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Sci Rep
. 2024 Jun 3;14(1):12726.
doi: 10.1038/s41598-024-62718-4. Basic host response parameters to classify mortality risk in COVID-19 and community-acquired pneumonia
Rosario Menéndez # 1 2 3 4 , Raúl Méndez # 5 6 7 8 , Paula González-Jiménez 1 2 3 , Ana Latorre 2 , Soledad Reyes 1 2 , Rafael Zalacain 9 , Luis A Ruiz 9 10 , Leyre Serrano 9 10 , Pedro P España 11 , Ane Uranga 11 , Catia Cillóniz 4 12 13 14 , Andrea Gaetano-Gil 15 16 , Borja M Fernández-Félix 15 16 , Luis Pérez-de-Llano 17 , Rafael Golpe 17 , Antoni Torres 4 12 13 14
Affiliations
Improved phenotyping in pneumonia is necessary to strengthen risk assessment. Via a feasible and multidimensional approach with basic parameters, we aimed to evaluate the effect of host response at admission on severity stratification in COVID-19 and community-acquired pneumonia (CAP). Three COVID-19 and one CAP multicenter cohorts including hospitalized patients were recruited. Three easily available variables reflecting different pathophysiologic mechanisms-immune, inflammation, and respiratory-were selected (absolute lymphocyte count [ALC], C-reactive protein [CRP] and, SpO2/FiO2). In-hospital mortality and intensive care unit (ICU) admission were analyzed as outcomes. A multivariable, penalized maximum likelihood logistic regression was performed with ALC (< 724 lymphocytes/mm3), CRP (> 60 mg/L), and, SpO2/FiO2 (< 450). A total of 1452, 1222 and 462 patients were included in the three COVID-19 and 1292 in the CAP cohort for the analysis. Mortality ranged between 4 and 32% (0 to 3 abnormal biomarkers) and 0-9% in SARS-CoV-2 pneumonia and CAP, respectively. In the first COVID-19 cohort, adjusted for age and sex, we observed an increased odds ratio for in-hospital mortality in COVID-19 with elevated biomarkers altered (OR 1.8, 3, and 6.3 with 1, 2, and 3 abnormal biomarkers, respectively). The model had an AUROC of 0.83. Comparable findings were found for ICU admission, with an AUROC of 0.76. These results were confirmed in the other COVID-19 cohorts Similar OR trends were reported in the CAP cohort; however, results were not statistically significant. Assessing the host response via accessible biomarkers is a simple and rapidly applicable approach for pneumonia.
Keywords: Biomarkers; COVID-19; Host response; Mortality; Pneumonia.
. 2024 Jun 3;14(1):12726.
doi: 10.1038/s41598-024-62718-4. Basic host response parameters to classify mortality risk in COVID-19 and community-acquired pneumonia
Rosario Menéndez # 1 2 3 4 , Raúl Méndez # 5 6 7 8 , Paula González-Jiménez 1 2 3 , Ana Latorre 2 , Soledad Reyes 1 2 , Rafael Zalacain 9 , Luis A Ruiz 9 10 , Leyre Serrano 9 10 , Pedro P España 11 , Ane Uranga 11 , Catia Cillóniz 4 12 13 14 , Andrea Gaetano-Gil 15 16 , Borja M Fernández-Félix 15 16 , Luis Pérez-de-Llano 17 , Rafael Golpe 17 , Antoni Torres 4 12 13 14
Affiliations
- PMID: 38830925
- DOI: 10.1038/s41598-024-62718-4
Improved phenotyping in pneumonia is necessary to strengthen risk assessment. Via a feasible and multidimensional approach with basic parameters, we aimed to evaluate the effect of host response at admission on severity stratification in COVID-19 and community-acquired pneumonia (CAP). Three COVID-19 and one CAP multicenter cohorts including hospitalized patients were recruited. Three easily available variables reflecting different pathophysiologic mechanisms-immune, inflammation, and respiratory-were selected (absolute lymphocyte count [ALC], C-reactive protein [CRP] and, SpO2/FiO2). In-hospital mortality and intensive care unit (ICU) admission were analyzed as outcomes. A multivariable, penalized maximum likelihood logistic regression was performed with ALC (< 724 lymphocytes/mm3), CRP (> 60 mg/L), and, SpO2/FiO2 (< 450). A total of 1452, 1222 and 462 patients were included in the three COVID-19 and 1292 in the CAP cohort for the analysis. Mortality ranged between 4 and 32% (0 to 3 abnormal biomarkers) and 0-9% in SARS-CoV-2 pneumonia and CAP, respectively. In the first COVID-19 cohort, adjusted for age and sex, we observed an increased odds ratio for in-hospital mortality in COVID-19 with elevated biomarkers altered (OR 1.8, 3, and 6.3 with 1, 2, and 3 abnormal biomarkers, respectively). The model had an AUROC of 0.83. Comparable findings were found for ICU admission, with an AUROC of 0.76. These results were confirmed in the other COVID-19 cohorts Similar OR trends were reported in the CAP cohort; however, results were not statistically significant. Assessing the host response via accessible biomarkers is a simple and rapidly applicable approach for pneumonia.
Keywords: Biomarkers; COVID-19; Host response; Mortality; Pneumonia.