Correlation among Blood Sugar Levels, C-Reactive Protein, Total Lymphocyte Count with SOFA Score on Sepsis COVID-19 Patients
DOI:
https://doi.org/10.21776/ub.crjim.2024.005.02.06Keywords:
COVID-19, Sepsis, SOFA Score, PrognosisAbstract
Background: COVID-19 is a caused a pandemic since early January 2020. Sequential Organ Failure Assessment (SOFA) score can assess organ dysfunction in the state of Sepsis MODS.
Aim: This study aims to determine the relationship between Blood Sugar Levels, C-Reactive Protein (CRP), and Total Lymphocyte Count (TLC) with SOFA score in COVID-19 patients with Sepsis.
Methods: An observational study using the cross-sectional method was carried out in 2020-2021 at Ulin Hospital Banjarmasin with a total sample of 87 participants.
Results: Based on the Spearman test, there were a positive correlation between Random Blood Sugar levels and SOFA with the scores r = 0.778 (p = 0.000); significant negative correlation between TLC and SOFA with the score r = -0.409 (p = 0.000); and no significant correlation between CRP and SOFA with the score r = -0.077 (p = 0.507). The multivariate test showed that the correlation value for each Random Blood Sugar with a SOFA score is R=0.664 (p=0.000), and the Total Lymphocyte Count with a SOFA score is R=-0.270 (p=0.001). The statistical analysis model revealed that Blood Sugar Levels and Total Lymphocyte Count could predict SOFA scores of as much as 60.9%.
Conclusion: Blood sugar levels can be a marker of poor prognosis in COVID-19 patients with Sepsis. Hyperglycemia can be caused by pancreatic cell damage due to SARS-CoV2 invasion, acute insulin resistance, and inflammation caused by Sepsis and COVID-19. Total Lymphocyte Count is one of the many factors contributing to organ dysfunction caused by Sepsis in COVID-19.
Keywords: COVID-19, Sepsis, SOFA Score, Prognosis
References
World Health Organization. WHO coronavirus disease (COVID-19) dashboard. Geneva: World Health Organization. Published 2020. Accessed August 9, 2020. https://covid19.who.int/
Zeng F, Huang Y, Guo Y, et al. Association of inflammatory markers with the severity of COVID-19: A meta-analysis. Int J Infect Dis IJID Off Publ Int Soc Infect Dis. 2020;96:467-474. doi:10.1016/j.ijid.2020.05.055
Organization WH. Clinical Management of COVID-19: Interim Guidance, 27 May 2020. World Health Organization https://apps.who.int/iris/handle/10665/332196
Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, Evaluation, and Treatment of Coronavirus (COVID-19). In: ; 2020.
Zhu L, She ZG, Cheng X, et al. Association of Blood Glucose Control and Outcomes in Patients with COVID-19 and Pre-existing Type 2 Diabetes. Cell Metab. 2020;31(6):1068-1077.e3.
doi:10.1016/j.cmet.2020.04.021
Póvoa P, Coelho L, Almeida E, et al. C-reactive protein as a marker of infection in critically ill patients. Clin Microbiol Infect. 2005;11(2):101-108.
doi:https://doi.org/10.1111/j.1469-0691.2004.01044.x
Singer M, Deutschman CS, Seymour C, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA - J Am Med Assoc. 2016;315(8):801-810. doi:10.1001/jama.2016.0287
Guo W, Li M, Dong Y, et al. Diabetes is a risk factor for the progression and prognosis of COVID-19. Diabetes Metab Res Rev. Published online March 2020:e3319. doi:10.1002/dmrr.3319
Qin C. Dysregulation of immune response in patients with COVID-19 in Wuhan, China Chuan. Clin Infect Dis 2020 Mar 12 ciaa248.
Gao J, Zhong L, Wu M, et al. Risk factors for mortality in critically ill patients with COVID-19: a multicenter retrospective case-control study. BMC Infect Dis. 2021;21(1):602. doi:10.1186/s12879-021-06300-7
Tessaro FHG, Ayala TS, Nolasco EL, Bella LM, Martins JO. Insulin Influences LPS-Induced TNF-α and IL-6 Release Through Distinct Pathways in Mouse Macrophages from Different Compartments. Cell Physiol Biochem. 2017;42(5):2093-2104. doi:10.1159/000479904
Jafar N, Edriss H, Nugent K. The Effect of Short-Term Hyperglycemia on the Innate Immune System. Am J Med Sci. 2016;351(2):201-211. doi:10.1016/j.amjms.2015.11.011
Singh AK, Gupta R, Ghosh A, Misra A. Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations. Diabetes Metab Syndr. 2020;14(4):303-310. doi:10.1016/j.dsx.2020.04.004
Rod JE, Oviedo-Trespalacios O, Cortes-Ramirez J. A brief-review of the risk factors for covid-19 severity. Rev Saude Publica. 2020;54:60. doi:10.11606/s1518-8787.2020054002481
Codo AC, Davanzo GG, Monteiro L de B, et al. Elevated Glucose Levels Favor SARS-CoV-2 Infection and Monocyte Response through a HIF-1α/Glycolysis-Dependent Axis. Cell Metab. 2020;32(3):437-446.e5. doi:10.1016/j.cmet.2020.07.007
Chen G, Wu D, Guo W, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020;130(5):2620-2629. doi:10.1172/JCI137244
Zhou Y, Fu B, Zheng X, et al. Pathogenic T-cells and inflammatory monocytes incite inflammatory storms in severe COVID-19 patients. Natl Sci Rev. 2020;7(6):998-1002. doi:10.1093/nsr/nwaa041
Tan L, Wang Q, Zhang D, et al. Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Signal Transduct Target Ther. 2020;5(1):16-18. doi:10.1038/s41392-020-0148-4
Zhao Q, Meng M, Kumar R, Wu Y, Huang J. Lymphopenia is associated with severe coronavirus disease 2019 ( COVID-19 ) infections : A systemic review and meta-analysis. nternational J Infect Dis. 2020;96(January):131-135. doi:10.1016/j.ijid.2020.04.086
Tan C, Huang Y, Shi F, et al. C-reactive protein correlates with computed tomographic findings and predicts severe COVID-19 early. J Med Virol. 2020;92(7):856-862. doi:10.1002/jmv.25871
Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-513. doi:10.1016/S0140-6736(20)30211-7
Hotchkiss RS, Swanson PE, Freeman BD, et al. Apoptotic cell death in patients with sepsis, shock, and multiple organ dysfunction. Crit Care Med. 1999;27(7):1230-1251. doi:10.1097/00003246-199907000-00002
Joshi VD, Kalvakolanu D V, Cross AS. Simultaneous activation of apoptosis and inflammation in pathogenesis of septic shock: a hypothesis. FEBS Lett. 2003;555(2):180-184. doi:10.1016/s0014-5793(03)01271-7
Qin C, Zhou L, Hu Z, et al. Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71(15):762-768. doi:10.1093/cid/ciaa248
Liu F, Li L, Xu M, et al. Prognostic value of interleukin-6 , C-reactive protein , and procalcitonin in patients with COVID-19. J Clin Virol. 2020;127(April):104370. doi:10.1016/j.jcv.2020.104370
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