Inflammatory Biomarker Trends Predict Respiratory Decline in COVID-19 Patients.
Inflammatory Biomarker Trends Predict Respiratory Decline in COVID-19 Patients.
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DOI：
10.1016/j.xcrm.2020.100144
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发表时间：
2020-11-17
期刊：
影响因子：
--
通讯作者：
Kim EY
中科院分区：
文献类型：
--
作者：
Mueller AA;Tamura T;Crowley CP;DeGrado JR;Haider H;Jezmir JL;Keras G;Penn EH;Massaro AF;Kim EY
在这项对2019冠状病毒病（COVID-19）住院患者的单中心回顾性队列分析中，我们研究了炎症生物标志物水平是否可以预测最初病情稳定的患者的呼吸下降。C-反应蛋白（CRP）趋势的检查显示，CRP水平的快速上升，呼吸恶化和插管之前，虽然CRP水平在患者谁保持稳定的平台。与初始CRP水平或ROX指数（呼吸功能的生理评分）相比，在住院的前48小时内CRP升高是呼吸下降的更好预测因子（具有更高的灵敏度）。CRP、促炎细胞因子白细胞介素-6（IL-6）和低氧性呼吸衰竭的生理指标相关，这表明存在机械联系。我们的研究表明，CRP升高可预测COVID-19随后的呼吸恶化，并可能表明在住院期间早期对一部分患者进行靶向免疫调节的机制和潜在作用。CRP水平升高可预测COVID-19住院患者在入院时稳定的插管早期CRP趋势在预测呼吸衰竭方面优于初始CRP水平CRP趋势在预测呼吸衰竭方面优于生理指数（ROX）CRP和IL-6水平相互关联并与低氧血症（PaO 2/FiO 2）相关Mueller et al.在住院的COVID-19患者中证明，趋势C反应蛋白（CRP）是一种炎症生物标志物，是预测呼吸恶化的简单易行的策略。CRP早期升高预示插管，CRP水平与IL-6水平和低氧性呼吸衰竭的生理指标相关。
In this single-center, retrospective cohort analysis of hospitalized coronavirus disease 2019 (COVID-19) patients, we investigate whether inflammatory biomarker levels predict respiratory decline in patients who initially present with stable disease. Examination of C-reactive protein (CRP) trends reveals that a rapid rise in CRP levels precedes respiratory deterioration and intubation, although CRP levels plateau in patients who remain stable. Increasing CRP during the first 48 h of hospitalization is a better predictor (with higher sensitivity) of respiratory decline than initial CRP levels or ROX indices (a physiological score of respiratory function). CRP, the proinflammatory cytokine interleukin-6 (IL-6), and physiological measures of hypoxemic respiratory failure are correlated, which suggests a mechanistic link. Our work shows that rising CRP predicts subsequent respiratory deterioration in COVID-19 and may suggest mechanistic insight and a potential role for targeted immunomodulation in a subset of patients early during hospitalization. Rising CRP levels predict intubation in COVID-19 inpatients stable at admission Early CRP trend outperforms initial CRP level in prediction of respiratory failure CRP trend outperforms a physiological index (ROX) in prediction of respiratory failure CRP and IL-6 levels correlate with each other and with hypoxemia (PaO2/FiO2) Mueller et al. demonstrate in hospitalized COVID-19 patients that trending C-reactive protein (CRP), an inflammatory biomarker, is a simple and accessible strategy for predicting respiratory deterioration. An early rise in CRP predicts intubation, and CRP levels correlate with IL-6 levels and physiological measures of hypoxemic respiratory failure.
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发表时间：
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影响因子：
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