The association of baseline C-reactive protein, D-dimer, and lymphocytes levels with health-related quality of life in severe COVID-19 survivors

Ida Ayu Ika Wari Utami; I Ketut Agus Somia; Ni Luh Putu Eka Arisanti; Ida Bagus Ngurah Rai; Ida Ayu Jasminarti Dwi Kusumawardani; Ni Wayan Candrawati; I Gusti Ngurah Bagus Artana

doi:10.53730/ijhs.v6nS6.12962

Authors

Ida Ayu Ika Wari Utami Department of Pulmonology and Respiration Medicine, Faculty of Medicine, Udayana University, Prof. Dr. IGNG Ngoerah General Hospital, Bali, Indonesia, 80114
I Ketut Agus Somia Tropic Infection Division of Internal Medicine Department, Faculty of Medicine, Udayana University, Prof. Dr. IGNG Ngoerah General Hospital, Bali, Indonesia, 80114
Ni Luh Putu Eka Arisanti
eka.arisanti@unud.ac.id
Department of Pulmonology and Respiration Medicine, Faculty of Medicine, Udayana University, Prof. Dr. IGNG Ngoerah General Hospital, Bali, Indonesia, 80114
Ida Bagus Ngurah Rai Department of Pulmonology and Respiration Medicine, Faculty of Medicine, Udayana University, Prof. Dr. IGNG Ngoerah General Hospital, Bali, Indonesia, 80114
Ida Ayu Jasminarti Dwi Kusumawardani Department of Pulmonology and Respiration Medicine, Faculty of Medicine, Udayana University, Prof. Dr. IGNG Ngoerah General Hospital, Bali, Indonesia, 80114
Ni Wayan Candrawati Department of Pulmonology and Respiration Medicine, Faculty of Medicine, Udayana University, Prof. Dr. IGNG Ngoerah General Hospital, Bali, Indonesia, 80114
I Gusti Ngurah Bagus Artana Department of Pulmonology and Respiration Medicine, Faculty of Medicine, Udayana University, Udayana University Hospital, Bali, Indonesia, 80114

Keywords:

absolute lymphocytes, CRP, D-dimer, HrQoL, severe COVID-19 survivors

Abstract

This study examined the association between baseline inflammatory markers and HrQoL (assessment using the SF-36 instrument) in severe COVID-19 survivors with cross-sectional observational analysis. The total subject is 80 people. Poor HrQoL findings based on the Physical Component Summary (PCS) were seen in 22 individuals (27.5%), and poor HrQoL findings based on the Mental Component Summary (MCS) were seen in 22 individuals (27.5%). The results showed that eight subjects (47.1%) with high D-dimer levels had poor PCS and MCS scores, with the same PR 2.1 (CI 95% 1.069-4.196;p=0.042). High levels of D-dimer and a duration of 12-16 weeks of confirmation were independently associated with PCS values with PR values of 5.5 (95% CI 1.190 – 25.144;p=0.029) and 4.5 (95% CI 1.402 – 14.647; p= 0.012). Meanwhile, a history of not taking routine medication for the treatment of comorbid diseases was a predictor that was independently associated with the MCS value, PR 0.3 (95% CI 0.115 – 0.956; p=0.041). This conclusion is CRP; absolute lymphocyte levels were not associated with HrQoL of severe COVID-19 survivors.

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References

Albitar, O., Ballouze, R., Ooi, J.P. and Sheikh Ghadzi, S.M. (2020) ‘Risk factors for mortality among COVID-19 patients’, Diabetes Research and Clinical Practice, 166, p. 108293. Available at: https://doi.org/10.1016/j.diabres.2020.108293.

Asare-Nuamah, P., Dick-Sagoe, C., Sakah, B.N., Muzee, H., Asamoah, J.O. and Kessie, K.O. (2021) ‘Determinants of COVID-19 Response Strategies in Selected African Countries’, Journal of Applied Social Science, 16(1), pp. 281–304. Available at: https://doi.org/10.1177/19367244211055799.

Bompard F, Monnier H, Saab I and et al (2020) ‘Pulmonary embolism in patients with Covid-19 pneumonia’, European Respiratory Journal [Preprint].

Brake, S.J., Barnsley, K., Lu, W., McAlinden, K.D., Eapen, M.S. and Sohal, S.S. (2020) ‘Smoking Upregulates Angiotensin-Converting Enzyme-2 Receptor: A Potential Adhesion Site for Novel Coronavirus SARS-CoV-2 (Covid-19)’, Journal of clinical medicine, 9(3). Available at: https://doi.org/10.3390/JCM9030841.

Brugliera L and et al (2020) ‘Rehabilitation of COVID-19 patients’, Journal of Rehabilitation Medicine, 52(4), pp. 2–4.

Chauhan, A.J., Wiffen, L.J. and Brown, T.P. (2020) ‘COVID-19: A collision of complement, coagulation and inflammatory pathways’, Journal of Thrombosis and Haemostasis, 18(9), pp. 2110–2117. Available at: https://doi.org/10.1111/jth.14981.

Clark, A., Jit, M., Warren-Gash, C., Guthrie, B., and Ong, K.L. (2020) ‘Global, regional, and national estimates of the population at increased risk of severe COVID-19 due to underlying health conditions in 2020: a modelling study’, The Lancet Global Health, 8(8), pp. e1003–e1017.

Del Valle, D.M., Kim-Schulze, S., Huang, H.-H., B and Gnjatic, S. (2020) ‘An inflammatory cytokine signature predicts COVID-19 severity and survival’, Nature Medicine, 26(10), pp. 1636–1643. Available at: https://doi.org/10.1038/s41591-020-1051-9.

Ding, T., Zhang, J., Wang, T., Cui, P., Chen, Z., Jiang, J and equally, C. (2020) ‘A Multi-hospital Study in Wuhan, China: Protective Effects of Non-menopause and Female Hormones on SARS-CoV-2 infection’, medRxiv, p. 2020.03.26.20043943. Available at: https://doi.org/10.1101/2020.03.26.20043943.

Ellis, R.J., Letendre, S.L., Atkinson, J.H., Clifford, D., Collier, A.C., Gelman, B.B., Marra, C., McCutchan, J.A., and Heaton, R.K. (2020) ‘Higher levels of plasma inflammation biomarkers are associated with depressed mood and quality of life in aging, virally suppressed men, but not women, with HIV.’, Brain, behavior, & immunity - health, 7, p. 100121. Available at: https://doi.org/10.1016/j.bbih.2020.100121.

Fogarty, H., Townsend, L., Ni Cheallaigh, C., Bergin, C., and Byrne, M. (2020) ‘COVID19 coagulopathy in Caucasian patients’, British journal of haematology, 189(6), pp. 1044–1049.

Gallo Marin, B., Aghagoli, G., Lavine, K., Yang, L., Siff, E.J., and Michelow, I.C. (2021) ‘Predictors of COVID-19 severity: A literature review’, Reviews in Medical Virology, 31(1), pp. 1–10. Available at: https://doi.org/10.1002/rmv.2146.

Gao M, Piernas C, Astbury NM and et al (2021) ‘Associations between body-mass index and COVID-19 severity in 6·9 million people in England: a prospective, community-based, cohort study’, Lancet Diabetes Endocrinol, 9, pp. 350–9.

Garrigues, E., Janvier, P., Kherabi, Y., Le Bot, A., Hamon, A., Gouze, and Nguyen, Y. (2020) ‘Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19.’, The Journal of infection, pp. e4–e6. Available at: https://doi.org/10.1016/j.jinf.2020.08.029.

Gill M, Maheshwari V, Narang A and et al (2018) ‘Impact on Cognitive Improvement Following Burr Hole Evacuation of Chronic Subdural Hematoma: A Prospective Observational Study’, J Neurosci Rural Pract, 9(4), pp. 457–60.

Haris, R., Makmur, R., Andayani, T. and Kristina, S. (2019) ‘Penilaian Properti Psikometrik Instrumen Kualitas Hidup (HRQol) pada Populasi Umum: Tinjauan Sistematik’, JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice), 9. Available at: https://doi.org/10.22146/jmpf.41911.

Jana, S.K., K, N.B., Chattopadhyay, R., Chakravarty, B. and Chaudhury, K. (2010) ‘Upper control limit of reactive oxygen species in follicular fluid beyond which viable embryo formation is not favorable.’, Reproductive toxicology (Elmsford, N.Y.), 29(4), pp. 447–451. Available at: https://doi.org/10.1016/j.reprotox.2010.04.002.

Jones, E.A.K., Mitra, A.K. and Bhuiyan, A.R. (2021) ‘Impact of COVID-19 on Mental Health in Adolescents: A Systematic Review.’, International journal of environmental research and public health, 18(5). Available at: https://doi.org/10.3390/ijerph18052470.

Kaur, A., Di Mascio, M., Barabasz, A., Rosenzweig, M., McClure, H.M., Perelson, A.S., Ribeiro, R.M. and Johnson, R.P. (2008) ‘Dynamics of T- and B-lymphocyte turnover in a natural host of simian immunodeficiency virus.’, Journal of virology, 82(3), pp. 1084–1093. Available at: https://doi.org/10.1128/JVI.02197-07.

Leentjens J, Haaps TF, Wessels PF and et al (2021) ‘COVID-19-associated coagulopathy and antithrombotic agents—lessons after 1 year’, The Lancet Haematology [Preprint].

Lehmann, A., Prosch, H., Zehetmayer, S., Gysan, M.R., Bernitzky, D., Vonbank, K., Idzko, M. and Gompelmann, D. (2021) ‘Impact of persistent D-dimer elevation following recovery from COVID-19.’, PloS one, 16(10), p. e0258351. Available at: https://doi.org/10.1371/journal.pone.0258351.

Lindert, J., Jakubauskiene, M. and Bilsen, J. (2021) ‘The COVID-19 disaster and mental health-assessing, responding and recovering.’, European journal of public health, 31(Supplement_4), pp. iv31–iv35. Available at: https://doi.org/10.1093/eurpub/ckab153.

Liu, Jing, Li, S., Liu, Jia, Liang, B., and Zheng, X. (2020) ‘Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients.’, EBioMedicine, 55, p. 102763. Available at: https://doi.org/10.1016/j.ebiom.2020.102763.

Marosszeky, N. and Sansoni, J. (2005) ‘Instrument review-SF-36® health survey (version 1.0) for use in Australia’.

Meixuan, L., Huang, L., Zheng, D., Zhang, L., and Zhang, Z. (2021) Health-related quality of life of COVID-19 survivors at 6 months after hospital discharge: a cohort study. Available at: https://doi.org/10.21203/rs.3.rs-176489/v1.

Mendy, A., Apewokin, S., Wells, A.A. and Morrow, A.L. (2020) ‘Factors Associated with Hospitalization and Disease Severity in a Racially and Ethnically Diverse Population of COVID-19 Patients’, medRxiv, pp. 1–24. Available at: https://doi.org/10.1101/2020.06.25.20137323.

Pambudi, I.G.P.B., Suryana, I.K., Rai, I.B.N., Kusumawardani, I.A.J.D., Candrawati, N.W., Sajinadiyasa, I.G.K. and Arisanti, N.L.P.E. (2022) ‘High Neutrophil to Lymphocyte Ratio, C-Reactive Protein, Procalcitonin and D-dimer as Risk Factors for Severe COVID-19.’, Medico-Legal Update, 22(1).

Pijls, B.G., Jolani, S., Atherley, A., Derckx, R.T., Dijkstra, J.I.R., Franssen, G.H.L., Hendriks, S., Richters, A., Venemans-Jellema, A. and Zalpuri, S. (2021) ‘Demographic risk factors for COVID-19 infection, severity, ICU admission and death: a meta-analysis of 59 studies’, BMJ open, 11(1), p. e044640.

Poudel, A.N., Zhu, S., Cooper, N., Roderick, P., Alwan, N., Tarrant, C., Ziauddeen, N. and Yao, G.L. (2021) ‘Impact of Covid-19 on health-related quality of life of patients: A structured review’, PLOS ONE, 16(10), p. e0259164.

Sadeghi-Haddad-Zavareh M, Bayani M, Shokri M and et al (2021) ‘C-Reactive Protein as a Prognostic Indicator in COVID-19 Patients’, Interdisciplinary Perspective on Infectious Disease, 7(8), pp. 61–9.

