The systemic inflammatory response and clinicopathological characteristics in patients admitted to hospital with COVID-19 infection: comparison of 2 consecutive cohorts

Maguire, D. et al. (2021) The systemic inflammatory response and clinicopathological characteristics in patients admitted to hospital with COVID-19 infection: comparison of 2 consecutive cohorts. PLoS ONE, 16(5), e0251924. (doi: 10.1371/journal.pone.0251924) (PMID:34043668) (PMCID:PMC8159002)

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Abstract

Background: In order to manage the COVID-19 systemic inflammatory response, it is important to identify clinicopathological characteristics across multiple cohorts. Methods: The aim of the present study was to compare the 4C mortality score, other measures of the systemic inflammatory response and clinicopathological characteristics in two consecutive cohorts of patients on admission with COVID-19. Electronic patient records for 2 consecutive cohorts of patients admitted to two urban teaching hospitals with COVID-19 during two 7-week periods of the COVID-19 pandemic in Glasgow, U.K. (cohort 1: 17/3/2020–1/5/2020) and (cohort 2: 18/5/2020–6/7/2020) were examined for routine clinical, laboratory and clinical outcome data. Results: Compared with cohort 1, cohort 2 were older (p<0.001), more likely to be female (p<0.05) and have less independent living circumstances (p<0.001). More patients in cohort 2 were PCR positive, CXR negative (both p<0.001) and had low serum albumin concentrations (p<0.001). 30-day mortality was similar between both cohorts (23% and 22%). In cohort 2, age >70 (p<0.05), male gender (p<0.05), COPD (p<0.05), cognitive impairment (p<0.05), frailty (p<0.001), delirium (p = 0.001), CRP>150mg/L (p<0.05), albumin <30 g/L (p<0.01), elevated perioperative Glasgow Prognostic Score (p<0.05), elevated neutrophil-lymphocyte ratio (p<0.001), low haematocrit (p<0.01), elevated PT (p<0.05), sodium <133 mmol/L (p<0.01) elevated urea (p<0.001), creatinine (p<0.001), glucose (p<0.05) and lactate (p<0.001) and the 4C score (p<0.001) were associated with 30-day mortality. In multivariate analysis, greater frailty (CFS>3) (OR 11.3, 95% C.I. 2.3–96.7, p<0.05), low albumin (<30g/L) (OR 2.5, 95% C.I. 1.0–6.2, p<0.05), high NLR (≥3) (OR 2.2, 95% C.I. 1.5–4.5, p<0.05) and the 4C score (OR 2.4, 95% C.I. 1.0–5.6, p<0.05) remained independently associated with 30-day mortality. Conclusion: In addition to the 4C mortality score, frailty score and a low albumin were strongly independently associated with 30-day mortality in two consecutive cohorts of patients admitted to hospital with COVID-19. Trial registration: clinicaltrials.gov: NCT04484545.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Brown, Dr Amy and McMillan, Professor Donald and Cameron, Dr Allan and Maguire, Donogh and Dolan, Dr Ross and Laird, Dr Barry
Creator Roles:
Maguire, D.Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Supervision, Writing – original draft
Dolan, R.Conceptualization, Investigation, Methodology, Project administration, Supervision, Writing – review and editing
Brown, A.Investigation, Writing – review and editing
Cameron, A.Data curation, Investigation, Writing – review and editing
Laird, B.Conceptualization, Writing – review and editing
McMillan, D. C.Conceptualization, Formal analysis, Investigation, Methodology, Supervision, Writing – original draft
Authors: Maguire, D., Richards, C., Woods, M., Dolan, R., Wilson Veitch, J., Sim, W. M. J., Kemmett, O. E. H., Milton, D. C., Randall, S. L. W., Bui, L. D., Goldmann, N., Brown, A., Gillen, E., Cameron, A., Laird, B., Talwar, D., Godber, I. M., Wadsworth, J., Catchpole, A., Davidson, A., and McMillan, D. C.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:PLoS ONE
Publisher:Public Library of Science
ISSN:1932-6203
ISSN (Online):1932-6203
Copyright Holders:Copyright © 2021 Maguire et al.
First Published:First published in PLoS ONE 16(5): e0251924
Publisher Policy:Reproduced under a Creative Commons License
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