S45 Inflammatory biomarkers as predictors of mortality and persistent symptoms at follow-up in patients with severe COVID-19. (11th November 2022)

• Record Type: Journal Article
• Authors: Sykes, DL; Holdsworth, L; O'Halloran, J; Vanderfeltz-Cornelis, C; Holding, S; Crooks, MG
• Is Part Of: Thorax. Volume 77(2022)Supplement 1
• Page Start: A31
• Page End: A31
• Publication Date: 2022-11-11
• Subjects: Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thorax-2022-BTSabstracts.51
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Introduction: Inflammatory biomarkers such as C-reactive protein (CRP) are an established tool for predicting mortality in COVID-19 patients. The role of biomarkers such as Interleukin-6 (IL-6) have also been studied, with anti-IL-6 therapy now a cornerstone of treatment of COVID-19. Data have also suggested that such biomarkers are persistently elevated in patients with Long-COVID. In this study we aimed to assess the relationship between a panel of biomarkers (CRP, IL-6, troponin-T, and ferritin), inpatient mortality, and persistent symptoms post-discharge in COVID-19 survivors. Methods: Data were collected prospectively for all patients with COVID-19 admitted between 1stSeptember 2020 and 10th January 2021 at a single NHS teaching hospital trust. Admission CRP, IL-6, ferritin, and troponin-T (TT) were analysed as part of routine clinical care and collected alongside routinely collected clinical data. A standardised dataset was collected for survivors when they attended clinical follow-up with the local post-hospitalisation COVID-19 follow-up service. The relationship between inflammatory biomarkers and symptoms at follow-up was evaluated post-hoc. Results: A total of 626 patients (mean age 70.1 [SD=15.8], 55% male) had all biomarkers recorded and were included in the analysis. There overall mortality rate in this cohort was 28.4%. Log rank testing revealed higher levels of IL-6 (p<0.001) and troponin-T (p<0.001) were associated with a significantly higher risk of inpatient mortality. When levels of IL-6 and TT were split into quintiles, those in the highest quintiles had a >50% mortality rate, which was significantly higher than those in the lower quintiles ( figure 1 ). A total of 144 patients received 3-month follow-up, the commonest reported symptoms were fatigue (54.2%), breathlessness (52.8%), and sleep disturbance (37.5%). There was no association between elevated inflammatory biomarkers at hospital admission and reported symptoms at follow-up. There were no statistically significant associations between levels of inflammatory biomarkers on admission and presence of persistent symptoms at follow-up. Conclusions: Raised levels of IL-6 and TT on admission are associated with a significantly increased risk of inpatient mortality in those hospitalised with COVID-19, however, raised inflammatory markers at the time of hospital admission show no association with residual symptom burden at 3-month follow-up in surviving patients.