Simonnet, A., Chetboun, M., Poissy, J., Raverdy, V., Noulette, J., Duhamel, A., Labreuche, J., Mathieu, D., Pattou, F. and Jourdain, M. (2020) ‘High prevalence of obesity in severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) requiring invasive mechanical ventilation’, Obesity, 28(7), pp. 1195–1199.

Singh, Y., Singh, A., Rudravaram, S., Soni, K.D., Aggarwal, R., Patel, N., Wig, N. and Trikha, A. (2021) ‘Neutrophil-to-lymphocyte Ratio and Platelet-to-lymphocyte Ratio as Markers for Predicting the Severity in COVID-19 Patients: A Prospective Observational Study.’, Indian journal of critical care medicine : 25(8), pp. 847–852. Available at: https://doi.org/10.5005/jp-journals-10071-23906.

Soni, S.L., Kajal, K., Yaddanapudi, L.N., Malhotra, P., Puri, G.D., Bhalla, A., Singh, M.P., Sehgal, I.S., Koushal, V., and Guru, R.R. (2021) ‘Demographic & clinical profile of patients with COVID-19 at a tertiary care hospital in north India’, Indian Journal of Medical Research, 153, pp. 115–125. Available at: https://doi.org/10.4103/ijmr.IJMR_2311_20.

Talman, S., Boonman-de Winter, L.J.M., De Mol, M., Hoefman, E., Van Etten, R.W. and De Backer, I.C. (2021) ‘Pulmonary function and health-related quality of life after COVID-19 pneumonia’, Respiratory medicine, 176, p. 106272.

Torales, J., O’Higgins, M., Castaldelli-Maia, J.M. and Ventriglio, A. (2020) ‘The outbreak of COVID-19 coronavirus and its impact on global mental health.’, The International journal of social psychiatry, 66(4), pp. 317–320. Available at: https://doi.org/10.1177/0020764020915212.

Townsend, L., Dyer, A.H., Jones, K., Dunne, J., Mooney, A., Gaffney, F., O’Connor, L., Leavy, D., O’Brien, K. and Dowds, J. (2020) ‘Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection’, PloS one, 15(11), p. e0240784.

Vehar, S., Boushra, M., Ntiamoah, P. and Biehl, M. (2021) ‘Post-acute sequelae of SARS-CoV-2 infection: Caring for the “long-haulers”.’, Cleveland Clinic journal of medicine, 88(5), pp. 267–272. Available at: https://doi.org/10.3949/ccjm.88a.21010.

Wade, D.T. (2020) ‘Rehabilitation after COVID-19: an evidence-based approach’, Clinical medicine, 20(4), p. 359.

Wang, C., Yu, C., Jing, H., Wu, X., Novakovic, V.A., Xie, R. and Shi, J. (2022) ‘Long COVID: The Nature of Thrombotic Sequelae Determines the Necessity of Early Anticoagulation’, Frontiers in Cellular and Infection Microbiology, 12.

WHO Indonesia (2021) Coronavirus disease (COVID-19).

Wilkins, J., Ghosh, P., Vivar, J., Chakraborty, B. and Ghosh, S. (2018) ‘Exploring the associations between systemic inflammation, obesity and healthy days: a health related quality of life (HRQOL) analysis of NHANES 2005–2008’, BMC obesity, 5(1), pp. 1–12.

Yitbarek, G.Y., Ayehu, G.W., Asnakew, S., Ayele, F.Y., Gare, M.B., Mulu, A.T., Dagnaw, F.T. and Melesie, B.D. (2021) ‘The role of C-reactive protein in predicting the severity of COVID-19 disease: A systematic review’, SAGE Open Medicine, 9, p. 205031212110507. Available at: https://doi.org/10.1177/20503121211050755.

Yong, S.J. (2021) ‘Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments’, Infectious diseases, 53(10), pp. 737–754.

Zhao, Y., Shang, Y., Song, W., Li, Q., Xie, H., Xu, Q., Jia, J., Li, L., Mao, H. and Zhou, X. (2020) ‘Follow-up study of the pulmonary function and related physiological characteristics of COVID-19 survivors three months after recovery’, EClinicalMedicine, 25, p. 100463.

Zimmermann, P., Pittet, L.F. and Curtis, N. (2022) ‘Long covid in children and adolescents’, BMJ, 376, p. o143. Available at: https://doi.org/10.1136/bmj.o143.