poor outcomes [ 7 , 8 ]. We have analyzed the results of 6MWT among the patients fit for discharge as per the prevailing national guidelines and compared it with the laboratory markers of disease severity at discharge.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Six-Minute Walk Test Among Discharge-Ready Severe COVID-19 Patients: A Cross-Sectional Study

Yanamandra¹,

Saxena²,

Srinath³

et al. 2022

Cureus

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Background Among patients hospitalized for severe pneumonia due to coronavirus disease (COVID-19), clinical stability and normal resting peripheral oxygen saturation (SpO 2 ) levels are widely used as a discharge criterion after recovery. It is unknown whether a test to assess the functional exercise capacity, like a six-minute walk test (6MWT), can add to the appropriateness of discharge criteria. Methods A cross-sectional study was conducted at a tertiary care COVID-19 hospital in India from 01 st to 31 st May 2021. All patients considered fit for discharge after recovery from "severe" COVID-19 pneumonia were subjected to 6MWT. Fitness for discharge was assessed by clinical stability and resting SpO 2 above 93% for three consecutive days. Patients were considered to have failed the 6MWT if there was ≥4% fall in SpO 2 or if they could not complete the test. Serum samples were analyzed for levels of C-reactive protein (CRP), interleukin-6 (IL-6), and lactate dehydrogenase (LDH) at the time of discharge. Results Fifty-three discharge-ready patients with a mean age of 54.54 ± 14.35 years with a male preponderance (60.38%) were analyzed. Thirty-three (62.26%) patients failed the 6MWT with a median six-minute walk distance (6MWD) of 270 m (60-360). A total of 45 (84.91%) patients had a fall in SpO 2 during the test. The median change in SpO 2 (∆SpO 2 ) was 5% ranging from -6% to 8%. Serum LDH was significantly higher among patients who failed the 6MWT with a median LDH of 334 IU/L (38.96-2339) versus 261 IU/L (49.2-494) (p = 0.02). The difference was not significant for CRP or IL-6. There was no statistically significant correlation between the inflammatory markers with either 6MWD or (∆SpO 2 ). Conclusion Two-thirds of the patients considered fit for discharge after recovery from severe COVID-19 pneumonia failed 6MWT, implying reduced functional exercise capacity and exertional hypoxia. Serum LDH levels were higher in these patients but not in other inflammatory markers. None of the inflammatory markers at discharge correlated with 6MWD or ∆SpO 2 of 6MWT.

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Section: Introductionmentioning

confidence: 99%