The Influence of inflammatory factors (IL-6, CRP, NLPR, D-Dimer, LDH) on the PaO2/FiO2 ratio, in patients with severe and critical degrees of COVID-19

Authors

  • Yulia Octaviany Harnoto Department of Pulmonology and Respiratory Health, Faculty of Medicine, University of Lambung Mangkurat, Ulin Hospital, Banjarmasin, Indonesia, Indonesia
  • Ali Assagaf Department of Pulmonology and Respiratory Health, Faculty of Medicine, University of Lambung Mangkurat, Ulin Hospital, Banjarmasin, Indonesia, Indonesia
  • Dewi Indah Noviana Pratiwi Department of Clinical Pathology, Faculty of Medicine, Lambung Mangkurat University, Ulin Hospital, Banjarmasin, Indonesia, Indonesia
  • Mohamad Isa Department of Pulmonology and Respiratory Health, Faculty of Medicine, University of Lambung Mangkurat, Ulin Hospital, Banjarmasin, Indonesia, Indonesia
  • Ira Nurrasyidah Department of Pulmonology and Respiratory Health, Faculty of Medicine, University of Lambung Mangkurat, Ulin Hospital, Banjarmasin, Indonesia, Indonesia
  • Erna Kusumawardhani Department of Pulmonology and Respiratory Health, Faculty of Medicine, University of Lambung Mangkurat, Ulin Hospital, Banjarmasin, Indonesia, Indonesia

DOI:

https://doi.org/10.36408/mhjcm.v10i3.1014

Keywords:

COVID-19, PaO2/FiO2 ratio, NLPR, LDH, D-dimer

Abstract

BACKGROUND: Several types of inflammatory biomarkers that are important in severe and critical Covid-19 infections include: levels of IL-6, C-reactive protein (CRP), lactate dehydrogenase (LDH), D-Dimer and neutrophil-lymphocyte platelet ratio (NLRP), which are independent variables. Meanwhile, the severity of Covid-19 infection can be determined by measuring the PaO2 /FiO2 ratio. However, the relationship between the PaO2/FiO2 ratio as the dependent variable is not yet known.

AIMS: To analyze the relationship between PaO2/FiO2 ratio and inflammatory biomarkers in COVID-19 patients

METHOD: An analytic observational study with a retrospective, cross-sectional approach. The research sample consisted of PCR-confirmed severe and critical COVID-19 patients who were treated in the isolation room of the Ulin Hospital in Banjarmasin from August–December 2021, who met the inclusion and exclusion criteria. Data analysis used the Spearman test to see the relationship between the PaO2/FiO2 ratio and various inflammatory markers.

RESULT: 52 severe and critical patients were observed according to the research flow. The number of male and female subjects (32/20) was found. The mean age was 55.38 years. The correlation test found that: there was no significant relationship between the PaO2/FiO2 ratio and IL-6 (p = 0.964), but there was a negative correlation between the PaO2/FiO2 ratio and: a).CRP (p = 0.038), b).LDH ( p<0.001), c).NLPR (p = 0.013), and d). D-dimer (p<0.001). The inflammatory biomarkers NLPR, LDH, and D-dimer are important independent variables for the severity of COVID-19, namely the PaO2/FiO2 ratio.

CONCLUSION: There are a significant correlation between the PaO2/FiO2 ratio to measure the severity of Covid-19 and several inflammatory biomarkers CRP, LDH, NLPR and D-dimer

 

Downloads

Download data is not yet available.

References

1. Aslan A, Aslan C, Zolbanin NM, Jafari R. Acute respiratory distress syndrome in COVID-19: possible mechanisms and therapeutic management. Pneumonia [Internet]. 2021;13(1).

2. Majidpoor J, Mortezaee K. Interleukin-6 in SARS-CoV-2 induced disease: Interactions and therapeutic applications. Biomed Pharmacother [Internet]. 2022;145:112419.

3. Bonaventura A, Mumoli N, Mazzone A, Colombo A, Evangelista I, Cerutti S, et al. Correlation of SpO2/FiO2 and PaO2/FiO2 in patients with symptomatic COVID-19: An observational, retrospective study. Intern Emerg Med. 2022;17(6):1769–75.

4. Gu Y, Wang D, Chen C, Lu W, Liu H, Lv T, et al. PaO2/FiO2 and IL-6 are risk factors of mortality for intensive care COVID-19 patients. Sci Rep [Internet]. 2021;11(1):1–8.

