Discrepancy between biomarkers of lung injury and 1‐year mortality in COVID‐19. (8th July 2022) - Atalay, Basak
Abstract: Background: COVID‐19 global pandemic started in late 2019 with the first wave. In this cross‐sectional and observational study, we evaluated the associations between the biomarkers, COVID‐19 pneumonia severity and 1‐year mortality. Methods: A sample of 276 polymerase chain reaction (PCR)‐positive patients for SARS‐CoV‐2 was included. Computerized tomography severity score (CT‐SS) was used to assess the severity of COVID‐19 pneumonia in 222 cases. Multivariate analyses were performed to find the predictors of CT‐SS, severe CT‐SS (≥20) and 1‐year mortality. Biomarkers of ferritin, high‐sensitive C‐reactive protein (CRP), lactate dehydrogenase (LDH), cardiac troponin (cTn), neutrophil‐to‐lymphocyte ratio (NLR), uric acid (UA) and d ‐dimer were routinely measured. Results: Severe CT‐SS (>20) was observed in 86 (31.2%) cases. Mortality was observed in 75 (27.2%) patients at 1 year. LDH displayed the highest predictive accuracy for severe CT‐SS (AUC 0.741, sensitivity = 81% and specificity = 68%, cut‐off value: 360 mg/dl). Linear regression analysis displayed that LDH predicted CT‐SS [B = 11 (95% CI for B = 5–17, p < .001)]. Age was the most significant parameter that was associated with severe CT‐SS (OR 0.96, 95% CI 0.92–0.99, p = .015). d ‐dimer was the only biomarker that predicted with 1‐year mortality (OR 1.62, 95% CI 1.08–2.42, p = .020). Conclusion: LDH is a sensitive and specific biomarker to determine patients with severe lung injury in COVID‐19. d ‐dimer is the only biomarker that predicts 1‐year mortality. Neither LDH nor CT‐SS is associated with 1‐year mortality.