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NEWS2 predicts severity of underlying inflammatory response and outcome in COVID-19 patients

M Howard, Ollie Watson, Jun-Cezar Zaldua Orcid Logo, Suresh Pillai, J Whitley, M Lawrence, Karl Hawkins Orcid Logo, Owen Guy Orcid Logo, Adrian Evans Orcid Logo

Critical Care, Volume: 26, Issue: S1, Pages: 25 - 26

Swansea University Authors: Ollie Watson, Jun-Cezar Zaldua Orcid Logo, Suresh Pillai, Karl Hawkins Orcid Logo, Owen Guy Orcid Logo, Adrian Evans Orcid Logo

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DOI (Published version): 10.1186/s13054-022-03927-z

Abstract

Introduction: COVID-19 is a severe respiratory disease associated with a marked inflammatory response. Clinical methods of assessing severity of disease, including National Early Warning Score 2 (NEWS2), have been shown to predict severity in COVID-19 [1]. However, little research has been undertake...

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Published in: Critical Care
ISSN: 1364-8535
Published: Springer Science and Business Media LLC 2022
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URI: https://cronfa.swan.ac.uk/Record/cronfa65240
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Clinical methods of assessing severity of disease, including National Early Warning Score 2 (NEWS2), have been shown to predict severity in COVID-19 [1]. However, little research has been undertaken comparing NEWS2 to underlying inflammatory processes. In this study, we assessed whether inflammatory markers taken at presentation to the Emergency Department could predict and mortality in COVID-19 patients.Methods: Whole blood samples were taken at admission to the emergency department for procalcitonin, fibrinogen, CRP, von Willebrand Factor (vWF), IL-6 and TNFα. NEWS2 was also recorded on admission. Levels of inflammatory markers were retrospectively compared to NEWS2 scores and mortality outcomes.Results: A total of 95 patients positive for COVID-19 were included. NEWS2 values &gt; 5 were associated with higher CRP (131.5 ± 87.9 vs 86.4 ± 106.5, p = 0.03), IL-6 (71.9 ± 111 vs 43.4 ± 99, p = 0.007), and vWF (334.1 ± 83.3 vs 296.3 ± 93.4, p = 0.04). The trend of increasing inflammatory markers was also shown in patients who died, significantly so for IL-6 (44.4 ± 54.97 vs 18.8 ± 48.36, p = 0.035). NEWS2 was also shown to be significantly higher in patients who died (7.8 ± 2.2 vs 4.3 ± 2.8, p =  &lt; 0.01).Conclusions: NEWS2 predicted the severity of underlying inflammatory response. All inflammatory markers showed a marked increase with severity and mortality, most significant with IL-6. This suggests NEWS2 and inflammatory markers may predict severity and mortality in COVID-19 patients. Further research is required to evaluate these mechanistic changes in inflammatory response.Reference1.Kostakis I et al. Resuscitation. 159:150–157, 2021.</abstract><type>Conference Paper/Proceeding/Abstract</type><journal>Critical Care</journal><volume>26</volume><journalNumber>S1</journalNumber><paginationStart>25</paginationStart><paginationEnd>26</paginationEnd><publisher>Springer Science and Business Media LLC</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>1364-8535</issnElectronic><keywords/><publishedDay>25</publishedDay><publishedMonth>3</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-03-25</publishedDate><doi>10.1186/s13054-022-03927-z</doi><url>http://dx.doi.org/10.1186/s13054-022-03927-z</url><notes/><college>COLLEGE NANME</college><department>Medicine, Health and Life Science - Faculty</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>FGMHL</DepartmentCode><institution>Swansea University</institution><apcterm/><funders/><projectreference/><lastEdited>2024-04-11T19:28:02.7864785</lastEdited><Created>2023-12-07T13:18:51.2767167</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Biomedical