Laboratory Biomarker Variability in Diagnostic and Prognostic Outcome of Neuropsychiatric Disorders in ICU Admitted COVID-19 Patients

ABSTRACT

Introduction: There is growing evidence of neuropsychiatric presentations in patients of COVID-19, but literature is scarce on laboratory biomarkers for its objectivity as diagnostic or prognostic purpose and how they are impacted in clinical course of systemic outcome in COVID-19 infection. Materials and methods: Authors screened 430 ICU patients admitted to our tertiary care hospitals, out of whom 67 were diagnosed positively with definitive neuropsychiatric sequalae and receive psychotropic interventions during their hospital stay. Authors compared their D-dimer levels, C-reactive proteins, serum ferritin levels, serum procalcitonin and Vitamin D levels and further analyzed CORADS severity score with psychiatric severity and outcome. Results: Among the clinical laboratory biomarkers only D-dimer levels were found to be significantly impacting the variability among various psychiatric diagnosis (F=2.479, p <0.033). while serum ferritin levels were just marginally close to significance (F= 2.221, p=0.053). We observed that serum CRP, vitamin D levels and serum procalcitonin levels were not significantly variable between seven domains of psychiatric disorders. These laboratory biomarkers were considered to be useful not only for early suspicion of neuropsychiatric disorders and identifying high risk cohorts but also rationalizing therapies, predicting outcome and framing ICU admissions. Conclusions: The present study has found significant association of elevated levels of D-dimer variability but not the other laboratory biomarkers among various neuropsychiatric comorbid sequalae in ICU admitted COVID-19 patients. This particular observation might have potential for serum D-dimer levels to be possibly used as an early biomarker to screen or suspect for comorbid neuropsychiatric presentations and their prognosis.