PLoS ONE (Jan 2021)

Early risk markers for severe clinical course and fatal outcome in German patients with COVID-19.

  • Paul Balfanz,
  • Bojan Hartmann,
  • Dirk Müller-Wieland,
  • Michael Kleines,
  • Dennis Häckl,
  • Nils Kossack,
  • Alexander Kersten,
  • Christian Cornelissen,
  • Tobias Müller,
  • Ayham Daher,
  • Robert Stöhr,
  • Johannes Bickenbach,
  • Gernot Marx,
  • Nikolaus Marx,
  • Michael Dreher

DOI
https://doi.org/10.1371/journal.pone.0246182
Journal volume & issue
Vol. 16, no. 1
p. e0246182

Abstract

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BackgroundSome patients with Corona Virus Disease 2019 (COVID-19) develop a severe clinical course with acute respiratory distress syndrome (ARDS) and fatal outcome. Clinical manifestations and biomarkers in early stages of disease with relevant predictive impact for outcomes remain largely unexplored. We aimed to identify parameters which are significantly different between subgroups.Design125 patients with COVID-19 were analysed. Patients with ARDS (N = 59) or non-ARDS (N = 66) were compared, as well as fatal outcome versus survival in the two groups.Key resultsARDS and non-ARDS patients did not differ with respect to comorbidities or medication on developing a fatal outcome versus survival. Body mass index was higher in patients with ARDS versus non-ARDS (p = 0.01), but not different within the groups in survivors versus non-survivors. Interleukin-6 levels on admission were higher in patients with ARDS compared to non-ARDS as well as in patients with fatal outcome versus survivors, whereas lymphocyte levels were lower in the different subgroups (all pConclusionsWe have identified early risk markers for a severe clinical course, like ARDS or fatal outcome. This data might help develop a strategy to address new therapeutic options early in patients with COVID-19 and at high risk for fatal outcome.