The laboratory parameters-derived CoLab-score as an indicator of the host response in ICU COVID-19 patients decreases over time: the Maastricht intensive care COVID cohort

ABSTRACT

Introduction: The CoLab-score was originally developed and validated to rule out COVID-19 in suspected patients presenting in the emergency department [1, 2]. The CoLab-score includes the patient's age and ten blood parameters, reflecting the host response to SARSCoV-2 infection. Here, we investigated the CoLab-score over time in mechanically ventilated COVID-19 patients at the ICU. We hypothesized that the CoLab-score will decrease over time, independent of survival, disease severity and pandemic periods. This would create the opportunity to monitor COVID-19 patients and potentially ruling out the need for isolation when the host response decreases and the infection is overcome. Method(s) We used serial data of the Maastricht Intensive Care Covid (MaastrICCht) cohort of mechanically ventilated COVID-19 patients to investigate the association between time and daily CoLab-score using linear-mixed models. Crude models were adjusted for sex, APACHE II score, SOFA score, and stratified for intensive care mortality. Result(s) 324 patients (73% men), aged 64 +/- 12 years with 5959 daily CoLab-scores, were included. CoLab-score decreased with 0.31 points per day (95% CI -0.33 to -0.28). Adjustment for sex, APACHE II and stratification for mortality did not change this result. Conclusion(s) The CoLab-score decreased over time in mechanically ventilated ICU COVID-19 patients, with a point reduction per three days. This suggests that the CoLab-score eventually decreases to a normal state, reflecting a host response that has overcome infection. Future investigation is warranted to assess whether the need for isolation can be ruled out based on the CoLab-score.