Science</level></path><authors><author><firstname>M</firstname><surname>Howard</surname><order>1</order></author><author><firstname>Ollie</firstname><surname>Watson</surname><order>2</order></author><author><firstname>Jun-Cezar</firstname><surname>Zaldua</surname><orcid>0000-0003-0315-5852</orcid><order>3</order></author><author><firstname>Suresh</firstname><surname>Pillai</surname><order>4</order></author><author><firstname>J</firstname><surname>Whitley</surname><order>5</order></author><author><firstname>M</firstname><surname>Lawrence</surname><order>6</order></author><author><firstname>Karl</firstname><surname>Hawkins</surname><orcid>0000-0003-0174-4151</orcid><order>7</order></author><author><firstname>Owen</firstname><surname>Guy</surname><orcid>0000-0002-6449-4033</orcid><order>8</order></author><author><firstname>Adrian</firstname><surname>Evans</surname><orcid>0000-0002-0814-5162</orcid><order>9</order></author></authors><documents><document><filename>65240__29365__cf9b2731b27a42f7978926291170e553.pdf</filename><originalFilename>65240.pdf</originalFilename><uploaded>2024-01-04T10:48:43.4268932</uploaded><type>Output</type><contentLength>8584156</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.</documentNotes><copyrightCorrect>false</copyrightCorrect><language>eng</language><licence>https://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling v2 65240 2023-12-07 NEWS2 predicts severity of underlying inflammatory response and outcome in COVID-19 patients ade04a9569ea949d1935673488770ab9 Ollie Watson Ollie Watson true false 8657447b46aaea58c1d3a36faa04e37f 0000-0003-0315-5852 Jun-Cezar Zaldua Jun-Cezar Zaldua true false f567f8d5db61d62ef08e811676fd8430 Suresh Pillai Suresh Pillai true false 77c39404a9a98c6e2283d84815cba053 0000-0003-0174-4151 Karl Hawkins Karl Hawkins true false c7fa5949b8528e048c5b978005f66794 0000-0002-6449-4033 Owen Guy Owen Guy true false 21761f6eb805546a561c9f036e85405b 0000-0002-0814-5162 Adrian Evans Adrian Evans true false 2023-12-07 FGMHL Introduction: COVID-19 is a severe respiratory disease associated with a marked inflammatory response. Clinical methods of assessing severity of disease, including National Early Warning Score 2 (NEWS2), have been shown to predict severity in COVID-19 [1]. However, little research has been undertaken comparing NEWS2 to underlying inflammatory processes. In this study, we assessed whether inflammatory markers taken at presentation to the Emergency Department could predict and mortality in COVID-19 patients.Methods: Whole blood samples were taken at admission to the emergency department for procalcitonin, fibrinogen, CRP, von Willebrand Factor (vWF), IL-6 and TNFα. NEWS2 was also recorded on admission. Levels of inflammatory markers were retrospectively compared to NEWS2 scores and mortality outcomes.Results: A total of 95 patients positive for COVID-19 were included. NEWS2 values > 5 were associated with higher CRP (131.5 ± 87.9 vs 86.4 ± 106.5, p = 0.03), IL-6 (71.9 ± 111 vs 43.4 ± 99, p = 0.007), and vWF (334.1 ± 83.3 vs 296.3 ± 93.4, p = 0.04). The trend of increasing inflammatory markers was also shown in patients who died, significantly so for IL-6 (44.4 ± 54.97 vs 18.8 ± 48.36, p = 0.035). NEWS2 was also shown to be significantly higher in patients who died (7.8 ± 2.2 vs 4.3 ± 2.8, p =  < 0.01).Conclusions: NEWS2 predicted the severity of underlying inflammatory response. All inflammatory markers showed a marked increase with severity and mortality, most significant with IL-6. This suggests NEWS2 and inflammatory markers may predict severity and mortality in COVID-19 patients. Further research is required to evaluate these mechanistic changes in inflammatory response.Reference1.Kostakis I et al. Resuscitation. 159:150–157, 2021. Conference Paper/Proceeding/Abstract Critical Care 26 S1 25 26 Springer Science and Business Media LLC 1364-8535 25 3 2022 2022-03-25 10.1186/s13054-022-03927-z http://dx.doi.org/10.1186/s13054-022-03927-z COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University 2024-04-11T19:28:02.7864785 2023-12-07T13:18:51.2767167 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Biomedical Science M Howard 1 Ollie Watson 2 Jun-Cezar Zaldua 0000-0003-0315-5852 3 Suresh Pillai 4 J Whitley 5 M Lawrence 6 Karl Hawkins 0000-0003-0174-4151 7 Owen Guy 0000-0002-6449-4033 8 Adrian Evans 0000-0002-0814-5162 9 65240__29365__cf9b2731b27a42f7978926291170e553.pdf 65240.pdf 2024-01-04T10:48:43.4268932 Output 8584156 application/pdf Version of Record true This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. false eng https://creativecommons.org/licenses/by/4.0/
