Published online Dec 25, 2023. doi: 10.5501/wjv.v12.i5.286
Peer-review started: September 4, 2023
First decision: October 17, 2023
Revised: October 26, 2023
Accepted: November 24, 2023
Article in press: November 24, 2023
Published online: December 25, 2023
Processing time: 111 Days and 13.9 Hours
Inflammatory markers have been validated in multiple studies to help predict the severity of disease and the need for mechanical ventilation (MV). Studies have shown baseline elevation in these same inflammatory markers in patients with chronic kidney disease (CKD) alone, due to a chronic inflammatory milieu in CKD and reduced renal clearance of these inflammatory markers. The clinical utility of these inflammatory markers to predict the need for MV among patients with coronavirus disease 2019 (COVID-19) and underlying CKD is unclear.
The use of biomarkers has been progressively increasing since the COVID-19 pandemic and the need for establishing the utility of these biomarkers in the presence of multiple comorbidities becomes essential to establish their clinical utility. Hence there is utmost need for this study to assess use of C-reactive protein level in assessing MV risk in CKD patients.
Since an increased level of inflammatory markers were observed in patients with chronic kidney disease, especially amongst those with stages IIIb-V, we planned to assess the utility of inflammatory biomarkers by evaluating the rate of MV and the levels of inflammatory biomarkers in stages IIIb-V chronic kidney disease patients who are diagnosed with COVID-19.
In order to analyze the association between inflammatory marker levels and rate of MV, we did a single-center retro
A total of 290 patients were admitted between the study period of December 2019 to January, 2022 and amongst them 118 met the inclusion criteria. When we compared the rates of IMV, the group with IMV patients had a greater level of inflammatory markers. We also found a similar result when we compared the inflammatory marker levels amongst NIMV patients.
Our results showed that elevated inflammatory marker levels were still associated with an increased rate of IMV and NIMV even amongst stage IIIb-V CKD patients with COVID-19 disease, thereby demonstrating the clinical utility of these biomarkers in assessing disease severity despite their baseline elevated levels observed in CKD patients.
Validation of these inflammatory biomarkers is key in establishing their use as predictive indices. With the clinical utility of these inflammatory markers being described, it is imperative to study the impact of different disease processes on these inflammatory markers before employing them as clinical tools to guide the diagnosis and management of acute COVID-19 infection.