Clinical Decision Support Tool and Rapid Point-of-Care Platform for Determining Disease Severity in Patients with COVID-19

Michael P McRae; Glennon W Simmons; Nicolaos J Christodoulides; Zhibing Lu; Stella K Kang; David Fenyo; Timothy Alcorn; Isaac P Dapkins; Iman Sharif; Deniz Vurmaz; Sayli S Modak; Kritika Srinivasan; Shruti Warhadpande; Ravi Shrivastav; John T McDevitt

Biomarker tests provide key information about the health or disease status of an individual, including COVID- 19 . In an analysis of 127 hospitalized COVID-19 patients in Wuhan, China, the most common complications leading to death were acute cardiac injury (58.3%), ARDS (55.6%), coagulation dysfunction (38.9%), and acute kidney injury (33.3%). 9 Biomarkers, such as cardiac troponin I (cTnI), C-reactive protein (CRP), D-dimer, and procalcitonin (PCT) were significantly increased in those that died versus those that recovered with prognostic values (as determined by area under the curve [AUC]) of 0.939, 0.870, 0.866, and 0.900, respectively. In another study, data from 82 COVID-19 deaths found that respiratory, cardiac, hemorrhage, hepatic, and renal damage were present in 100%, 89%, 80.5%, 78.0%, and 31.7% of patients, respectively, in which most patients had increased CRP (100%) and D-dimer (97.1%). 10 The importance of D-dimer as a prognostic factor was also demonstrated with odds of death significantly increased for levels greater than 1µg/mL on admission. 11 A biomarker of cardiac failure, N-terminal pro-B-type natriuretic peptide (NT-proBNP) has also been shown to be predictive of death in patients with community acquired pneumonia. 12 A recent study of 416 hospitalized patients with reported 82 patients (19.7%) had cardiac injury, 13 in which patients with myocardial damage had significantly higher levels of CRP, PCT, creatine kinase-myocardial band (CK-MB), cTnI, and NT-. CC-BY-NC-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity.