The spectrum of biochemical alterations associated with organ dysfunction and inflammatory status and their association with disease outcomes in severe COVID-19: A longitudinal cohort and time-series design study
Background: In patients with severe COVID-19, no data are available on the longitudinal evolution of biochemical abnormalities and their ability to predict disease outcomes. Methods: Using a retrospective, longitudinal cohort study design on consecutive patients with severe COVID-19, we used an exte...
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Format: | Article |
Language: | English |
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Elsevier
2020-10-01
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Series: | EClinicalMedicine |
Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537020302984 |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Abderrahim Oussalah Stanislas Gleye Isabelle Clerc Urmes Elodie Laugel Françoise Barbé Sophie Orlowski Catherine Malaplate Isabelle Aimone-Gastin Beatrice Maatem Caillierez Marc Merten Elise Jeannesson Raphaël Kormann Jean-Luc Olivier Rosa-Maria Rodriguez-Guéant Farès Namour Sybille Bevilacqua Nathalie Thilly Marie-Reine Losser Antoine Kimmoun Luc Frimat Bruno Levy Sébastien Gibot Evelyne Schvoerer Jean-Louis Guéant |
spellingShingle |
Abderrahim Oussalah Stanislas Gleye Isabelle Clerc Urmes Elodie Laugel Françoise Barbé Sophie Orlowski Catherine Malaplate Isabelle Aimone-Gastin Beatrice Maatem Caillierez Marc Merten Elise Jeannesson Raphaël Kormann Jean-Luc Olivier Rosa-Maria Rodriguez-Guéant Farès Namour Sybille Bevilacqua Nathalie Thilly Marie-Reine Losser Antoine Kimmoun Luc Frimat Bruno Levy Sébastien Gibot Evelyne Schvoerer Jean-Louis Guéant The spectrum of biochemical alterations associated with organ dysfunction and inflammatory status and their association with disease outcomes in severe COVID-19: A longitudinal cohort and time-series design study EClinicalMedicine |
author_facet |
Abderrahim Oussalah Stanislas Gleye Isabelle Clerc Urmes Elodie Laugel Françoise Barbé Sophie Orlowski Catherine Malaplate Isabelle Aimone-Gastin Beatrice Maatem Caillierez Marc Merten Elise Jeannesson Raphaël Kormann Jean-Luc Olivier Rosa-Maria Rodriguez-Guéant Farès Namour Sybille Bevilacqua Nathalie Thilly Marie-Reine Losser Antoine Kimmoun Luc Frimat Bruno Levy Sébastien Gibot Evelyne Schvoerer Jean-Louis Guéant |
author_sort |
Abderrahim Oussalah |
title |
The spectrum of biochemical alterations associated with organ dysfunction and inflammatory status and their association with disease outcomes in severe COVID-19: A longitudinal cohort and time-series design study |
title_short |
The spectrum of biochemical alterations associated with organ dysfunction and inflammatory status and their association with disease outcomes in severe COVID-19: A longitudinal cohort and time-series design study |
title_full |
The spectrum of biochemical alterations associated with organ dysfunction and inflammatory status and their association with disease outcomes in severe COVID-19: A longitudinal cohort and time-series design study |
title_fullStr |
The spectrum of biochemical alterations associated with organ dysfunction and inflammatory status and their association with disease outcomes in severe COVID-19: A longitudinal cohort and time-series design study |
title_full_unstemmed |
The spectrum of biochemical alterations associated with organ dysfunction and inflammatory status and their association with disease outcomes in severe COVID-19: A longitudinal cohort and time-series design study |
title_sort |
spectrum of biochemical alterations associated with organ dysfunction and inflammatory status and their association with disease outcomes in severe covid-19: a longitudinal cohort and time-series design study |
publisher |
Elsevier |
series |
EClinicalMedicine |
issn |
2589-5370 |
publishDate |
2020-10-01 |
description |
Background: In patients with severe COVID-19, no data are available on the longitudinal evolution of biochemical abnormalities and their ability to predict disease outcomes. Methods: Using a retrospective, longitudinal cohort study design on consecutive patients with severe COVID-19, we used an extensive biochemical dataset of serial data and time-series design to estimate the occurrence of organ dysfunction and the severity of the inflammatory reaction and their association with acute respiratory failure (ARF) and death. Findings: On the 162 studied patients, 1151 biochemical explorations were carried out for up to 59 biochemical markers, totaling 15,260 biochemical values. The spectrum of biochemical abnormalities and their kinetics were consistent with a multi-organ involvement, including lung, kidney, heart, liver, muscle, and pancreas, along with a severe inflammatory syndrome. The proportion of patients who developed an acute kidney injury (AKI) stage 3, increased significantly during follow-up (0·9%, day 0; 21·4%, day 14; P<0·001). On the 20 more representative biochemical markers (>250 iterations), only CRP >90 mg/L (odds ratio [OR] 6·87, 95% CI, 2·36–20·01) and urea nitrogen >0·36 g/L (OR 3·91, 95% CI, 1·15–13·29) were independently associated with the risk of ARF. Urea nitrogen >0·42 g/L was the only marker associated with the risk of COVID-19 related death. Interpretation: Our results point out the lack of the association between the inflammatory markers and the risk of death but rather highlight a significant association between renal dysfunction and the risk of COVID-19 related acute respiratory failure and death. |
url |
http://www.sciencedirect.com/science/article/pii/S2589537020302984 |
