Prediction of Cytokine Storm and Mortality in Patients with COVID-19 Admitted to ICU: Do Markers Tell the Story?

Introduction: COVID-19 has caused approximately one million deaths worldwide as of November 24, 2020. Markers of disease activity like ferritin, C-reactive protein (CRP), and D-dimers are frequently monitored to detect the best opportunity for intensive treatment. Methods: All patients of >...

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Main Authors: Rashid Nadeem, Ashraf Mahmoud Elhoufi, Naheed Elahi Iqbal, Zainab Abdulameer Obaida, Doaa Mohamed Elgohary, Mukesh Kumar Singh, Shymaa Farouk Zoraey, Rami M. Abdalla, Sara Yousif Eltayeb, Crystal Sharon Danthi, Nouha Azaza, Waleed Mohamed Ahmed, Muzammil Hafeez, Maryam AlSada, Fatima Farid Mir
Format: Article
Language:English
Published: Knowledge E 2021-04-01
Series:Dubai Medical Journal
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Online Access:https://www.karger.com/Article/FullText/514406
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author Rashid Nadeem
Ashraf Mahmoud Elhoufi
Naheed Elahi Iqbal
Zainab Abdulameer Obaida
Doaa Mohamed Elgohary
Mukesh Kumar Singh
Shymaa Farouk Zoraey
Rami M. Abdalla
Sara Yousif Eltayeb
Crystal Sharon Danthi
Nouha Azaza
Waleed Mohamed Ahmed
Muzammil Hafeez
Maryam AlSada
Fatima Farid Mir
author_facet Rashid Nadeem
Ashraf Mahmoud Elhoufi
Naheed Elahi Iqbal
Zainab Abdulameer Obaida
Doaa Mohamed Elgohary
Mukesh Kumar Singh
Shymaa Farouk Zoraey
Rami M. Abdalla
Sara Yousif Eltayeb
Crystal Sharon Danthi
Nouha Azaza
Waleed Mohamed Ahmed
Muzammil Hafeez
Maryam AlSada
Fatima Farid Mir
author_sort Rashid Nadeem
collection DOAJ
description Introduction: COVID-19 has caused approximately one million deaths worldwide as of November 24, 2020. Markers of disease activity like ferritin, C-reactive protein (CRP), and D-dimers are frequently monitored to detect the best opportunity for intensive treatment. Methods: All patients of >18 years of age were included. The primary variables of interest, ferritin, CRP, and D-dimers, for each patient throughout hospitalization were recorded. Primary clinical outcomes of length of stay in ICU and survival were recorded. Demographics: age, gender, BMI, and nationality. Ferritin, CRP, and D-dimers were recorded daily if available for the whole ICU stay, and all other variables were recorded on admission day to ICU. Results: The sample includes 235 records. More than 95% of patients have all markers on the day of admission to ICU were ferritin (median 1,278; IQR 1,424), D-dimer 1.21 (3.4), and CRP 129.5 (121). Daily average levels of markers were different from their admission day level: ferritin 1,395 (1,331), D-dimer 3.11 (5.52), and CRP 107 (75.8). Multiple logistic regression analysis determined that average CRP during the stay was the only predictor of survival. Discussion: Data on markers utilization to detect the acute phase of inflammation help clinicians focus on the opportunity window for intensive treatment. Conclusion: Average CRP during the stay in ICU is higher than CRP on admission. Average CRP is the only factor that predicts survival.
