PT  - JOURNAL ARTICLE
AU  - Hodges, Gethin
AU  - Pallisgaard, Jannik
AU  - Schjerning Olsen, Anne-Marie
AU  - McGettigan, Patricia
AU  - Andersen, Mikkel
AU  - Krogager, Maria
AU  - Kragholm, Kristian
AU  - Køber, Lars
AU  - Gislason, Gunnar Hilmar
AU  - Torp-Pedersen, Christian
AU  - Bang, Casper N
TI  - Association between biomarkers and COVID-19 severity and mortality: a nationwide Danish cohort study
AID  - 10.1136/bmjopen-2020-041295
DP  - 2020 Dec 01
TA  - BMJ Open
PG  - e041295
VI  - 10
IP  - 12
4099  - http://bmjopen.bmj.com/content/10/12/e041295.short
4100  - http://bmjopen.bmj.com/content/10/12/e041295.full
SO  - BMJ Open2020 Dec 01; 10
AB  - Objective To evaluate the association between common biomarkers, death and intensive care unit (ICU) admission in patients with COVID-19.Design Retrospective cohort study. From electronic national registry data, we used Cox analysis and bootstrapping to evaluate associations between baseline levels of biomarkers and standardised absolute risks of death/ICU admission, adjusted for age and gender.Setting All hospitals in Denmark.Participants 1310 patients aged ≥18 years admitted to hospital with COVID-19 from 27th of February to 1st of May 2020, with available biochemistry data.Main outcome measures A composite of death/ICU admission occurring within 30 days.Results Of the 1310 patients admitted to hospital (54.6% men; median age 73.6 years), 352 (26.9%) experienced the composite endpoint and 263 (20.1%) died. For the composite endpoint, the absolute risks for moderately and severely elevated C reactive protein (CRP) were significantly higher, 21.5% and 39.2%, respectively, compared with 5.0% for those with normal CRP. Moderately and severely elevated leucocytes were significantly higher, 34.5% and 46.6% risk, respectively, compared with 23.2% for those with normal leucocytes. Moderately and severely decreased estimated glomerular filtration rates (eGFR) were significantly higher, 41.5% and 45.9% risk, respectively, compared with 30.4% for those with normal/mildly decreased eGFR. Normal and elevated ureas were significantly higher, 22.3% and 40.6% risk, respectively, compared with 7.3% for those with low urea. Elevated D-dimer was significantly higher, 31.8% risk, compared with 17.5% for those with normal D-dimer. Moderately and severely elevated troponins were significantly higher, 27.7% and 57.3% risk, respectively, compared with 9.4% for those with normal troponin. Elevated procalcitonin was significantly higher, 52.1% risk, compared with 28.0% for those with normal procalcitonin.Conclusion In this nationwide study of patients admitted with COVID-19, elevated levels of CRP, leucocytes, procalcitonin, urea, troponins and D-dimer, and low levels of eGFR were associated with higher standardised absolute risk of death/ICU admission within 30 days.