Predictive Value of Blood Coagulation Parameters in Poor Outcomes in COVID-19 Patients: A Retrospective Observational Study in Romania

Cîtu, Cosmin; Burlea, Bogdan; Gorun, Florin; Motoc, Andrei Gheorghe Marius; Gorun, Oana Maria; Malița, Daniel; Rațiu, Adrian; Margan, Roxana; Grigoraş, Mirela Loredana; Bratosin, Felix; Citu, Ioana Mihaela

doi:10.3390/jcm11102831

Cited by 24 publications

(23 citation statements)

References 24 publications

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“…We found that patients who failed CPAP were older, had higher baseline IL-6, D-dimer, CURB-65, and blood urea, as well as worse oxygenation parameters and higher respiratory rate, and were more likely to be affected by ischemic heart disease, COPD, and chronic kidney failure. All these findings are coherent with well-known predictors of unfavorable outcomes in COVID-19 pneumonia [ 7 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ].…”

Section: Discussionsupporting

confidence: 86%

Acute Improvements of Oxygenation with Cpap and Clinical Outcomes in Severe COVID-19 Pneumonia: A Multicenter, Retrospective Study

Pini

Radovanovic

Saad

et al. 2022

JCM

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It is not known if the degrees of improvement in oxygenation obtained by CPAP can predict clinical outcomes in patients with COVID-19 pneumonia. This was a retrospective study conducted on patients with severe COVID-19 pneumonia treated with CPAP in three University hospitals in Milan, Italy, from March 2020 to March 2021. Arterial gas analysis was obtained before and 1 h after starting CPAP. CPAP failure included either death in the respiratory units while on CPAP or the need for intubation. Two hundred and eleven patients (mean age 64 years, 74% males) were included. Baseline median PaO2, PaO2/FiO2 ratio (P/F), and the alveolar-arterial (A-a) O2 gradient were 68 (57–83) mmHg, 129 (91–179) mmHg and 310 (177–559) mmHg, respectively. Forty-two (19.9%) patients died in the respiratory units and 51 (24.2%) were intubated. After starting CPAP, PaO2/FiO2 increased by 57 (12–113; p < 0.001) mmHg, and (A-a) O2 was reduced by 68 (−25–250; p < 0.001) mmHg. A substantial overlap of PaO2, P/F, and A-a gradient at baseline and during CPAP was observed in CPAP failures and successes; CPAP-associated improvements in oxygenation in both groups were similar. In conclusion, CPAP-associated improvements in oxygenation do not predict clinical outcomes in patients with severe COVID-19 pneumonia.

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Section: Discussionsupporting

confidence: 86%

Acute Improvements of Oxygenation with Cpap and Clinical Outcomes in Severe COVID-19 Pneumonia: A Multicenter, Retrospective Study

Pini

Radovanovic

Saad

et al. 2022

JCM

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“…Based on our results, INR constitutes a statistically significant parameter for in-hospital mortality of critical COVID-19 patients ( p = 0.0056) with a cut-off level of 1.075 (sensitivity 67.09%, specificity 64% and AUC = 0.684). Another retrospective study reported a similar cut-off point for INR of 1.08 with higher sensitivity, specificity (sensitivity 70%; specificity 71%) and a greater AUC (AUC = 0.724) [ 46 ]. In a meta-analysis performed by Zinellu et al [ 47 ], the prolonged INR is associated with COVID-19 mortality.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory Biomarkers Associated with In-Hospital Mortality in Critical COVID-19 Patients

