COVID-19: 5 biomarkers of a poor prognosis

  • Ayanian S & al.
  • Biomark Med
  • 17 Jul 2020

  • curated by Miriam Davis, PhD
  • Clinical Essentials
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • D-dimer and lactate dehydrogenase (LDH) are among 5 biomarkers that may independently predict clinical deterioration and death in hospitalized patients with COVID-19.

Why this matters

  • Elevated biomarkers of inflammation and coagulopathy identify high-risk patients who may need more aggressive early treatment.

Study design

  • Retrospective cohort of 299 US patients with laboratory-confirmed COVID-19 admitted to George Washington University Hospital in the District of Columbia (March 12-May 9, 2020).
  • 5 blood-based biomarkers were assayed on hospital admission: D-dimer, LDH, C-reactive protein (CRP), IL-6, and ferritin.
  • Funding: None disclosed.

Key results

  • 23% of patients were transferred to the ICU, 13% required intubation, and 23.7% died.
  • Elevations of D-dimer (≥3 μg/mL), LDH (≥1200 units/L), CRP (≥100 mg/L), IL-6 (≥50 pg/mL), and ferritin (≥450 ng/mL) were each independently associated with elevated odds of these 3 clinical outcomes:
    • aORs ranged from 4.5 (95% CI, 2.5-8.1) to 8.6 (95% CI, 4.1-18.1).
    • All P<.05.>
  • Highest mortality odds (aORs; 95% CIs) with:
    • Elevated LDH: 8.0 (4.1-15.3). 
    • D-dimer: 7.5 (3.8-14.6).

Limitations

  • Single-center study.
  • Retrospective, observational design.