The Diagnostic Value of Inflammatory Markers (CRP, IL6, CRP/IL6, CRP/L, LCR) for Assessing the Severity of COVID-19 Symptoms Based on the MEWS and Predicting the Risk of Mortality

Wolszczak-Biedrzycka, Blanka; Zińczuk, Justyna; Milewska, Anna Justyna; Łukaszyk, Mateusz; Naumnik, Wojciech; Kosidło, Jakub Wiktor; Dymicka-Piekarska, Violetta

doi:10.2147/jir.s406658

Cited by 12 publications

(10 citation statements)

References 53 publications

(61 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results of the ROC analysis indicate that tryptophan, KN, NFK, and AGEs are highly useful diagnostic parameters for differentiating between COVID-19 patients and healthy subjects (AUC = 0.9083, 0.9594, 0.9868, and 0.9971, respectively), and together with DT, these parameters are useful for differentiating between convalescents and healthy controls (AUC = 0.8241, 0.8546, 0.8697, 1.000). In the authors' previous research, the levels of proinflammatory cytokines were elevated during COVID-19 3 , 57 , 58 . Increased production of IFN-γ, IL-1β, IL-6, and ROS induces indoleamine 2,3-dioxygenase (IDO) which mediates tryptophan catabolism, decreases tryptophan concentration, and increases the levels of tryptophan catabolites (TRYCATs), including NFK and KN 59 .…”

Section: Discussionmentioning

confidence: 86%

“…COVID-19, an infection caused by the severe-acute-respiratory-syndrome-related coronavirus 2 (SARS-CoV-2), can be asymptomatic or can produce mild or severe symptoms that can lead to life-threatening multiorgan failure in patients 1 , 2 . The severity of symptoms is evaluated with the use of diagnostic scales, including the Modified Early Warning Score (MEWS) 3 , 4 An infection with the SARS-CoV-2 virus triggers excessive production of reactive oxygen species (ROS) 5 and reactive nitrogen species (RNS) 6 , which enhances protein glycoxidation 7 , 8 . In patients who had experienced severe symptoms, as well as mild and moderate symptoms of COVID-19, these processes are intensified and can lead to various complications 7 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Significance of nitrosative stress and glycoxidation products in the diagnosis of COVID-19

Wolszczak-Biedrzycka,

Dorf,

Matowicka-Karna

et al. 2024

Sci Rep

Self Cite

View full text Add to dashboard Cite

Nitrosative stress promotes protein glycoxidation, and both processes can occur during an infection with the SARS-CoV-2 virus. Therefore, the aim of this study was to assess selected nitrosative stress parameters and protein glycoxidation products in COVID-19 patients and convalescents relative to healthy subjects, including in reference to the severity of COVID-19 symptoms. The diagnostic utility of nitrosative stress and protein glycoxidation biomarkers was also evaluated in COVID-19 patients. The study involved 218 patients with COVID-19, 69 convalescents, and 48 healthy subjects. Nitrosative stress parameters (NO, S-nitrosothiols, nitrotyrosine) and protein glycoxidation products (tryptophan, kynurenine, N-formylkynurenine, dityrosine, AGEs) were measured in the blood plasma or serum with the use of colorimetric/fluorometric methods. The levels of NO (p = 0.0480), S-nitrosothiols (p = 0.0004), nitrotyrosine (p = 0.0175), kynurenine (p < 0.0001), N-formylkynurenine (p < 0.0001), dityrosine (p < 0.0001), and AGEs (p < 0.0001) were significantly higher, whereas tryptophan fluorescence was significantly (p < 0.0001) lower in COVID-19 patients than in the control group. Significant differences in the analyzed parameters were observed in different stages of COVID-19. In turn, the concentrations of kynurenine (p < 0.0001), N-formylkynurenine (p < 0.0001), dityrosine (p < 0.0001), and AGEs (p < 0.0001) were significantly higher, whereas tryptophan levels were significantly (p < 0.0001) lower in convalescents than in healthy controls. The ROC analysis revealed that protein glycoxidation products can be useful for diagnosing infections with the SARS-CoV-2 virus because they differentiate COVID-19 patients (KN: sensitivity—91.20%, specificity—92.00%; NFK: sensitivity—92.37%, specificity—92.00%; AGEs: sensitivity—99,02%, specificity—100%) and convalescents (KN: sensitivity—82.22%, specificity—84.00%; NFK: sensitivity—82,86%, specificity—86,00%; DT: sensitivity—100%, specificity—100%; AGE: sensitivity—100%, specificity—100%) from healthy subjects with high sensitivity and specificity. Nitrosative stress and protein glycoxidation are intensified both during and after an infection with the SARS-CoV-2 virus. The levels of redox biomarkers fluctuate in different stages of the disease. Circulating biomarkers of nitrosative stress/protein glycoxidation have potential diagnostic utility in both COVID-19 patients and convalescents.

show abstract

Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Significance of nitrosative stress and glycoxidation products in the diagnosis of COVID-19