Pál

Molnar

Huţanu

et al. 2022

IJMS

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The COVID-19 pandemic poses global healthcare challenges due to its unpredictable clinical course. The aim of this study is to identify inflammatory biomarkers and other routine laboratory parameters associated with in-hospital mortality in critical COVID-19 patients. We performed a retrospective observational study on 117 critical COVID-19 patients. Following descriptive statistical analysis of the survivor and non-survivor groups, optimal cut-off levels for the statistically significant parameters were determined using the ROC method, and the corresponding Kaplan-Meier survival curves were calculated. The inflammatory parameters that present statistically significant differences between survivors and non-survivors are IL-6 (p = 0.0004, cut-off = 27.68 pg/mL), CRP (p = 0.027, cut-off = 68.15 mg/L) and IL-6/Ly ratio (p = 0.0003, cut-off = 50.39). Additionally, other statistically significant markers are creatinine (p = 0.031, cut-off = 0.83 mg/dL), urea (p = 0.0002, cut-off = 55.85 mg/dL), AST (p = 0.0209, cut-off = 44.15 U/L), INR (p = 0.0055, cut-off = 1.075), WBC (p = 0.0223, cut-off = 11.68 × 109/L) and pH (p = 0.0055, cut-off = 7.455). A survival analysis demonstrated significantly higher in-hospital mortality rates of patients with values of IL-6, IL-6/Ly, AST, INR, and pH exceeding previously mentioned thresholds. In our study, IL-6 and IL-6/Ly have a predictive value for the mortality of critically-ill patients diagnosed with COVID-19. The integration of these parameters with AST, INR and pH could contribute to a prognostic score for the risk stratification of critical patients, reducing healthcare costs and facilitating clinical decision-making.

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“…In terms of laboratory parameters, a study also carried out in our center, on a similar population to the one in this study, shows that coagulation parameters can be used to predict mortality. However, the accuracy of prediction of these markers is lower compared to risk scores [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of SOFA and qSOFA for In-Hospital Mortality in COVID-19 Patients: A Single-Center Study in Romania

Cîtu

Citu

Motoc

et al. 2022

JPM

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Two years after the outbreak of the COVID-19 pandemic, the disease continues to claim victims worldwide. Assessing the disease’s severity on admission may be useful in reducing mortality among patients with COVID-19. The present study was designed to assess the prognostic value of SOFA and qSOFA scoring systems for in-hospital mortality among patients with COVID-19. The study included 133 patients with COVID-19 proven by reverse transcriptase polymerase chain reaction (RT-PCR) admitted to the Municipal Emergency Clinical Hospital of Timisoara, Romania between 1 October 2020 and 15 March 2021. Data on clinical features and laboratory findings on admission were collected from electronic medical records and used to compute SOFA and qSOFA. Mean SOFA and qSOFA values were higher in the non-survivor group compared to survivors (3.5 vs. 1 for SOFA and 2 vs. 1 for qSOFA, respectively). Receiver operating characteristic (ROC) and area under the curve (AUC) analyses were performed to determine the discrimination accuracy, both risk scores being excellent predictors of in-hospital mortality, with ROC–AUC values of 0.800 for SOFA and 0.794 for qSOFA. The regression analysis showed that for every one-point increase in SOFA score, mortality risk increased by 1.82 and for every one-point increase in qSOFA score, mortality risk increased by 5.23. In addition, patients with SOFA and qSOFA above the cut-off values have an increased risk of mortality with ORs of 7.46 and 11.3, respectively. In conclusion, SOFA and qSOFA are excellent predictors of in-hospital mortality among COVID-19 patients. These scores determined at admission could help physicians identify those patients at high risk of severe COVID-19.

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Predictive Value of Blood Coagulation Parameters in Poor Outcomes in COVID-19 Patients: A Retrospective Observational Study in Romania

Cited by 24 publications

References 24 publications

Acute Improvements of Oxygenation with Cpap and Clinical Outcomes in Severe COVID-19 Pneumonia: A Multicenter, Retrospective Study

Acute Improvements of Oxygenation with Cpap and Clinical Outcomes in Severe COVID-19 Pneumonia: A Multicenter, Retrospective Study

Inflammatory Biomarkers Associated with In-Hospital Mortality in Critical COVID-19 Patients

Predictive Value of SOFA and qSOFA for In-Hospital Mortality in COVID-19 Patients: A Single-Center Study in Romania

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