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spelling doaj-art-86b5487e9a8a4bd79e62c49a57bdc7572025-08-20T02:43:55ZengKnowledge EDubai Medical Journal2571-726X2021-04-011910.1159/000514406514406Prediction of Cytokine Storm and Mortality in Patients with COVID-19 Admitted to ICU: Do Markers Tell the Story?Rashid Nadeem0Ashraf Mahmoud Elhoufi1Naheed Elahi Iqbal2Zainab Abdulameer Obaida3Doaa Mohamed Elgohary4Mukesh Kumar Singh5Shymaa Farouk Zoraey6Rami M. Abdalla7Sara Yousif Eltayeb8Crystal Sharon Danthi9Nouha Azaza10Waleed Mohamed Ahmed11Muzammil Hafeez12Maryam AlSada13Fatima Farid Mir14Intensive Care Unit, Dubai Hospital, Dubai Health Authority, Dubai, United Arab EmiratesIntensive Care Unit, Dubai Hospital, Dubai Health Authority, Dubai, United Arab EmiratesIntensive Care Unit, Dubai Hospital, Dubai Health Authority, Dubai, United Arab EmiratesIntensive Care Unit, Dubai Hospital, Dubai Health Authority, Dubai, United Arab EmiratesIntensive Care Unit, Dubai Hospital, Dubai Health Authority, Dubai, United Arab EmiratesIntensive Care Unit, Dubai Hospital, Dubai Health Authority, Dubai, United Arab EmiratesIntensive Care Unit, Dubai Hospital, Dubai Health Authority, Dubai, United Arab EmiratesIntensive Care Unit, Dubai Hospital, Dubai Health Authority, Dubai, United Arab EmiratesInternal Medicine Department, Dubai Hospital, Dubai Health Authority, Dubai, United Arab EmiratesPediatrics Department, Dubai Hospital, Dubai Health Authority, Dubai, United Arab EmiratesInternal Medicine Department, Dubai Hospital, Dubai Health Authority, Dubai, United Arab EmiratesInternal Medicine Department, Dubai Hospital, Dubai Health Authority, Dubai, United Arab EmiratesNeonatal Intensive Care Unit, Dubai Hospital, Dubai Health Authority, Dubai, United Arab EmiratesPediatrics Department, Dubai Hospital, Dubai Health Authority, Dubai, United Arab EmiratesPediatrics Department, Dubai Hospital, Dubai Health Authority, Dubai, United Arab EmiratesIntroduction: COVID-19 has caused approximately one million deaths worldwide as of November 24, 2020. Markers of disease activity like ferritin, C-reactive protein (CRP), and D-dimers are frequently monitored to detect the best opportunity for intensive treatment. Methods: All patients of >18 years of age were included. The primary variables of interest, ferritin, CRP, and D-dimers, for each patient throughout hospitalization were recorded. Primary clinical outcomes of length of stay in ICU and survival were recorded. Demographics: age, gender, BMI, and nationality. Ferritin, CRP, and D-dimers were recorded daily if available for the whole ICU stay, and all other variables were recorded on admission day to ICU. Results: The sample includes 235 records. More than 95% of patients have all markers on the day of admission to ICU were ferritin (median 1,278; IQR 1,424), D-dimer 1.21 (3.4), and CRP 129.5 (121). Daily average levels of markers were different from their admission day level: ferritin 1,395 (1,331), D-dimer 3.11 (5.52), and CRP 107 (75.8). Multiple logistic regression analysis determined that average CRP during the stay was the only predictor of survival. Discussion: Data on markers utilization to detect the acute phase of inflammation help clinicians focus on the opportunity window for intensive treatment. Conclusion: Average CRP during the stay in ICU is higher than CRP on admission. Average CRP is the only factor that predicts survival.https://www.karger.com/Article/FullText/514406criticalinfectiousinflammatory markersmedicine
spellingShingle Rashid Nadeem
Ashraf Mahmoud Elhoufi
Naheed Elahi Iqbal
Zainab Abdulameer Obaida
Doaa Mohamed Elgohary
Mukesh Kumar Singh
Shymaa Farouk Zoraey
Rami M. Abdalla
Sara Yousif Eltayeb
Crystal Sharon Danthi
Nouha Azaza
Waleed Mohamed Ahmed
Muzammil Hafeez
Maryam AlSada
Fatima Farid Mir
Prediction of Cytokine Storm and Mortality in Patients with COVID-19 Admitted to ICU: Do Markers Tell the Story?
Dubai Medical Journal
critical
infectious
inflammatory markers
medicine
title Prediction of Cytokine Storm and Mortality in Patients with COVID-19 Admitted to ICU: Do Markers Tell the Story?
title_full Prediction of Cytokine Storm and Mortality in Patients with COVID-19 Admitted to ICU: Do Markers Tell the Story?
title_fullStr Prediction of Cytokine Storm and Mortality in Patients with COVID-19 Admitted to ICU: Do Markers Tell the Story?
title_full_unstemmed Prediction of Cytokine Storm and Mortality in Patients with COVID-19 Admitted to ICU: Do Markers Tell the Story?
title_short Prediction of Cytokine Storm and Mortality in Patients with COVID-19 Admitted to ICU: Do Markers Tell the Story?
title_sort prediction of cytokine storm and mortality in patients with covid 19 admitted to icu do markers tell the story
topic critical
infectious
inflammatory markers
medicine
url https://www.karger.com/Article/FullText/514406
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