Estudios originales
Medwave 2022;22(6):e002548 doi: 10.5867/medwave.2022.06.002548
Asociación de biomarcadores y severidad de COVID-19: estudio transversal
Association of biomarkers and severity of COVID-19: A crosssectional study
Mady Canelú Ramos Rojas, Edwin Antonio Cuaresma Cuadros, Jose Johao Cayo Castillo, Diego Alexander Monasterio Benique
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Palabras clave: COVID-19 disease, biomarkers, degree of severity

Abstract

Introduction
COVID- 19 is a disease that has claimed the lives of many people. However, alterations in labo-ratory profiles in the city of Tacna have not been accurately established in association with its severity to support diagnosis and treatment.

Objective
To determine biomarkers related to the severity of COVID- 19 in patients treated at the social security hospital in Tacna during 2020.

Methods
We performed an observational, cross- sectional, and analytical study that included 308 patients with COVID- 19 from the social security hospital in Tacna, Peru, during the "first wave" of the pandemic (from July to August 2020). Immunological, hematological, arterial gas, hemostasis, and biochemical markers were collected. Patients were categorized into mild, moderate, and severe based on the clinical criteria found on clinical records. Correlation strength was per-formed according to Spearman’s Rho coefficient. The performance of the biomarkers associat-ed with severity was analyzed with the Receiver Operating Characteristic curve.

Results
Regarding hematological markers there was a positive correlation with monocyte count (correla-tion coefficient: 0.841; area under the curve 97.0%; p < 0.05) and a negative correlation with lymphocyte count (correlation coefficient: -0.622; area under the curve 82.7%; p < 0.05). Regarding biochemical markers, arterial gases and hemostasis, no significant correlations were found. In immunological markers, we found positive correlation with ferritin (correlation coef-ficient: 0.805; area under the curve 94.0%; p < 0.05), and C- reactive protein (correlation coeffi-cient: 0.587; area under the curve 87.4%; p < 0.05).

Conclusions
The biomarkers that can be considered as parameters associated with the severity of COVID- 19 are the absolute blood count of monocytes and serum ferritin concentration.


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Error Content : No se econtro el path especificado

 

Introduction
COVID- 19 is a disease that has claimed the lives of many people. However, alterations in labo-ratory profiles in the city of Tacna have not been accurately established in association with its severity to support diagnosis and treatment.

Objective
To determine biomarkers related to the severity of COVID- 19 in patients treated at the social security hospital in Tacna during 2020.

Methods
We performed an observational, cross- sectional, and analytical study that included 308 patients with COVID- 19 from the social security hospital in Tacna, Peru, during the "first wave" of the pandemic (from July to August 2020). Immunological, hematological, arterial gas, hemostasis, and biochemical markers were collected. Patients were categorized into mild, moderate, and severe based on the clinical criteria found on clinical records. Correlation strength was per-formed according to Spearman’s Rho coefficient. The performance of the biomarkers associat-ed with severity was analyzed with the Receiver Operating Characteristic curve.

Results
Regarding hematological markers there was a positive correlation with monocyte count (correla-tion coefficient: 0.841; area under the curve 97.0%; p < 0.05) and a negative correlation with lymphocyte count (correlation coefficient: -0.622; area under the curve 82.7%; p < 0.05). Regarding biochemical markers, arterial gases and hemostasis, no significant correlations were found. In immunological markers, we found positive correlation with ferritin (correlation coef-ficient: 0.805; area under the curve 94.0%; p < 0.05), and C- reactive protein (correlation coeffi-cient: 0.587; area under the curve 87.4%; p < 0.05).

Conclusions
The biomarkers that can be considered as parameters associated with the severity of COVID- 19 are the absolute blood count of monocytes and serum ferritin concentration.

Autores: Mady Canelú Ramos Rojas[1,2], Edwin Antonio Cuaresma Cuadros[3], Jose Johao Cayo Castillo[4], Diego Alexander Monasterio Benique[5]

Filiación:
[1] Centro de Atención y Aislamiento Temporal Villa COVID-19, Tacna, Perú
[2] Escuela Profesional de Tecnología Médica, Facultad Ciencias de la Salud, Universidad Privada de Tacna, Tacna, Perú
[3] Hospital III Daniel Alcides Carrión, Tacna, Perú
[4] Emergencia, Hospital III Daniel Alcides Carrión, Tacna, Perú
[5] Escuela Profesional de Tecnología Médica, Facultad Ciencias de la Salud, Universidad Privada de Tacna, Tacna, Perú

E-mail: canelu.ramos.rojas@gmail.com

Correspondencia a:
[1] Cooperativa Gregorio
Albarracin B 7 Alto de la Alianza
Tacna, Perú

