Association between biomarkers and COVID-19 severity and mortality: a nationwide Danish cohort study.
Association between biomarkers and COVID-19 severity and mortality: a nationwide Danish cohort study.
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DOI：
10.1136/bmjopen-2020-041295
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发表时间：
2020-12-02
期刊：
影响因子：
2.9
通讯作者：
Bang CN
中科院分区：
文献类型：
--
作者：
Hodges G;Pallisgaard J;Schjerning Olsen AM;McGettigan P;Andersen M;Krogager M;Kragholm K;Køber L;Gislason GH;Torp-Pedersen C;Bang CN
评估COVID-19患者常见生物标志物、死亡和重症监护室（ICU）入院之间的相关性。回顾性队列研究。根据国家电子注册数据，我们使用考克斯分析和自举法来评估基线生物标志物水平与死亡/ICU入院的标准化绝对风险之间的相关性，并根据年龄和性别进行调整。丹麦的所有医院。2020年2月27日至5月1日，1310名年龄≥18岁的COVID-19患者入院，并提供了可用的生化数据。30天内发生的死亡/ICU入院复合事件。在1310例住院患者中（54.6%为男性;中位年龄73.6岁），352例（26.9%）发生复合终点，263例（20.1%）死亡。对于复合终点，中度和重度C反应蛋白（CRP）升高的绝对风险显著更高，分别为21.5%和39.2%，而CRP正常的绝对风险为5.0%。中度和重度白细胞升高的风险分别为34.5%和46.6%，而白细胞正常的风险为23.2%。中度和重度估计肾小球滤过率（eGFR）降低的风险分别为41.5%和45.9%，而eGFR正常/轻度降低的风险为30.4%。尿素正常和升高的风险分别为22.3%和40.6%，而低尿素的风险为7.3%。D-二聚体升高的风险明显更高，为31.8%，而D-二聚体正常的风险为17.5%。中度和重度肌钙蛋白升高的风险显著更高，分别为27.7%和57.3%，而肌钙蛋白正常的风险为9.4%。降钙素原升高的患者风险显著升高，为52.1%，而降钙素原正常的患者风险为28.0%。在这项针对COVID-19患者的全国性研究中，CRP、白细胞、降钙素原、尿素、肌钙蛋白和D-二聚体水平升高以及eGFR水平降低与30天内死亡/ICU入院的标准化绝对风险较高相关。
To evaluate the association between common biomarkers, death and intensive care unit (ICU) admission in patients with COVID-19. 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. All hospitals in Denmark. 1310 patients aged ≥18 years admitted to hospital with COVID-19 from 27th of February to 1st of May 2020, with available biochemistry data. A composite of death/ICU admission occurring within 30 days. 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. 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.
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影响因子：
168.9
作者：
Huang, Chaolin;Wang, Yeming;Cao, Bin
通讯作者：
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作者：
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