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Roy-Vallejo E, Cardeñoso L, Triguero-Martínez A, Chicot Llano M, Zurita N, Ávalos E, Barrios A, Hernando J, Ortiz J, Rodríguez-García SC, Ciudad Sañudo M, Marcos C, García Castillo E, Fontán García-Rodrigo L, González B, Méndez R, Iturrate I, Sanz-García A, Villa A, Sánchez-Azofra A, Quicios B, Arribas D, Álvarez Rodríguez J, Patiño P, Trigueros M, Uriarte M, Martín-Ramírez A, Arévalo Román C, Galván-Román JM, García-Vicuña R, Ancochea J, Muñoz-Calleja C, Fernández-Ruiz E, de la Cámara R, Suárez Fernández C, González-Álvaro I, Rodríguez-Serrano DA. SARS-CoV-2 Viremia Precedes an IL6 Response in Severe COVID-19 Patients: Results of a Longitudinal Prospective Cohort. Front Med (Lausanne) 2022; 9:855639. [PMID: 35783606 PMCID: PMC9240748 DOI: 10.3389/fmed.2022.855639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 05/30/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Interleukin 6 (IL6) levels and SARS-CoV-2 viremia have been correlated with COVID-19 severity. The association over time between them has not been assessed in a prospective cohort. Our aim was to evaluate the relationship between SARS-CoV-2 viremia and time evolution of IL6 levels in a COVID-19 prospective cohort. METHODS Secondary analysis from a prospective cohort including COVID-19 hospitalized patients from Hospital Universitario La Princesa between November 2020 and January 2021. Serial plasma samples were collected from admission until discharge. Viral load was quantified by Real-Time Polymerase Chain Reaction and IL6 levels with an enzyme immunoassay. To represent the evolution over time of both variables we used the graphic command twoway of Stata. RESULTS A total of 57 patients were recruited, with median age of 63 years (IQR [53-81]), 61.4% male and 68.4% Caucasian. The peak of viremia appeared shortly after symptom onset in patients with persistent viremia (more than 1 sample with > 1.3 log10 copies/ml) and also in those with at least one IL6 > 30 pg/ml, followed by a progressive increase in IL6 around 10 days later. Persistent viremia in the first week of hospitalization was associated with higher levels of IL6. Both IL6 and SARS-CoV-2 viral load were higher in males, with a quicker increase with age. CONCLUSION In those patients with worse outcomes, an early peak of SARS-CoV-2 viral load precedes an increase in IL6 levels. Monitoring SARS-CoV-2 viral load during the first week after symptom onset may be helpful to predict disease severity in COVID-19 patients.
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Affiliation(s)
- Emilia Roy-Vallejo
- Department of Internal Medicine, Hospital Universitario La Princesa, Madrid, Spain,*Correspondence: Emilia Roy-Vallejo,
| | - Laura Cardeñoso
- Department of Microbiology, Hospital Universitario La Princesa, Madrid, Spain
| | | | | | - Nelly Zurita
- Department of Microbiology, Hospital Universitario La Princesa, Madrid, Spain
| | - Elena Ávalos
- Department of Pneumology, Hospital Universitario La Princesa, Madrid, Spain
| | - Ana Barrios
- Department of Internal Medicine, Hospital Universitario La Princesa, Madrid, Spain
| | - Julia Hernando
- Department of Anesthesiology, Hospital Universitario La Princesa, Madrid, Spain
| | - Javier Ortiz
- Department of Hematology, Hospital Universitario La Princesa, Madrid, Spain
| | | | | | - Celeste Marcos
- Department of Pneumology, Hospital Universitario La Princesa, Madrid, Spain
| | | | | | - Begoña González
- Intensive Care Unit, Hospital Universitario La Princesa, Madrid, Spain
| | - Rosa Méndez
- Department of Anesthesiology, Hospital Universitario La Princesa, Madrid, Spain
| | - Isabel Iturrate
- Department of Hematology, Hospital Universitario La Princesa, Madrid, Spain
| | - Ancor Sanz-García
- Methodology Unit, Health Research Institute, Hospital Universitario La Princesa, IIS-IP, Madrid, Spain
| | - Almudena Villa
- Department of Internal Medicine, Hospital Universitario La Princesa, Madrid, Spain
| | - Ana Sánchez-Azofra
- Department of Pneumology, Hospital Universitario La Princesa, Madrid, Spain
| | - Begoña Quicios
- Intensive Care Unit, Hospital Universitario La Princesa, Madrid, Spain
| | - David Arribas
- Department of Anesthesiology, Hospital Universitario La Princesa, Madrid, Spain
| | | | - Pablo Patiño
- Intensive Care Unit, Hospital Universitario La Princesa, Madrid, Spain
| | - Marina Trigueros
- Intensive Care Unit, Hospital Universitario La Princesa, Madrid, Spain
| | - Miren Uriarte
- Department of Rheumatology, Hospital Universitario La Princesa, Madrid, Spain
| | | | | | | | | | - Julio Ancochea
- Department of Pneumology, Hospital Universitario La Princesa, Madrid, Spain
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Méndez R, Figuerola A, Chicot M, Barrios A, Pascual N, Ramasco F, Rodríguez D, García I, von Wernitz A, Zurita N, Semiglia A, Jiménez D, Navarro S, Rubio MJ, Vinuesa M, Del Campo L, Bautista A, Pizarro A. Sepsis Code: dodging mortality in a tertiary hospital. Rev Esp Quimioter 2022; 35:43-49. [PMID: 34812031 PMCID: PMC8790636 DOI: 10.37201/req/105.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introducción En el hospital de La Princesa comienza el “Código Sepsis” (CSP) en el año 2015, como un grupo multidisciplinar que dota al personal sanitario de herramientas clínicas, analíticas y organizativas, con el objetivo de la detección y el tratamiento precoz del paciente con sepsis. El objetivo de este estudio es evaluar el impacto de la implantación de CSP en la mortalidad y determinar las variables asociadas con un aumento de la misma. Material y métodos Se realizó un estudio analítico retrospectivo de los pacientes con activación de la alerta CSP de 2015 a 2018. Se recogieron variables clínico-epidemiológicas, parámetros analíticos y factores de gravedad como el ingreso en Unidades de Cuidados Críticos (UCC) y la necesidad de aminas. La significación estadística se estableció en una p < 0,05. Resultados Se incluyeron 1.121 pacientes. La estancia media fue de 16 días y un 32% requirieron ingreso en UCC. La mortalidad mostró una tendencia lineal descendente estadísticamente significativa del 24% en 2015 hasta el 15% en 2018. Las variables predictivas de mortalidad con asociación estadísticamente significativa fueron el lactato > 2 mmol/L, la creatinina > 1,6 mg/dL y la necesidad de aminas. Conclusiones La implementación de Código Sepsis disminuye la mortalidad de los pacientes con sepsis y shock séptico. La presencia de una cifra de lactato > 2 mmol/L, los niveles de creatinina > 1,6 mg/dL y/o la necesidad de administrar aminas en las primeras 24 horas, se asocian con un aumento de la mortalidad en el paciente con sepsis.
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Affiliation(s)
- R Méndez
- Rosa Méndez Hernández. Servicio de Anestesia y Reanimación. Hospital Universitario de La Princesa. Calle Diego de León 62. 28006. Madrid, Spain.
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