Citación: Ramos Rojas MC, Cuaresma Cuadros EA, Cayo Castillo JJ, Monasterio Benique DA. Association of biomarkers and severity of COVID-19: A crosssectional study. Medwave 2022;22(6):e002548 doi: 10.5867/medwave.2022.06.002548

Fecha de envío: 22/12/2021

Fecha de aceptación: 3/6/2022

Fecha de publicación: 6/7/2022

Origen: No solicitado

Tipo de revisión: Con revisión por pares externos, por tres árbitros a doble ciego

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  1. OMS. Enfermedad por Coronavirus COVID-19. 2020. | Link |
  2. MINSA. Situacion Actual “COVID-19” Perú-2020.2020. | Link |
  3. Assandri R, Buscarini E, Canetta C, Scartabellati A, Viganò G, Montanelli A. Laboratory Biomarkers Predicting COVID-19 Severity in the Emergency Room. Arch Med Res. 2020;51: 598–599. | CrossRef |
  4. Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med. 2020;58: 1131–1134. | CrossRef |
  5. Kermali M, Khalsa RK, Pillai K, Ismail Z, Harky A. The role of biomarkers in diagnosis of COVID- 19 - A systematic review. Life Sci. 2020;254: 117788. | CrossRef |
  6. Sirvent JM, Baro A, Morales M, Sebastian P, Saiz X. Biomarcadores predictivos de mortalidad en pacientes críticos con COVID- 19. Med Intensiva. 2022;46: 94–96. | CrossRef |
  7. Pujani M, Raychaudhuri S, Verma N, Kaur H, Agarwal S, Singh M, et al. Association of Hematologic biomarkers and their combinations with disease severity and mortality in COVID- 19-an Indian perspective. Am J Blood Res. 2021;11: 180–190. | Link |
  8. Galicia García C, Vega Sánchez ÁE. Asociación de ferritina con deterioro ventilatorio y mortalidad debido a COVID- 19 en terapia intensiva. Medicina Crítica. 2021;35: 121–129. | CrossRef |
  9. Zeng F, Huang Y, Guo Y, Yin M, Chen X, Xiao L, et al. Association of inflammatory markers with the severity of COVID- 19: A meta- analysis. Int J Infect Dis. 2020;96: 467–474. | CrossRef |
  10. Dirección Regional de Salud Tacna. DIRESA TACNA. 2020. | Link |
  11. Ponti G, Maccaferri M, Ruini C, Tomasi A, Ozben T. Biomarkers associated with COVID- 19 disease progression. Crit Rev Clin Lab Sci. 2020;57: 389–399. | CrossRef |
  12. Organización Mundial de la Salud. Clinical care of severe acute respiratory infections – Tool kit. | Link |
  13. Castro y Flores. Relación entre las comorbilidades y la morbilidad y la mortalidad en la COVID- 19. Anales de la Academia de Ciencias de Cuba. 2021;11: 2304–0106.
  14. Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID- 19): a meta- analysis. Clin Chem Lab Med. 2020;58: 1021–1028. | CrossRef |
  15. Ghahramani S, Tabrizi R, Lankarani KB, Kashani SMA, Rezaei S, Zeidi N, et al. Laboratory features of severe vs. non- severe COVID- 19 patients in Asian populations: a systematic review and meta- analysis. Eur J Med Res. 2020;25. | CrossRef |
  16. Mardani R, Ahmadi Vasmehjani A, Zali F, Gholami A, Mousavi Nasab SD, Kaghazian H, et al. Arch Acad Emerg Med. 2020;8.
  17. Dong X, Sun L, Li Y. Prognostic value of lactate dehydrogenase for in- hospital mortality in severe and critically ill patients with COVID- 19. Int J Med Sci. 2020;17: 2225–2231. | CrossRef |
  18. Bennouar S, Bachir Cherif A, Kessira A, Hamel H, Boudahdir A, Bouamra A, et al. Usefulness of biological markers in the early prediction of corona virus disease- 2019 severity. Scand J Clin Lab Invest. 2020;80: 611–618. | CrossRef |
  19. Aloisio E, Chibireva M, Serafini L, Pasqualetti S, Falvella FS, Dolci A, et al. A  Comprehensive Appraisal of Laboratory Biochemistry Tests as Major Predictors of COVID- 19 Severity. Arch Pathol Lab Med. 2020;144: 1457–1464. | CrossRef |
  20. Gutiérrez Suárez JC, Almonacid Urrego CC, Hernández Rojas E del C, Mendieta Zerón H. Valor pronóstico de los marcadores bioquímicos en pacientes con COVID- 19. nova. 2020;18: 53–60. | CrossRef |
  21. Huang I, Pranata R, Lim MA, Oehadian A, Alisjahbana B. Proteína C reactiva, procalcitonina, Dímero D y ferritina en la enfermedad grave por coronavirus- 2019: un metanálisis. Ther Adv Respir Dis. 2020;14: 17. | CrossRef |
  22. Long H, Nie L, Xiang X, Li H, Zhang X, Fu X, et al. D- Dimer and Prothrombin Time Are the Significant Indicators of Severe COVID- 19 and Poor Prognosis. Biomed Res Int. 2020;2020. | CrossRef |
  23. Gallo Marin B, Aghagoli G, Lavine K, Yang L, Siff EJ, Chiang SS, et al. Predictors of COVID- 19 severity: A literature review. Rev Med Virol. 2021;31: 1–10. | CrossRef |
  24. Tan L, Wang Q, Zhang D, Ding J, Huang Q, Tang Y- Q, et al. Lymphopenia predicts disease severity of COVID- 19: a descriptive and predictive study. Signal Transduct Target Ther. 2020;5: 33. | CrossRef |
  25. Henry B, Cheruiyot I, Vikse J, Mutua V, Kipkorir V, Benoit J, et al. Lymphopenia and neutrophilia at admission predicts severity and mortality in patients with COVID- 19: a meta- analysis. Acta Biomed. 2020;91. | CrossRef |
  26. Lippi G, South AM, Henry BM. Electrolyte imbalances in patients with severe coronavirus disease 2019 (COVID- 19). Ann Clin Biochem. 2020;57: 262–265. | CrossRef |
  27. Tjendra Y, Al Mana AF, Espejo AP, Akgun Y, Millan NC, Gomez-F ernandez C, et  al. Predicting Disease Severity and Outcome in COVID- 19 Patients: A Review of Multiple Biomarkers. Arch Pathol Lab Med. 2020;144: 1465–1474. | CrossRef |
  28. Tuta- Quintero E, Collazos E, Coronado- Sarmiento J, Pimentel J. Anemia como predictor de severidad en la COVID- 19: una revisión exploratoria. BMSA. 2021;61: 26–34. | CrossRef |
  29. Faghih Dinevari M, Somi MH, Sadeghi Majd E, Abbasalizad Farhangi M, Nikniaz Z. Anemia predicts poor outcomes of COVID- 19 in hospitalized patients: a prospective study in Iran. BMC Infect Dis. 2021;21. | CrossRef |
  30. Ocampo- Salgado C, Palacio- Uribe J, Duque- Ramírez M, Orrego- Garay MJ. Valor pronóstico de biomarcadores cardíacos en la enfermedad por COVID- 19. Revista Colombiana de Cardiología. 2020;27: 137–141. | CrossRef |
  31. Liu F, Li L, Xu M, Wu J, Luo D, Zhu Y, et al. Prognostic value of interleukin- 6, C- reactive protein, and procalcitonin in patients with COVID- 19. J  Clin Virol. 2020;127: 104370. | CrossRef |
OMS. Enfermedad por Coronavirus COVID-19. 2020. | Link |

