Potenciales biomarcadores predictores de mortalidad en pacientes COVID-19 en el Servicio de Urgencias

OBJECTIVE: Identify which biomarkers performed in the first emergency analysis help to stratify COVID-19 patients according to mortality risk METHODS: Observational, descriptive and cross-sectional study performed with data collected from patients with suspected COVID-19 in the Emergency Department from February 24 to March 16, 2020 The univariate and multivariate study was performed to find independent mortality markers and calculate risk by building a severity score RESULTS: A total of 163 patients were included, of whom 33 died and 29 of them were positive for the COVID-19 PCR test We obtained as possible factors to conform the Mortality Risk Score age>75 years ((adjusted OR = 12,347, 95% CI: 4,138-36,845 p = 0 001), total leukocytes>11,000 cells / mm3 (adjusted OR = 2,649, 95% CI: 0 879-7 981 p = 0 083), glucose>126 mg / dL (adjusted OR = 3 716, 95% CI: 1 247-11 074 p = 0 018) and creatinine>1 1 mg / dL (adjusted OR = 2 566, 95% CI: 0 889- 7 403, p = 0 081) This score was called COVEB (COVID, Age, Basic analytical profile) with an AUC 0 874 (95% CI: 0 816-0 933, p <0 001;Cut-off point = 1 (sensitivity = 89 66 % (95% CI: 72 6% -97 8%), specificity = 75 59% (95% CI: 67 2% -82 8%) A score <1 has a negative predictive value = 100% (95% CI: 93 51% -100%) and a positive predictive value = 18 59% (95% CI: 12 82% -25 59%) CONCLUSIONS: Clinical severity scales, kidney function biomarkers, white blood cell count parameters, the total neutrophils / total lymphocytes ratio and procalcitonin are early risk factors for mortality The variables age, glucose, creatinine and total leukocytes stand out as the best predictors of mortality A COVEB score <1 indicates with a 100% probability that the patient with suspected COVID-19 will not die in the next 30 days