COVID-19 Biomarkers Comparison: Children, Adults and Elders
Ionut Dragos Capraru, Dan Dumitru Vulcanescu, Iulia Cristina Bagiu, Florin George Horhat, Irina Maria Popescu, Luminita Mirela Baditoiu, Delia Muntean, Monica Licker, Matilda Radulescu, Ion Cristian Mot, Mircea Mihai Diaconu, Catalin Marian
Medicina, doi:10.3390/medicina59050877
Background and Objectives: this study aimed to research links between C-reactive protein (CRP), lactate dehydrogenase (LDH), creatinekinase (CK), 25-OH vitamin D (25-OHD), ferritin (FER), high-density lipoprotein cholesterol (HDL)cholesterol and clinical severity in patients from the western part of Romania, and compare their potential use as biomarkers for intensive care units (ICU) admission and death in children, adults and elders. Materials and Methods: this study is a retrospective cohort study, performed on patients positively diagnosed with COVID-19. Available CRP, LDH, CK 25-OH vitamin D, ferritin, HDL cholesterol and clinical severity were recorded. The following were assessed: median group differences, association, correlation and receiver operating characteristic. Results: 381 children, 614 adults and 381 elders were studied between 1 March 2021 and 1 March 2022. Most children and adults presented mild symptomatology (53.28%, 35.02%, respectively), while most elders presented severe symptomatology (30.04%). ICU admission was 3.67% for children, 13.19% for adults and 46.09% for elders, while mortality was 0.79% for children, 8.63% for adults and 25.1% for elders. With the exception of CK, all other biomarkers showed some significant associations with clinical severity, ICU admission and death. Conclusions: CRP, LDH, 25-OH vitamin D, ferritin and HDL are important biomarkers for COVID-19 positive patients, especially in the pediatric population, while CK was mostly within normal ranges.
Risk for ICU Admission Details from the testing using the ROC curve analysis with regard to ICU admission are shown in Table 18 . CK was excluded from this analysis, as, across all testing, its AUC (area under curve) was not statically significant. Graphically, this data can be seen in Supplementary Material, Figures S1-S6 . Observed differences are between the 25-OH vitamin D AUC of elders and both adults and children, being significantly smaller (0.631 vs. 0.838, 0.778, respectively) and ferritin where the AUC of children was significantly higher than both adults and elders (0.949 vs. 0.807, 0.735, respectively). Regarding 25-OH vitamin D, this might be due to lower levels in elders overall, considering that their median was also lower than that of both adults and children (19.21 vs. 25.96, 23.44, respectively). Ferritin might be a better marker in children than in adults or elders, due to its high AUC.
Risk for Death Details from the testing using the ROC curve analysis with regard to death are shown in Table 19 . CK was excluded from this analysis, as, across all testing, its AUC was not statically significant. Graphically, this data can be seen in Supplementary Material, Figures S7-S12 . Observed differences are between the CRP AUC of adults and elders (0.893 vs. 0.669); the LDH AUC of children with both adults and elders (0.936 vs. 0.729, 0.740, respectively); the 25-OH vitamin D AUC of elders with both adults and children (0.613 vs. 0.883, 0.803, respectively);..
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