About: COVID-19-associated hyperinflammation and escalation of patient care: a retrospective longitudinal cohort study

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About: COVID-19-associated hyperinflammation and escalation of patient care: a retrospective longitudinal cohort study Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	COVID-19-associated hyperinflammation and escalation of patient care: a retrospective longitudinal cohort study
Creator	Brown, Michael Singer, Mervyn Rampling, Tommy Marks, Michael Mehta, Puja Duncan, Christopher Robinson, G Williams, Bryan Peng, J Baker, Kenneth Hanrath, Aidan Lendrem, Clare Luintel, Akish Manson, ( Manson, Jessica Schim Van Der Loeff, Ina Tattersall, Rachel De Soyza, Anthony Greenwood, M Peng, Junjie Adeney, Christopher Collin, Matthew Crooks, Colin Goulden, Bethan Greenwood, Mandy Hawkins, Ellie Jury, Elizabeth Khan, Emon Ledlie, Amanda Liddle, Trevor Martin-Gutierrez, Lucia Naja, Meena Peckham, Hannah Robinson, George Snell, Antonia Waddington, Kirsty Bari, J West, Joe Bsc, Bari Hawkins, E Khan, E Ledlie, A Ledlie, L Manson, A Martin-Gutierrez, Martin-Gutierrez, L Mbbs, Mehta Mbbs, Naja Mcloughlin, E Mcloughlin, Eve Naja, M Peckham, H Santos, Liliana Santos, Ribeiro Waddington, E Waddington, K
Source	Elsevier; PMC
abstract	BACKGROUND: A subset of patients with severe COVID-19 develop a hyperinflammatory syndrome, which might contribute to morbidity and mortality. This study explores a specific phenotype of COVID-19-associated hyperinflammation (COV-HI), and its associations with escalation of respiratory support and survival. METHODS: In this retrospective cohort study, we enrolled consecutive inpatients (aged ≥18 years) admitted to University College London Hospitals and Newcastle upon Tyne Hospitals in the UK with PCR-confirmed COVID-19 during the first wave of community-acquired infection. Demographic data, laboratory tests, and clinical status were recorded from the day of admission until death or discharge, with a minimum follow-up time of 28 days. We defined COV-HI as a C-reactive protein concentration greater than 150 mg/L or doubling within 24 h from greater than 50 mg/L, or a ferritin concentration greater than 1500 μg/L. Respiratory support was categorised as oxygen only, non-invasive ventilation, and intubation. Initial and repeated measures of hyperinflammation were evaluated in relation to the next-day risk of death or need for escalation of respiratory support (as a combined endpoint), using a multi-level logistic regression model. FINDINGS: We included 269 patients admitted to one of the study hospitals between March 1 and March 31, 2020, among whom 178 (66%) were eligible for escalation of respiratory support and 91 (34%) patients were not eligible. Of the whole cohort, 90 (33%) patients met the COV-HI criteria at admission. Despite having a younger median age and lower median Charlson Comorbidity Index scores, a higher proportion of patients with COV-HI on admission died during follow-up (36 [40%] of 90 patients) compared with the patients without COV-HI on admission (46 [26%] of 179). Among the 178 patients who were eligible for full respiratory support, 65 (37%) met the definition for COV-HI at admission, and 67 (74%) of the 90 patients whose respiratory care was escalated met the criteria by the day of escalation. Meeting the COV-HI criteria was significantly associated with the risk of next-day escalation of respiratory support or death (hazard ratio 2·24 [95% CI 1·62–2·87]) after adjustment for age, sex, and comorbidity. INTERPRETATION: Associations between elevated inflammatory markers, escalation of respiratory support, and survival in people with COVID-19 indicate the existence of a high-risk inflammatory phenotype. COV-HI might be useful to stratify patient groups in trial design. FUNDING: None.
has issue date	2020-08-21(xsd:dateTime)
bibo:doi	10.1016/s2665-9913(20)30275-7
has license	no-cc
sha1sum (hex)	7258b6644650c972c99f6b4dcfdb95cd84abc1f9
schema:url	https://doi.org/10.1016/s2665-9913%2820%2930275-7
resource representing a document's title	COVID-19-associated hyperinflammation and escalation of patient care: a retrospective longitudinal cohort study
has PubMed Central identifier	PMC7442426
schema:publication	Lancet Rheumatol
resource representing a document's body	covid:7258b6644650c972c99f6b4dcfdb95cd84abc1f9#body_text
is schema:about of	named entity 'care' named entity 'ASSOCIATIONS' named entity 'respiratory' named entity 'morbidity' named entity 'hyperinflammation' named entity 'subset' named entity 'morbidity' named entity 'longitudinal cohort study' named entity 'nasal cannulae' named entity 'WHO' named entity 'London' named entity 'face mask' named entity 'COVID' named entity 'BCL' named entity 'medical records' named entity 'viruses' named entity 'cytokine storm syndrome' named entity 'hyperinflammation' named entity 'biomarkers' named entity 'hyperinflammation' named entity 'data dictionary' named entity 'comorbidity' named entity 'Shionogi' named entity 'comorbidity' named entity 'Charlson Comorbidity Index' named entity 'LOESS' named entity 'immunomodulation' named entity 'acute respiratory distress syndrome'

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