Use and misuse of biomarkers and the role of D-dimer and C-reactive protein in the management of COVID-19: A post-hoc analysis of a prospective cohort study

Gonçalves, Fábio Augusto Rodrigues; Besen, Bruno Adler Maccagnan Pinheiro; Lima, Clarice Antunes de; Corá, Aline Pivetta; Pereira, Antonio José Rodrigues; Perazzio, Sandro Félix; Gouvea, Christiane Pereira; Fonseca, Luiz Augusto Marcondes; Trindade, Evelinda; Sumita, Nairo Massakazu; Duarte, Alberto José da Silva; Lichtenstein, A.

doi:10.6061/clinics/2021/e3547

Cited by 13 publications

(5 citation statements)

References 31 publications

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“…In conclusion, the existing evidence about the association of an atypical presentation with mortality is conflicting, and our study adds to this evidence base. However, it is important that, as in our study, future studies correct for confounders, such as high age, male sex, frailty and higher CRP levels as these are associated with higher mortality in patients with COVID-19 [20,27,[32][33][34][35][36][37]. In addition, we would recommend to investigate whether there is a difference in mortality between patients that present atypically but develop fever, cough or dyspnea later in their disease trajectory and those who do not develop any typical complaints.…”

Section: Discussionmentioning

confidence: 92%

Atypical presentation of COVID-19 in older patients is associated with frailty but not with adverse outcomes

et al. 2023

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Key Summary Points Aim To study the association between atypical presentation of COVID-19, frailty and adverse outcomes, as well as the incidence of atypical presentation. Findings In this study, an atypical presentation of COVID-19 was significantly associated with frailty. However, patients with an atypical presentation of COVID-19 did not have worse disease outcomes. Message Physicians need to remain alert for COVID-19 in frail older patients, as they may present without typical complaints. Supplementary Information The online version contains supplementary material available at 10.1007/s41999-022-00736-z.

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Section: Discussionmentioning

confidence: 92%

Atypical presentation of COVID-19 in older patients is associated with frailty but not with adverse outcomes

et al. 2023

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“…Regarding patients’ age, the present study is in accordance with the literature. 24 , 28 The group of patients with VTE was older than the group without VTE. Since long ago, several epidemiological studies 29 and guidelines 18 have established that the incidence of VTE increases exponentially with age.…”

Section: Discussionmentioning

confidence: 95%

“…A D-dimer 4,000 ng/mL threshold and a CRP 220 mg/dL threshold were adopted, as they were previously associated with the highest mortality. 24 Two groups of COVID-19 patients were compared: G1 with confirmed VTE versus G2 without VTE during hospitalization.…”

Section: Methodsmentioning

confidence: 99%

Immunothrombosis and COVID-19 ‒ a nested post-hoc analysis from a 3186 patient cohort in a Latin American public reference hospital

Lima¹,

Gonçalves²,

Besen³

et al. 2023

Clinics

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“…Conventional blood tests included blood cell counts (especially neutrophils and lymphocytes) and size distribution [5][6][7][8]. Common laboratory tests included procalcitonin (PCT) [9], C-reactive protein (CRP) [10], D-dimer [11], interleukin-6 (IL-6) [12], and others [13]. In addition, parameters reflecting organ dysfunction have been extensively studied [14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

A two-gene marker for the two-tiered innate immune response in COVID-19 patients

Lei

2023

PLoS ONE

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For coronavirus disease 2019 (COVID-19), a pandemic disease characterized by strong immune dysregulation in severe patients, convenient and efficient monitoring of the host immune response is critical. Human hosts respond to viral and bacterial infections in different ways, the former is characterized by the activation of interferon stimulated genes (ISGs) such as IFI27, while the latter is characterized by the activation of anti-bacterial associated genes (ABGs) such as S100A12. This two-tiered innate immune response has not been examined in COVID-19. In this study, the activation patterns of this two-tiered innate immune response represented by IFI27 and S100A12 were explored based on 1421 samples from 17 transcriptome datasets derived from the blood of COVID-19 patients and relevant controls. It was found that IFI27 activation occurred in most of the symptomatic patients and displayed no correlation with disease severity, while S100A12 activation was more restricted to patients under severe and critical conditions with a stepwise activation pattern. In addition, most of the S100A12 activation was accompanied by IFI27 activation. Furthermore, the activation of IFI27 was most pronounced within the first week of symptom onset, but generally waned after 2–3 weeks. On the other hand, the activation of S100A12 displayed no apparent correlation with disease duration and could last for several months in certain patients. These features of the two-tiered innate immune response can further our understanding on the disease mechanism of COVID-19 and may have implications to the clinical triage. Development of a convenient two-gene protocol for the routine serial monitoring of this two-tiered immune response will be a valuable addition to the existing laboratory tests.

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Use and misuse of biomarkers and the role of D-dimer and C-reactive protein in the management of COVID-19: A post-hoc analysis of a prospective cohort study

Cited by 13 publications

References 31 publications

Atypical presentation of COVID-19 in older patients is associated with frailty but not with adverse outcomes

Atypical presentation of COVID-19 in older patients is associated with frailty but not with adverse outcomes

Immunothrombosis and COVID-19 ‒ a nested post-hoc analysis from a 3186 patient cohort in a Latin American public reference hospital

A two-gene marker for the two-tiered innate immune response in COVID-19 patients

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