Wolszczak-Biedrzycka,

Dorf,

Matowicka-Karna

et al. 2024

Sci Rep

Self Cite

View full text Add to dashboard Cite

show abstract

“…This finding is supported by several previous studies. 42 , 43 IL-6 typically helps maintain immune homeostasis and combats infections by regulating the immune response, promoting inflammation, and modulating platelet function. 44 However, in severe COVID-19 cases, excessively elevated IL-6 levels can trigger a cytokine storm, resulting in ARDS and thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Mortality Among Severe Omicron Patients for COVID-19

Wu,

Liao,

Mao

et al. 2024

IDR

View full text Add to dashboard Cite

Purpose The purpose of the study was to explore the potential risk factors of mortality in patients with severe pneumonia during the omicron pandemic in South China in 2022. Methods Clinical data was collected from patients hospitalized with omicron COVID-19. Then, patients were categorized into the non-survival and survival groups. A comprehensive analysis was conducted to analyze the factors associated with negative outcome in individuals suffering from severe omicron COVID-19. Results In this study, 155 severe COVID-19 patients were included, comprising 55 non-survivors and 100 survivors. Non-survivors, in comparison to survivors, exhibited elevated levels of various biomarkers including neutrophil count, hypersensitive troponin T, urea, creatinine, C-reactive protein, procalcitonin, interleukin-6, plasma D-dimer, and derived neutrophil-to-lymphocyte ratio (dNLR) ( P < 0.05). They also displayed reduced lymphocyte count, platelet count, and albumin levels ( P < 0.05) and were more prone to developing comorbidities, including shock, acute cardiac and renal injury, acute respiratory distress syndrome, coagulation disorders, and secondary infections. Platelet count (PLT) <100 × 10^/L, interleukin-6 (IL-6) >100 pg/mL, and dNLR >5.0 independently contributed to the risk of death in patients suffering from severe COVID-19. Conclusion PLT, IL-6, and dNRL independently contributed to the risk of mortality in patients with severe pneumonia during the 2022 omicron pandemic in South China.

show abstract

“…It is generally known that COVID-19 can lead to post-infection complications and increases the risk of inflammatory, 7 , 8 metabolic, and neurodegenerative diseases which are also caused by an oxidation-reduction (redox) imbalance. 9 Therefore, oxidative stress parameters and antioxidant levels should be compared in convalescents vs individuals without a history of SARS-CoV-2 infection and COVID-19 patients.…”

Section: Introductionmentioning

confidence: 99%

Redox Biomarkers – An Effective Tool for Diagnosing COVID-19 Patients and Convalescents

Wolszczak-Biedrzycka,

Dorf,

Matowicka-Karna

et al. 2024

JIR

Self Cite

View full text Add to dashboard Cite

Aim COVID-19 triggers the overproduction of reactive oxygen species (ROS) which, in combination with a weakened antioxidant barrier, can lead to protein oxidation and lipid peroxidation. The aim of this study was to evaluate enzymatic and non-enzymatic antioxidants, the overall redox potential, and protein and lipid peroxidation products in COVID-19 patients, convalescents, and healthy subjects, and to the determine the diagnostic applicability of these parameters in COVID-19 patients. Materials and Methods The study involved 218 patients with COVID-19, 69 convalescents, and 48 healthy subjects who were selected for the research based on age and sex. The study was conducted between 20 February 2021 and 20 November 2021 in Białystok, Poland. The antioxidant barrier, redox status, and oxidative damage products were assessed in serum/plasma samples with the use of colorimetric and spectrophotometric assays. Results Glutathione reductase (GR) activity was higher, whereas total antioxidant capacity (TAC) was lower in COVID-19 patients than in convalescents (p<0.0001) and the control group (p<0.0001). The concentrations of advanced glycation end products (AGEs), advanced oxidation protein products (AOPP), 4-hydroxynonenal (4-HNE), and malondialdehyde (MDA) were higher in COVID-19 patients (p<0.0001) and convalescents (p<0.0001) than in the control group. AGEs were the most effective diagnostic biomarker for differentiating COVID-19 patients from the control group (AUC=0.9971) and convalescents from the control group (AUC=1.000). Conclusion An infection with the SARS-CoV-2 disrupts the redox balance and increases protein oxidation and lipid peroxidation. AGEs fulfill the criteria for a potential diagnostic biomarker in COVID-19 patients and convalescents.

show abstract

The Diagnostic Value of Inflammatory Markers (CRP, IL6, CRP/IL6, CRP/L, LCR) for Assessing the Severity of COVID-19 Symptoms Based on the MEWS and Predicting the Risk of Mortality

Cited by 12 publications

References 53 publications

Significance of nitrosative stress and glycoxidation products in the diagnosis of COVID-19

Significance of nitrosative stress and glycoxidation products in the diagnosis of COVID-19

Factors Associated with Mortality Among Severe Omicron Patients for COVID-19

Redox Biomarkers – An Effective Tool for Diagnosing COVID-19 Patients and Convalescents

Contact Info

Product

Resources

About