MINSA. Situacion Actual “COVID-19” Perú-2020.2020. | Link |

Assandri R, Buscarini E, Canetta C, Scartabellati A, Viganò G, Montanelli A. Laboratory Biomarkers Predicting COVID-19 Severity in the Emergency Room. Arch Med Res. 2020;51: 598–599. | CrossRef |

Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med. 2020;58: 1131–1134. | CrossRef |

Kermali M, Khalsa RK, Pillai K, Ismail Z, Harky A. The role of biomarkers in diagnosis of COVID- 19 - A systematic review. Life Sci. 2020;254: 117788. | CrossRef |

Sirvent JM, Baro A, Morales M, Sebastian P, Saiz X. Biomarcadores predictivos de mortalidad en pacientes críticos con COVID- 19. Med Intensiva. 2022;46: 94–96. | CrossRef |

Pujani M, Raychaudhuri S, Verma N, Kaur H, Agarwal S, Singh M, et al. Association of Hematologic biomarkers and their combinations with disease severity and mortality in COVID- 19-an Indian perspective. Am J Blood Res. 2021;11: 180–190. | Link |

Galicia García C, Vega Sánchez ÁE. Asociación de ferritina con deterioro ventilatorio y mortalidad debido a COVID- 19 en terapia intensiva. Medicina Crítica. 2021;35: 121–129. | CrossRef |

Zeng F, Huang Y, Guo Y, Yin M, Chen X, Xiao L, et al. Association of inflammatory markers with the severity of COVID- 19: A meta- analysis. Int J Infect Dis. 2020;96: 467–474. | CrossRef |

Dirección Regional de Salud Tacna. DIRESA TACNA. 2020. | Link |

Ponti G, Maccaferri M, Ruini C, Tomasi A, Ozben T. Biomarkers associated with COVID- 19 disease progression. Crit Rev Clin Lab Sci. 2020;57: 389–399. | CrossRef |

Organización Mundial de la Salud. Clinical care of severe acute respiratory infections – Tool kit. | Link |

Castro y Flores. Relación entre las comorbilidades y la morbilidad y la mortalidad en la COVID- 19. Anales de la Academia de Ciencias de Cuba. 2021;11: 2304–0106.

Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID- 19): a meta- analysis. Clin Chem Lab Med. 2020;58: 1021–1028. | CrossRef |

Ghahramani S, Tabrizi R, Lankarani KB, Kashani SMA, Rezaei S, Zeidi N, et al. Laboratory features of severe vs. non- severe COVID- 19 patients in Asian populations: a systematic review and meta- analysis. Eur J Med Res. 2020;25. | CrossRef |

Mardani R, Ahmadi Vasmehjani A, Zali F, Gholami A, Mousavi Nasab SD, Kaghazian H, et al. Arch Acad Emerg Med. 2020;8.

Dong X, Sun L, Li Y. Prognostic value of lactate dehydrogenase for in- hospital mortality in severe and critically ill patients with COVID- 19. Int J Med Sci. 2020;17: 2225–2231. | CrossRef |

Bennouar S, Bachir Cherif A, Kessira A, Hamel H, Boudahdir A, Bouamra A, et al. Usefulness of biological markers in the early prediction of corona virus disease- 2019 severity. Scand J Clin Lab Invest. 2020;80: 611–618. | CrossRef |

Aloisio E, Chibireva M, Serafini L, Pasqualetti S, Falvella FS, Dolci A, et al. A  Comprehensive Appraisal of Laboratory Biochemistry Tests as Major Predictors of COVID- 19 Severity. Arch Pathol Lab Med. 2020;144: 1457–1464. | CrossRef |

Gutiérrez Suárez JC, Almonacid Urrego CC, Hernández Rojas E del C, Mendieta Zerón H. Valor pronóstico de los marcadores bioquímicos en pacientes con COVID- 19. nova. 2020;18: 53–60. | CrossRef |

Huang I, Pranata R, Lim MA, Oehadian A, Alisjahbana B. Proteína C reactiva, procalcitonina, Dímero D y ferritina en la enfermedad grave por coronavirus- 2019: un metanálisis. Ther Adv Respir Dis. 2020;14: 17. | CrossRef |

Long H, Nie L, Xiang X, Li H, Zhang X, Fu X, et al. D- Dimer and Prothrombin Time Are the Significant Indicators of Severe COVID- 19 and Poor Prognosis. Biomed Res Int. 2020;2020. | CrossRef |

Gallo Marin B, Aghagoli G, Lavine K, Yang L, Siff EJ, Chiang SS, et al. Predictors of COVID- 19 severity: A literature review. Rev Med Virol. 2021;31: 1–10. | CrossRef |

Tan L, Wang Q, Zhang D, Ding J, Huang Q, Tang Y- Q, et al. Lymphopenia predicts disease severity of COVID- 19: a descriptive and predictive study. Signal Transduct Target Ther. 2020;5: 33. | CrossRef |

Henry B, Cheruiyot I, Vikse J, Mutua V, Kipkorir V, Benoit J, et al. Lymphopenia and neutrophilia at admission predicts severity and mortality in patients with COVID- 19: a meta- analysis. Acta Biomed. 2020;91. | CrossRef |

Lippi G, South AM, Henry BM. Electrolyte imbalances in patients with severe coronavirus disease 2019 (COVID- 19). Ann Clin Biochem. 2020;57: 262–265. | CrossRef |

Tjendra Y, Al Mana AF, Espejo AP, Akgun Y, Millan NC, Gomez-F ernandez C, et  al. Predicting Disease Severity and Outcome in COVID- 19 Patients: A Review of Multiple Biomarkers. Arch Pathol Lab Med. 2020;144: 1465–1474. | CrossRef |

Tuta- Quintero E, Collazos E, Coronado- Sarmiento J, Pimentel J. Anemia como predictor de severidad en la COVID- 19: una revisión exploratoria. BMSA. 2021;61: 26–34. | CrossRef |

Faghih Dinevari M, Somi MH, Sadeghi Majd E, Abbasalizad Farhangi M, Nikniaz Z. Anemia predicts poor outcomes of COVID- 19 in hospitalized patients: a prospective study in Iran. BMC Infect Dis. 2021;21. | CrossRef |

Ocampo- Salgado C, Palacio- Uribe J, Duque- Ramírez M, Orrego- Garay MJ. Valor pronóstico de biomarcadores cardíacos en la enfermedad por COVID- 19. Revista Colombiana de Cardiología. 2020;27: 137–141. | CrossRef |

Liu F, Li L, Xu M, Wu J, Luo D, Zhu Y, et al. Prognostic value of interleukin- 6, C- reactive protein, and procalcitonin in patients with COVID- 19. J  Clin Virol. 2020;127: 104370. | CrossRef |