title NEWS2 predicts severity of underlying inflammatory response and outcome in COVID-19 patients
spellingShingle NEWS2 predicts severity of underlying inflammatory response and outcome in COVID-19 patients
Ollie Watson
Jun-Cezar Zaldua
Suresh Pillai
Karl Hawkins
Owen Guy
Adrian Evans
title_short NEWS2 predicts severity of underlying inflammatory response and outcome in COVID-19 patients
title_full NEWS2 predicts severity of underlying inflammatory response and outcome in COVID-19 patients
title_fullStr NEWS2 predicts severity of underlying inflammatory response and outcome in COVID-19 patients
title_full_unstemmed NEWS2 predicts severity of underlying inflammatory response and outcome in COVID-19 patients
title_sort NEWS2 predicts severity of underlying inflammatory response and outcome in COVID-19 patients
author_id_str_mv ade04a9569ea949d1935673488770ab9
8657447b46aaea58c1d3a36faa04e37f
f567f8d5db61d62ef08e811676fd8430
77c39404a9a98c6e2283d84815cba053
c7fa5949b8528e048c5b978005f66794
21761f6eb805546a561c9f036e85405b
author_id_fullname_str_mv ade04a9569ea949d1935673488770ab9_***_Ollie Watson
8657447b46aaea58c1d3a36faa04e37f_***_Jun-Cezar Zaldua
f567f8d5db61d62ef08e811676fd8430_***_Suresh Pillai
77c39404a9a98c6e2283d84815cba053_***_Karl Hawkins
c7fa5949b8528e048c5b978005f66794_***_Owen Guy
21761f6eb805546a561c9f036e85405b_***_Adrian Evans
author Ollie Watson
Jun-Cezar Zaldua
Suresh Pillai
Karl Hawkins
Owen Guy
Adrian Evans
author2 M Howard
Ollie Watson
Jun-Cezar Zaldua
Suresh Pillai
J Whitley
M Lawrence
Karl Hawkins
Owen Guy
Adrian Evans
format Conference Paper/Proceeding/Abstract
container_title Critical Care
container_volume 26
container_issue S1
container_start_page 25
publishDate 2022
institution Swansea University
issn 1364-8535
doi_str_mv 10.1186/s13054-022-03927-z
publisher Springer Science and Business Media LLC
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Biomedical Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Biomedical Science
url http://dx.doi.org/10.1186/s13054-022-03927-z
document_store_str 1
active_str 0
description Introduction: COVID-19 is a severe respiratory disease associated with a marked inflammatory response. Clinical methods of assessing severity of disease, including National Early Warning Score 2 (NEWS2), have been shown to predict severity in COVID-19 [1]. However, little research has been undertaken comparing NEWS2 to underlying inflammatory processes. In this study, we assessed whether inflammatory markers taken at presentation to the Emergency Department could predict and mortality in COVID-19 patients.Methods: Whole blood samples were taken at admission to the emergency department for procalcitonin, fibrinogen, CRP, von Willebrand Factor (vWF), IL-6 and TNFα. NEWS2 was also recorded on admission. Levels of inflammatory markers were retrospectively compared to NEWS2 scores and mortality outcomes.Results: A total of 95 patients positive for COVID-19 were included. NEWS2 values > 5 were associated with higher CRP (131.5 ± 87.9 vs 86.4 ± 106.5, p = 0.03), IL-6 (71.9 ± 111 vs 43.4 ± 99, p = 0.007), and vWF (334.1 ± 83.3 vs 296.3 ± 93.4, p = 0.04). The trend of increasing inflammatory markers was also shown in patients who died, significantly so for IL-6 (44.4 ± 54.97 vs 18.8 ± 48.36, p = 0.035). NEWS2 was also shown to be significantly higher in patients who died (7.8 ± 2.2 vs 4.3 ± 2.8, p =  < 0.01).Conclusions: NEWS2 predicted the severity of underlying inflammatory response. All inflammatory markers showed a marked increase with severity and mortality, most significant with IL-6. This suggests NEWS2 and inflammatory markers may predict severity and mortality in COVID-19 patients. Further research is required to evaluate these mechanistic changes in inflammatory response.Reference1.Kostakis I et al. Resuscitation. 159:150–157, 2021.
published_date 2022-03-25T19:27:58Z
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