Inflammatory and thrombotic parameters associated with the COVID-19 course in Poland (SARSTer study) |
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| Affiliation: | 1. Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, Bialystok, Poland;2. Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Bialystok, Poland;3. Department of Infectious Diseases, Jan Kochanowski University, Kielce, Poland;4. Pomeranian Center of Infectious Diseases, Department of Infectious Diseases, Medical University of Gdańsk, Gdańsk, Poland;5. Department of Forensic Medicine, Wroc?aw Medical University, Wroc?aw, Poland;6. First Infectious Diseases Ward, Gromkowski Regional Specialist Hospital in Wroc?aw, Wroc?aw, Poland;7. Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Poland;8. Department of Infectious Diseases and Hepatology, Medical University of Lublin, Lublin, Poland;9. Department of Tropical Medicine and Epidemiology, Medical University of Gdańsk, Gdańsk, Poland;10. Department of Infectious Diseases and Hepatology, Medical University of ?ód?, ?ód?, Poland;11. Department of Infectious Diseases, University of Medical Sciences, Poznań, Poland;12. Clinical Department of Infectios Diseases, Specialistic Hospital in Chorzów, Chorzów, Poland;13. Department of Adult''s Infectious Diseases, Medical University of Warsaw, Warsaw, Poland;14. Department of Infectious Diseases in Bytom, Medical University of Silesia, Katowice, Poland;15. Hospital of Infectious Diseases in Warsaw, Warsaw, Poland;p. Department of Infectious Diseases and Allergology, Military Institute of Medicine, Warsaw, Poland;r. Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiencies, Wroc?aw Medical University, Wroc?aw, Poland;s. Department of Rheumatology, Rehabilitation and Internal Medicine, Poznan University of Medical Sciences, Poland;t. Department of Infectious Diseases, Tropical Diseases and Acquired Immunodeficiency, Pomeranian Medical University in Szczecin, Szczecin, Poland;u. Department of Statistics and Medical Informatics, Medical University of Bialystok, Bialystok, Poland |
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| Abstract: | PurposeThe aim of the study was to assess the coagulation and inflammatory markers connected with severe course of COVID-19 and no clinical improvement.Material and methodsThe study population included 2590 adult patients, diagnosed with COVID-19, selected from the SARSTer national database - an ongoing project led by the Polish Association of Epidemiologists and Infectiologists and supported by the Medical Research Agency. Clinical and laboratory parameters, such as C-reactive protein (CRP), white blood cells (WBCs), neutrophil and lymphocyte count, procalcitonin, ferritin, interleukin-6 (IL-6), D-dimer concentration and platelet (PLT) count were analyzed before and after treatment (remdesivir, tocilizumab, dexamethasone, anticoagulants).ResultsSignificant differences between patients with mild and severe course of the disease were observed in all examined parameters before treatment (p ?< ?0.05). After treatment only ferritin concentration did not differ significantly. In patients with pulmonary embolism, CRP concentration, neutrophil count, D-dimer and IL-6 concentration were significantly higher than in patients without embolism (p ?< ?0.05). The significant differences between the groups with and without fatal outcome were observed within all analyzed parameters. Significant differences in all examined parameters before treatment were observed between patients with and without clinical improvement (p ?< ?0.05).Multivariate logistic regression showed that no clinical improvement was associated with: IL-6>100 ?pg/ml (OR-2.14), D-dimer concentration over 1000 ?ng/ml (OR-1.62) and PLT count below 150,000/μl (OR-1.57).ConclusionsSevere course of the disease is associated with lower PLT and lymphocyte count, higher D-dimer, CRP, neutrophil count and IL-6 concentration. The best predictors of no clinical improvement in COVID-19 are: IL-6>100 ?pg/ml, D-dimer>1000 ?ng/ml and PLT<150,000/μl. |
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| Keywords: | COVID-19 Neutrophil IL-6 Ferritin D-dimer |
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