Selection of an Optimal Combination Panel to Better Triage COVID-19 Hospitalized Patients

Yueting Tang,1 Yirong Li,1 Jiayu Sun,2 Huaqin Pan,3 Fen Yao,2 Xiaoyang Jiao2 1Department of Clinical Laboratory, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China; 2Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, Guangdong...

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Autores principales:	Tang Y, Li Y, Sun J, Pan H, Yao F, Jiao X
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	covid-19 diagnostic panel cytokine acute phase protein Pathology RB1-214 Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/cd8a720b5e374c1f8f1d8739980bf8bc
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spelling	oai:doaj.org-article:cd8a720b5e374c1f8f1d8739980bf8bc2021-12-02T12:10:00ZSelection of an Optimal Combination Panel to Better Triage COVID-19 Hospitalized Patients1178-7031https://doaj.org/article/cd8a720b5e374c1f8f1d8739980bf8bc2020-10-01T00:00:00Zhttps://www.dovepress.com/selection-of-an-optimal-combination-panel-to-better-triage-covid-19-ho-peer-reviewed-article-JIRhttps://doaj.org/toc/1178-7031Yueting Tang,1 Yirong Li,1 Jiayu Sun,2 Huaqin Pan,3 Fen Yao,2 Xiaoyang Jiao2 1Department of Clinical Laboratory, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China; 2Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, Guangdong, People’s Republic of China; 3Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of ChinaCorrespondence: Xiaoyang JiaoShantou University Medical College, Shantou, Guangdong, People’s Republic of ChinaTel +86-754-88900459Fax +86-754-88557562Email xyjiao@stu.edu.cnPurpose: It is difficult to predict the prognosis of COVID-19 patients at the disease onset. This study was designed to add new biomarkers into conventional inflammatory panels to build an optimal combination panel, to better triage patients and predict their outcomes.Patients and Methods: Biochemical parameters representing multi-organ functions, cytokines, acute-phase proteins, and other inflammatory markers were measured in COVID-19 patients on hospital admission. Receiver operating characteristic (ROC) curves, logistic regression, event-free survival (EFS), and Cox analyses were performed to screen and compare the predictive capabilities of the new panel in patients with different illness severity and outcome.Results: This study included 120 patients with COVID-19, consisting of 32 critical, 28 severe, and 60 mild/moderate patients. Initial levels of the selected biomarkers showed a significant difference in the three groups, all of which influenced patient outcome and EFS to varying degrees. Cox proportional hazard model revealed that procalcitonin (PCT) and interleukin 10 (IL-10) were independent risk factors, while superoxide dismutase (SOD) was an independent protective factor influencing EFS. In discriminating the critical and mild patients, a panel combining PCT, IL-6, and neutrophil (NEUT) yielded the best diagnostic performance with an AUC of 0.99, the sensitivity of 90.60% and specificity of 100%. In distinguishing between severe and mild patients, SOD’s AUC of 0.89 was higher than any other single biomarker. In differentiating the critical and severe patients, the combination of white blood cell count (WBC), PCT, IL-6, IL-10, and SOD achieved the highest AUC of 0.95 with a sensitivity of 75.00% and specificity of 100%.Conclusion: The optimal combination panel has a substantial potential to better triage COVID-19 patients on admission. Better triage of patients will benefit the rational use of medical resources.Keywords: COVID-19, diagnostic panel, cytokine, acute-phase proteinTang YLi YSun JPan HYao FJiao XDove Medical Pressarticlecovid-19diagnostic panelcytokineacute phase proteinPathologyRB1-214Therapeutics. PharmacologyRM1-950ENJournal of Inflammation Research, Vol Volume 13, Pp 773-787 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	covid-19 diagnostic panel cytokine acute phase protein Pathology RB1-214 Therapeutics. Pharmacology RM1-950
spellingShingle	covid-19 diagnostic panel cytokine acute phase protein Pathology RB1-214 Therapeutics. Pharmacology RM1-950 Tang Y Li Y Sun J Pan H Yao F Jiao X Selection of an Optimal Combination Panel to Better Triage COVID-19 Hospitalized Patients
description	Yueting Tang,1 Yirong Li,1 Jiayu Sun,2 Huaqin Pan,3 Fen Yao,2 Xiaoyang Jiao2 1Department of Clinical Laboratory, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China; 2Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, Guangdong, People’s Republic of China; 3Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of ChinaCorrespondence: Xiaoyang JiaoShantou University Medical College, Shantou, Guangdong, People’s Republic of ChinaTel +86-754-88900459Fax +86-754-88557562Email xyjiao@stu.edu.cnPurpose: It is difficult to predict the prognosis of COVID-19 patients at the disease onset. This study was designed to add new biomarkers into conventional inflammatory panels to build an optimal combination panel, to better triage patients and predict their outcomes.Patients and Methods: Biochemical parameters representing multi-organ functions, cytokines, acute-phase proteins, and other inflammatory markers were measured in COVID-19 patients on hospital admission. Receiver operating characteristic (ROC) curves, logistic regression, event-free survival (EFS), and Cox analyses were performed to screen and compare the predictive capabilities of the new panel in patients with different illness severity and outcome.Results: This study included 120 patients with COVID-19, consisting of 32 critical, 28 severe, and 60 mild/moderate patients. Initial levels of the selected biomarkers showed a significant difference in the three groups, all of which influenced patient outcome and EFS to varying degrees. Cox proportional hazard model revealed that procalcitonin (PCT) and interleukin 10 (IL-10) were independent risk factors, while superoxide dismutase (SOD) was an independent protective factor influencing EFS. In discriminating the critical and mild patients, a panel combining PCT, IL-6, and neutrophil (NEUT) yielded the best diagnostic performance with an AUC of 0.99, the sensitivity of 90.60% and specificity of 100%. In distinguishing between severe and mild patients, SOD’s AUC of 0.89 was higher than any other single biomarker. In differentiating the critical and severe patients, the combination of white blood cell count (WBC), PCT, IL-6, IL-10, and SOD achieved the highest AUC of 0.95 with a sensitivity of 75.00% and specificity of 100%.Conclusion: The optimal combination panel has a substantial potential to better triage COVID-19 patients on admission. Better triage of patients will benefit the rational use of medical resources.Keywords: COVID-19, diagnostic panel, cytokine, acute-phase protein
format	article
author	Tang Y Li Y Sun J Pan H Yao F Jiao X
author_facet	Tang Y Li Y Sun J Pan H Yao F Jiao X
author_sort	Tang Y
title	Selection of an Optimal Combination Panel to Better Triage COVID-19 Hospitalized Patients
title_short	Selection of an Optimal Combination Panel to Better Triage COVID-19 Hospitalized Patients
title_full	Selection of an Optimal Combination Panel to Better Triage COVID-19 Hospitalized Patients
title_fullStr	Selection of an Optimal Combination Panel to Better Triage COVID-19 Hospitalized Patients
title_full_unstemmed	Selection of an Optimal Combination Panel to Better Triage COVID-19 Hospitalized Patients
title_sort	selection of an optimal combination panel to better triage covid-19 hospitalized patients
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/cd8a720b5e374c1f8f1d8739980bf8bc
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Selection of an Optimal Combination Panel to Better Triage COVID-19 Hospitalized Patients

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