A Clinical Risk Score to Identify Patients with COVID-19 at High Risk of Critical Care Admission or Death: An Observational Cohort Study

Galloway, James; Norton, Sam; Barker, Richard D.; Brookes, A.; Carey, Ivana; Clarke, Benjamin D; Jina, Raeesa; Reid, Carole; Russell, Mark; Sneep, Ruth; Sugarman, Leah; Williams, Sarah; Yates, Mark; Teo, James; Shah, Ajay M.; Cantle, Fleur

doi:10.2139/ssrn.3590486

Cited by 47 publications

(89 citation statements)

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“…According to WHO clinical criteria at admission time, patients were hospitalized in High (HIC) and Low Intensity Care (LIC) wards, respectively. Severity of Covid-19 at the time of blood sampling was quantified using a Covid-score, attributing a value ranging from 0 to 100% 4 – 7 , 9 . Main variables incorporated in the Covid-score included: older age, male sex, comorbidities, respiratory rate, oxygenation, radiographic severity, higher neutrophils, higher CRP and lower albumin at presentation, predicted critical care admission and mortality; in particular: age > 50, male, oxygen saturation < 93%, radiological severity score > 3, neutrophil count > 8.0 × 10 9 /L, CRP > 40 mg/L, albumin < 34 g/L, creatinine > 100 μmol/L, comorbidity and chronic lung disease, ALT > 40 IU/L; Creatinine > 100 μmol/L; D-dimer > 0.5 μg/L; Prothrombin-time > 16 s; Ferritin > 300 μg/L; Procalcitonin > 0.1 ng/mL.…”

Section: Methodsmentioning

confidence: 99%

“…Evaluation of Covid-19 severity and possible outcomes is limited by clinical heterogeneity and lack of specific markers 1 – 3 . Several laboratory parameters are considered in clinical practice, but the identification of novel indicators in blood specimens is a key issue for understanding the underlying biological mechanisms and improving prognostic accuracy 4 – 9 .As a candidate marker we focused on the S100B protein, which is regarded to be involved in inflammatory processes as a Danger-Associated Molecular Patterns (DAMP) molecule 10 , 11 . S100B is a small acidic calcium-binding protein, originally isolated in the nervous system, where it is concentrated in astrocytes, being also present in oligodendrocytes, Schwann cells, enteric glial cells, and some neuron subpopulations 12 , 13 .…”

Section: Introductionmentioning

confidence: 99%

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Serum S100B protein as a marker of severity in Covid-19 patients

Aceti

Margarucci

Scaramucci

et al. 2020

Sci Rep

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SARS-CoV-2 infection shows a wide-ranging clinical severity, requiring prognostic markers. We focused on S100B, a calcium-binding protein present in biological fluids, being a reliable biomarker in disorders having inflammatory processes as common basis and RAGE as main receptor. Since Covid-19 is characterized by a potent inflammatory response also involving RAGE, we tested if S100B serum levels were related to disease severity. Serum samples (n = 74) were collected from hospitalized SARS-CoV-2 positive patients admitted to Covid center. Illness severity was established by admission clinical criteria and Covid risk score. Treatment protocols followed WHO guidelines available at the time. Circulating S100B was determined by ELISA assay. Statistical analysis used Pearson’s χ2 test, t-Test, and ANOVA, ANCOVA, Linear Regression. S100B was detected in serum from Covid-19 patients, significantly correlating with disease severity as shown both by the level of intensity of care (p < 0.006) as well by the value of Covid score (Multiple R-squared: 0.3751); the correlation between Covid-Score and S100B was 0.61 (p < 0.01). S100B concentration was associated with inflammation markers (Ferritin, C-Reactive Protein, Procalcitonin), and organ damage markers (Alanine Aminotransferase, Creatinine). Serum S100B plays a role in Covid-19 and can represent a marker of clinical severity in Sars-CoV-2 infected patients.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Serum S100B protein as a marker of severity in Covid-19 patients

Aceti

Margarucci

Scaramucci

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…According to WHO clinical criteria at admission time, patients were hospitalized in High (HIC) and Low Intensity Care (LIC) wards, respectively. Severity of Covid-19 at the time of blood sampling was quanti ed using a Covidscore, attributing a value ranging from 0% to 100% [4][5][6][7]9]. Namely, patients recovered in HIC (n=16) presented: severe pneumonia (fever or suspected respiratory infection, plus one of the following: respiratory rate >30 breaths/min; severe respiratory distress or SpO2 ≤93% on room air); and LIC (n=58) comprehended a group spanning from uncomplicated disease to pneumonia but without signs of severe pneumonia.…”

Section: Methodsmentioning

confidence: 99%

“…Evaluation of Covid-19 severity and possible outcomes is limited by clinical heterogeneity and lack of speci c markers [1][2][3] Several laboratory parameters are considered in clinical practice, but the identi cation of novel indicators in blood specimens is a key issue for understanding the underlying biological mechanisms and improving prognostic accuracy [4][5][6][7][8][9] As a candidate marker we focused on the S100B protein, which is regarded to be involved in in ammatory processes as a Danger-Associated Molecular Patterns (DAMP) molecule [10,11]. S100B is a small acidic calcium-binding protein, originally isolated in the nervous system, where it is concentrated in astrocytes, being also present in oligodendrocytes, Schwann cells, enteric glial cells, and some neuron subpopulations [12,13].…”

Section: Introductionmentioning

confidence: 99%

Serum S100B protein as a marker of severity in Covid-19 patients

Aceti

Margarucci

Scaramucci

et al. 2020

Preprint

View full text Add to dashboard Cite

SARS-CoV-2 infection shows a wide-ranging clinical severity, requiring prognostic markers. We focused on S100B, a calcium-binding protein present in biological fluids, being a reliable biomarker in disorders having inflammatory processes as common basis and RAGE as main receptor. Since Covid-19 is characterized by a potent inflammatory response also involving RAGE, we tested if S100B serum levels were related to disease severity.Serum samples (n=74) were collected from hospitalized SARS-CoV-2 positive patients admitted to Covid center. Illness severity was established by admission clinical criteria and Covid risk score. Treatment protocols followed WHO guidelines available at the time. Circulating S100B was determined by ELISA assay. Statistical analysis used Pearson’s χ2 test, t-Test, and ANOVA, ANCOVA, Linear Regression.S100B was detected in serum from Covid-19 patients, significantly correlating with disease severity as shown both by the level of intensity of care (p<0.006) as well by the value of Covid score (Multiple R-squared: 0.3751); the correlation between Covid-Score and S100B was 0.61 (p<0.01). S100B concentration was associated with inflammation markers (Ferritin, C-Reactive Protein, Procalcitonin), and organ damage markers (Alanine Aminotransferase, Creatinine). Serum S100B plays a role in Covid-19 and can represent a prognostic marker in Sars-CoV-2 infected patients.

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“…As COVID-19 pandemic continues to escalate, hospitals around the world confront with the need to attend an increasing number of patients. Therefore, we read with much interest the recent study published in the Journal of Infection by Galloway JB et al, reinforcing the importance of stratifying patients to ease their management and their incorporation to potential clinical trials 1 . For this purpose, these authors developed a valuable and complex risk score based on twelve parameters, including, among others, age, gender, diabetes mellitus, hypertension, and chronic lung disease.…”

mentioning

confidence: 97%