[Potential biomarkers predictors of mortality in COVID-19 patients in the Emergency Department]. / Potenciales biomarcadores predictores de mortalidad en pacientes COVID-19 en el Servicio de Urgencias.

ABSTRACT

OBJECTIVE: Identify which biomarkers performed in the first emergency analysis help to stratify COVID-19 patients according to mortality risk. METHODS: Observational, descriptive and cross-sectional study performed with data collected from patients with suspected COVID-19 in the Emergency Department from February 24 to March 16, 2020. The univariate and multivariate study was performed to find independent mortality markers and calculate risk by building a severity score. RESULTS: A total of 163 patients were included, of whom 33 died and 29 of them were positive for the COVID-19 PCR test. We obtained as possible factors to conform the Mortality Risk Score age> 75 years ((adjusted OR = 12,347, 95% CI 4,138-36,845 p = 0.001), total leukocytes> 11,000 cells / mm3 (adjusted OR = 2,649, 95% CI 0.879-7.981 p = 0.083), glucose> 126 mg / dL (adjusted OR = 3.716, 95% CI 1.247-11.074 p = 0.018) and creatinine> 1.1 mg / dL (adjusted OR = 2.566, 95% CI 0.889- 7.403, p = 0.081) This score was called COVEB (COVID, Age, Basic analytical profile) with an AUC 0.874 (95% CI 0.816-0.933, p <0.001; Cut-off point = 1 (sensitivity = 89.66 % (95% CI 72.6% -97.8%), specificity = 75.59% (95% CI 67.2% -82.8%). A score <1 has a negative predictive value = 100% (95% CI 93.51% -100%) and a positive predictive value = 18.59% (95% CI 12.82% -25.59%). CONCLUSIONS: Clinical severity scales, kidney function biomarkers, white blood cell count parameters, the total neutrophils / total lymphocytes ratio and procalcitonin are early risk factors for mortality. The variables age, glucose, creatinine and total leukocytes stand out as the best predictors of mortality. A COVEB score <1 indicates with a 100% probability that the patient with suspected COVID-19 will not die in the next 30 days.