5. Stringer D, Braude P, Myint PK, Evans L, Collins JT, Verduri A, et al. The role of C-reactive protein as a prognostic marker in COVID-19. Int J Epidemiol. 2021 May 17;50(2):420–9.

6. Eljilany I, Elzouki AN. D-dimer, fibrinogen, and il-6 in covid-19 patients with suspected venous thromboembolism: A narrative review. Vasc Health Risk Manag. 2020;16:455–62.

7. Ghobadi H, Mohammadshahi J, Javaheri N, Fouladi N, Mirzazadeh Y, Aslani MR. Role of leukocytes and systemic inflammation indexes (NLR, PLR, MLP, dNLR, NLPR, AISI, SIR-I, and SII) on admission predicts in-hospital mortality in non-elderly and elderly COVID-19 patients. Front Med. 2022;9.

8. Ade Saputro T, Vita Purwaningsih N, Watoyani T, Aliviameita A. Correlation between Corona Viruses Disease (Covid-19) and C-Reactive Protein (CRP) in Patients at Haji Hospital Surabaya Hubungan Corona Viruses Disease (Covid-19) Dan C-Reactive Protein (CRP) Pada Pasien Di Rumah Sakit Umum Haji Surabaya. 2022;5(1).

9. Fialek B, Pruc M, Smereka J, Jas R, Rahnama-Hezavah M, Denegri A, et al. Diagnostic value of lactate dehydrogenase in COVID-19: A systematic review and meta-analysis. Cardiol J. 2022;29(5):751–8.

10. Riandini HM, Syarani F, Bihar S, Eyanoer PC. Original Article The Associations Between Severity Of Symptoms , D-Dimer and Incidence of ARDS In COVID-19. 2022;2(3):143–7.

11. Rumaratu SPH, Putra NPP, Sugiri YJ, Djajalaksana S, Listyoko AS, Al Rasyid H. The Effect of N-Acetylcysteine as Adjuvant Therapy of Hypoxemia in COVID-19 Patients, Assessed by Interleukin-6 Level and PaO2/FiO2 Ratio. J Respirologi Indones. 2022;42(3):226–36.

12. Zinellu A, De Vito A, Scano V, Paliogiannis P, Fiore V, Madeddu G, et al. The PaO2/FiO2ratio on admission is independently associated with prolonged hospitalization in COVID-19 patients. J Infect Dev Ctries. 2021;15(3):353–9.

13. Statsenko Y, Zahmi F Al, Habuza T, Almansoori TM, Smetanina D, Simiyu GL, et al. Impact of Age and Sex on COVID-19 Severity Assessed From Radiologic and Clinical Findings. 2022;11(February).

14. Hu C, Li J, Xing X, Gao J, Zhao S, Xing L. The effect of age on the clinical and immune characteristics of critically ill patients with COVID-19: A preliminary report. PLoS One [Internet]. 2021;16(3 March):1–11.

15. Fu Y, Cheng Y, Wu Y. Understanding SARS-CoV-2-Mediated Inflammatory Responses: From Mechanisms to Potential Therapeutic Tools. Virol Sin [Internet]. 2020;35(3):266–71.

16. Syahrini H, Fadjari TH, Dalimoenthe NZ. Neutrophil-Lymphocyte Ratio (NLR) and Lymphocyte-Monocyte Ratio (LMR) as Covid-19 Screening Parameters. Indones J Med Lab Sci Technol. 2022;4(1):10–23.

17. Haryati H, Wicaksono B, Syahadatina M. Complete blood count derived inflammation indexes predict outcome in COVID-19 patients: a study in Indonesia. J Infect Dev Ctries [Internet]. 2023;17(3):319–26.

18. Agustama A, Utariani A, Kriswidyatomo P, Surya Airlangga P, Pujo Semedi B. Correlation of Neutrophil Elastase to D-Dimer, Pao2/Fio2 Ratio and SOFA Score In COVID-19 Patients. Int J Res Publ. 2022;93(1):251–7.

19. Parthasarathi A, Basavaraja CK, Arunachala S, Chandran S, Venkataraman H, Satheesh A, et al. Comorbidities influence the predictive power of hematological markers for mortality in hospitalized COVID-19 patients. Adv Respir Med. 2022;90(1):49–59.

