324: Correlational Analysis of EAA With Other Inflammatory Markers in Critically Ill SARS-CoV-2 Patients

INTRODUCTION: The Endotoxin Activity Assay (EAA) is a lab analysis to detect primed neutrophils in inflammatory states such as sepsis Its use as a potential biomarker in SARS-CoV-2 patients has not been previously studied Other markers such as CRP, ESR, LDH, ferritin, d-dimer, WBC count, procalcitonin, and IL-6 have all been shown to be reliable predictors of inflammatory states We sought to find out the correlation between EAA and other inflammatory markers in patients admitted to the ICU with SARS-CoV-2 infection METHODS: This is a prospective cohort analysis of SARSCoV- 2 patients admitted to the ICU at a single academic hospital from March to June 2020 Values for all study variables were obtained from each COVID-positive patient on days 1, 2, and 7 of ICU stay, and also for the onset of mechanical ventilation, vasopressors, acute kidney injury, and increase in ferritin >50% from the level at admission Logistic and linear regression analyses were used to compare EAA with IL-6, CRP, ferritin, ESR, LDH, d-dimer, WBC, and procalcitonin RESULTS: A total of 214 EAA results were recorded from 99 patients, with characteristics of: median age 61 84, 45% female, 74% Black, 21% Hispanic, 4% White, and 1% Asian A significant linear regression equation was found between EAA and CRP: F (1, 168)=19 20, p< 0001, with an R2 of 0 1031 and Pearson's r of 0 32109, indicating a moderate correlation Significant Spearman Correlation Coefficients were found between EAA and CRP, LDH, and D-dimer: ρ (169)=0 2896, p=0 0001;ρ (180)=0 179, p=0 01;ρ (165)=0 169, p=0 03, suggesting a mild correlation Other markers did not show a significant correlation with EAA: IL-6 ρ (35)=0 144, p=0 40;Ferritin ρ (173)=0 0533 p=0 48;ESR ρ (37)=0 067, p=0 69;WBC ρ (213)=0 057, p=0 40;Procalcitonin ρ (14)=0 014, p=0 96 CONCLUSIONS: EAA has a statistically significant positive correlation with CRP, LDH, and D-dimer, but not with IL-6, ferritin, ESR, WBC, and procalcitonin Further studies exploring the relationship between EAA and other biomarkers can establish the validity and reliability of EAA in inflammatory states such as COVID sepsis This can help identify the role of EAA as an adjunct biomarker to assess the efficacy of therapeutic strategies and to prognosticate and predict mortality in patients with SARS-CoV-19