• Brendan Barrett, Styve Pamphile, Fan Yang, Farnia Naeem, Jinsung Kim, Jayabhargav Annam, Rachel Borczuk, Shira Yellin, Carly Bass, Sabrina Fowler, Maykl Mosheyev, Yael Jessica Mayer, and Benjamin W Friedman.
• Department of Emergency Medicine, Albert Einstein College of Medicine, Montefiore Health System, Bronx, NY, USA; Department of Emergency Medicine, Jacobi Medical Center, Bronx, NY, USA. Electronic address: brbarret@montefiore.org.
• Am J Emerg Med. 2021 Aug 1; 46: 595598595-598.

BackgroundInflammatory markers are often elevated in patients with COVID-19. The objective of this study is to assess the prognostic capability of these tests in predicting clinical outcomes.MethodsThis was a retrospective cohort study including all patients at least 16 years old with COVID-19 who were admitted from one of five Emergency Departments between March 6th and April 4th, 2020. We included 1123 laboratory-confirmed cases of COVID-19. We analyzed white blood cell count (WBC), absolute lymphocyte count (ALC), lactate dehydrogenase (LDH), C-reactive protein (CRP), procalcitonin (PCT), D-dimer, ferritin, and erythrocyte sedimentation rate (ESR). We looked at clinical outcomes including death, the need for endotracheal intubation (ETT), the need for renal replacement therapy (RRT), and ICU admission. We report Spearman's ρ2 and statistical significance for each correlation with outcomes. We also report positive predictive value, negative predictive value, sensitivity, specificity, positive likelihood ratios, and negative likelihood ratios.ResultsThe mean age of our patient population was 62 (SD 16). Thirty-seven percent of patients self-reported Spanish/Hispanic/Latino ethnicity, 47% reported their race as Black or African-American, and 10% reported their race as non-Hispanic white. Inter-rater reliability was 96%. There was no laboratory value that had both sensitivity and specificity of at least 0.90, or that had a positive predictive value and negative predictive value of at least 0.90, or that had likelihood ratios that could reliably predict a severe course of disease.ConclusionInflammatory markers drawn within 48 h of arrival, though often correlated with clinical outcomes, are not individually highly predictive of which patients in a predominantly older and minority population will die or require intubation, RRT, or ICU admission.Copyright © 2020 Elsevier Inc. All rights reserved.

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