COVID-19 risk stratification algorithms based on sTREM-1 and IL-6 in emergency department.

Details

Serval ID
serval:BIB_2B9D86D92566
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
COVID-19 risk stratification algorithms based on sTREM-1 and IL-6 in emergency department.
Journal
The Journal of allergy and clinical immunology
Author(s)
Van Singer M., Brahier T., Ngai M., Wright J., Weckman A.M., Erice C., Meuwly J.Y., Hugli O., Kain K.C., Boillat-Blanco N.
ISSN
1097-6825 (Electronic)
ISSN-L
0091-6749
Publication state
Published
Issued date
01/2021
Peer-reviewed
Oui
Volume
147
Number
1
Pages
99-106.e4
Language
english
Notes
Publication types: Clinical Trial ; Journal Article ; Multicenter Study ; Observational Study
Publication Status: ppublish
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has led to surges of patients presenting to emergency departments (EDs) and potentially overwhelming health systems.
We sought to assess the predictive accuracy of host biomarkers at clinical presentation to the ED for adverse outcome.
Prospective observational study of PCR-confirmed COVID-19 patients in the ED of a Swiss hospital. Concentrations of inflammatory and endothelial dysfunction biomarkers were determined at clinical presentation. We evaluated the accuracy of clinical signs and these biomarkers in predicting 30-day intubation/mortality, and oxygen requirement by calculating the area under the receiver-operating characteristic curve and by classification and regression tree analysis.
Of 76 included patients with COVID-19, 24 were outpatients or hospitalized without oxygen requirement, 35 hospitalized with oxygen requirement, and 17 intubated/died. We found that soluble triggering receptor expressed on myeloid cells had the best prognostic accuracy for 30-day intubation/mortality (area under the receiver-operating characteristic curve, 0.86; 95% CI, 0.77-0.95) and IL-6 measured at presentation to the ED had the best accuracy for 30-day oxygen requirement (area under the receiver-operating characteristic curve, 0.84; 95% CI, 0.74-0.94). An algorithm based on respiratory rate and sTREM-1 predicted 30-day intubation/mortality with 94% sensitivity and 0.1 negative likelihood ratio. An IL-6-based algorithm had 98% sensitivity and 0.04 negative likelihood ratio for 30-day oxygen requirement.
sTREM-1 and IL-6 concentrations in COVID-19 in the ED have good predictive accuracy for intubation/mortality and oxygen requirement. sTREM-1- and IL-6-based algorithms are highly sensitive to identify patients with adverse outcome and could serve as early triage tools.
Keywords
Adult, Aged, Aged, 80 and over, Algorithms, COVID-19/blood, Emergency Service, Hospital, Humans, Interleukin-6/blood, Middle Aged, Prospective Studies, Risk Assessment, SARS-CoV-2/metabolism, Triage, Triggering Receptor Expressed on Myeloid Cells-1/blood, COVID-19, Endothelial dysfunction, biomarkers, immune activation
Pubmed
Open Access
Yes
Create date
19/10/2020 14:40
Last modification date
26/01/2021 15:39
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