20. Yanti B, Agustika R, Zulfikar T. Correlation Between Lymphocyte and Clinical Severity of Covid-19 in Banda Aceh, Indonesia. Malaysian J Public Heal Med. 2022;22(1):213–9.

21. Zaid Y, Guessous F, Puhm F, Elhamdani W, Chentoufi L, Morris AC, et al. Platelet reactivity to thrombin differs between patients with COVID-19 and those with ARDS unrelated to COVID-19. Blood Adv. 2021;5(3):635–9.

22. Wang R, Dai H. Association of platelet count with all-cause mortality from acute respiratory distress syndrome: A cohort study. J Clin Lab Anal. 2022;36(5):1–7.

23. Fazal M. C-Reactive Protein a Promising Biomarker of COVID-19 Severity. Korean J Clin Lab Sci. 2021;53(3):201–7.

24. Erika P, Domenica Z, Paolo I, Luca R, Giulia L, Alessandro D, et al. Lactate dehydrogenase and C-reactive protein as predictors of respiratory failure in CoVID-19 patients. Clin Chim Acta. 2020 Oct 1;509:135–8.

25. Kojima K, Yoon H, Okishio K, Tsuyuguchi K. Increased lactate dehydrogenase reflects the progression of COVID-19 pneumonia on chest computed tomography and predicts subsequent severe disease. Sci Rep [Internet]. 2023;13(1):1–10.

26. Mubarak R, Esa T, Widaningsih Y, Bahrun U. D-Dimer Analysis in COVID-19 Patients. Vol. 28, Indonesian Journal of Clinical Pathology and Medical Laboratory. 2021. p. 5–9.

27. Loffredo L, Pignatelli P, Pirro M, Ceccarelli G, Oliva A, Maggio E, et al. Association between ­ PaO 2 / FiO 2 ratio and thrombotic events in COVID ‑ 19 patients. 2023;(0123456789).

28. Leonora Trisna G, Utariani A, Pujo Semedi B. Relationship of Ferritin, Interleukin-8, and D-Dimer Levels with PaO2/FiO2 Ratio and Mortality in ARDS COVID-19. Int J Res Publ. 2021;92(1):106–15.

29. Herold T, Jurinovic V, Arnreich C, Lipworth BJ. Elevated levels of IL-6 and CRP predict the need for mechanical ventilation in COVID-19. 2020;(January).

30. Rosales C. Neutrophil: A cell with many roles in inflammation or several cell types? Front Physiol. 2018;9(FEB):1–17.

Additional Files

Published

2023-11-29

How to Cite

1.
Harnoto YO, Assagaf A, Pratiwi DIN, Isa M, Nurrasyidah I, Kusumawardhani E. The Influence of inflammatory factors (IL-6, CRP, NLPR, D-Dimer, LDH) on the PaO2/FiO2 ratio, in patients with severe and critical degrees of COVID-19. Medica Hospitalia J. Clin. Med. [Internet]. 2023 Nov. 29 [cited 2024 May 14];10(3):352-8. Available from: http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/1014

Issue

Vol. 10 No. 3 (2023): Med Hosp; Nov 2023

Section

Original Article

Citation Check

License

Copyright (c) 2023 Yulia Octaviany Harnoto, Ali Assagaf, Dewi Indah Noviana Pratiwi, Mohamad Isa, Ira Nurrasyidah, Erna Kusumawardhani

Creative Commons License

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Copyrights Notice
Copyrights:
Researchers publishing manuscrips at Medica Hospitalis: Journal of Clinical Medicine agree with regulations as follow:
Copyrights of each article belong to researchers, and it is likewise the patent rights
Researchers admit that Medica Hospitalia: Journal of Clinical Medicine has the right of first publication
Researchers may submit manuscripts separately, manage non exclusive distribution of published manuscripts into other versions (such as: being sent to researchers’ institutional repository, publication in the books, etc), admitting that manuscripts have been firstly published at Medica Hospitalia: Journal of Clinical Medicine
License:
Medica Hospitalia: Journal of Clinical Medicine is disseminated based on provisions of Creative Common Attribution-Share Alike 4.0 Internasional It allows individuals to duplicate and disseminate manuscripts in any formats, to alter, compose and make derivatives of manuscripts for any purpose. You are not allowed to use manuscripts for commercial purposes. You should properly acknowledge, reference links, and state that alterations have been made. You can do so in proper ways, but it does not hint that the licensors support you or your usage.