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doaj-e2149a7db628491d977b018dd8df1f082020-11-25T03:36:40ZengElsevierEClinicalMedicine2589-53702020-10-0127100554The spectrum of biochemical alterations associated with organ dysfunction and inflammatory status and their association with disease outcomes in severe COVID-19: A longitudinal cohort and time-series design studyAbderrahim Oussalah0Stanislas Gleye1Isabelle Clerc Urmes2Elodie Laugel3Françoise Barbé4Sophie Orlowski5Catherine Malaplate6Isabelle Aimone-Gastin7Beatrice Maatem Caillierez8Marc Merten9Elise Jeannesson10Raphaël Kormann11Jean-Luc Olivier12Rosa-Maria Rodriguez-Guéant13Farès Namour14Sybille Bevilacqua15Nathalie Thilly16Marie-Reine Losser17Antoine Kimmoun18Luc Frimat19Bruno Levy20Sébastien Gibot21Evelyne Schvoerer22Jean-Louis Guéant23Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, F-54000 Nancy, France; Faculty of Medicine of Nancy, University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), F-54000 Nancy, France; Corresponding author at: Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, F-54000 Nancy, France.Department of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, F-54000 Nancy, FranceDepartment of Methodology, Promotion and Investigation, University of Lorraine, University Hospital of Nancy, F-54000 Nancy, FranceDepartment of Virology, University Hospital of Nancy, F-54000 Nancy, France; Laboratory of Physical Chemistry and Microbiology for the Environment, LCPME UMR 7564 CNRS-UL, F-54600 Villers-les-Nancy, FranceDepartment of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, F-54000 Nancy, FranceDepartment of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, F-54000 Nancy, FranceDepartment of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, F-54000 Nancy, FranceDepartment of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, F-54000 Nancy, France; Faculty of Medicine of Nancy, University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), F-54000 Nancy, FranceDepartment of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, F-54000 Nancy, FranceDepartment of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, F-54000 Nancy, France; Faculty of Medicine of Nancy, University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), F-54000 Nancy, FranceDepartment of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, F-54000 Nancy, FranceDepartment of Nephrology, University Hospital of Nancy, F-54000 Nancy, FranceDepartment of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, F-54000 Nancy, FranceDepartment of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, F-54000 Nancy, France; Faculty of Medicine of Nancy, University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), F-54000 Nancy, FranceDepartment of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, F-54000 Nancy, France; Faculty of Medicine of Nancy, University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), F-54000 Nancy, FranceDepartment of Infectious Diseases, University Hospital of Nancy, F-54000 Nancy, FranceDepartment of Methodology, Promotion and Investigation, University of Lorraine, University Hospital of Nancy, F-54000 Nancy, FranceDepartment of Anesthesiology and Intensive Care Medicine, University Hospital of Nancy, Vandoeuvre-Lès-Nancy F-54511, FranceMedical Intensive Care Unit, University Hospital of Nancy, Brabois Hospital, F-54000 Nancy, FranceDepartment of Nephrology, University Hospital of Nancy, F-54000 Nancy, FranceMedical Intensive Care Unit, University Hospital of Nancy, Brabois Hospital, F-54000 Nancy, FranceMedical Intensive Care Unit, University Hospital of Nancy, Central Hospital, F-54000 Nancy, FranceDepartment of Virology, University Hospital of Nancy, F-54000 Nancy, France; Laboratory of Physical Chemistry and Microbiology for the Environment, LCPME UMR 7564 CNRS-UL, F-54600 Villers-les-Nancy, FranceDepartment of Molecular Medicine, Division of Biochemistry, Molecular Biology, and Nutrition, University Hospital of Nancy, F-54000 Nancy, France; Faculty of Medicine of Nancy, University of Lorraine, INSERM UMR_S 1256, Nutrition, Genetics, and Environmental Risk Exposure (NGERE), F-54000 Nancy, FranceBackground: In patients with severe COVID-19, no data are available on the longitudinal evolution of biochemical abnormalities and their ability to predict disease outcomes. Methods: Using a retrospective, longitudinal cohort study design on consecutive patients with severe COVID-19, we used an extensive biochemical dataset of serial data and time-series design to estimate the occurrence of organ dysfunction and the severity of the inflammatory reaction and their association with acute respiratory failure (ARF) and death. Findings: On the 162 studied patients, 1151 biochemical explorations were carried out for up to 59 biochemical markers, totaling 15,260 biochemical values. The spectrum of biochemical abnormalities and their kinetics were consistent with a multi-organ involvement, including lung, kidney, heart, liver, muscle, and pancreas, along with a severe inflammatory syndrome. The proportion of patients who developed an acute kidney injury (AKI) stage 3, increased significantly during follow-up (0·9%, day 0; 21·4%, day 14; P<0·001). On the 20 more representative biochemical markers (>250 iterations), only CRP >90 mg/L (odds ratio [OR] 6·87, 95% CI, 2·36–20·01) and urea nitrogen >0·36 g/L (OR 3·91, 95% CI, 1·15–13·29) were independently associated with the risk of ARF. Urea nitrogen >0·42 g/L was the only marker associated with the risk of COVID-19 related death. Interpretation: Our results point out the lack of the association between the inflammatory markers and the risk of death but rather highlight a significant association between renal dysfunction and the risk of COVID-19 related acute respiratory failure and death.http://www.sciencedirect.com/science/article/pii/S2589537020302984 |