Characterising biological mechanisms underlying ethnicity-associated outcomes in COVID-19 through biomarker trajectories: a multicentre registry analysis

• DOI: 10.1016/j.bja.2023.04.008
• Publication Date: 2023-04-21T23:23:54Z
• Authors: Yize I. Wan; Zudin A. Puthucheary; Rupert M. Pearse; John R. Prowle
• Keywords: Critical Care; SARS-CoV-2; COVID-19; frailty; survival; 3. Good health; trajectory cluster; C-Reactive Protein; inflammation; Ethnicity; critical illness; ethnicity; Humans; Registries; Biomarkers

BackgroundDifferences in routinely collected biomarkers between ethnic groups could reflect dysregulated host responses to disease and treatments, be associated with excess morbidity mortality COVID-19.MethodsA multicentre registry analysis from patients aged ≥16 yr SARS-CoV-2 infection emergency admission Barts Health NHS Trust hospitals during January 1, 2020 May 13, (wave 1) September February 17, 2021 2) was subjected unsupervised longitudinal clustering techniques identify distinct phenotypic patient clusters based on trajectories of routine blood results over the first 15 days hospital admission. Distribution trajectory across categories determined, associations ethnicity, clusters, 30-day survival were assessed using multivariable Cox proportional hazards modelling. Secondary outcomes ICU admission, discharge, long-term 640 days.ResultsWe included 3237 length stay ≥7 days. In who died, there greater representation Black Asian ethnicity for C-reactive protein urea-to-creatinine ratio increased risk death. Inclusion analyses attenuated or abrogated higher death patients. went hazard (HR) 1.36 [0.95–1.94] HR 0.97 [0.59–1.59] 1), 1.42 [1.15–1.75]) 1.04 [0.78–1.39] Trajectory reduced similarly worse secondary outcomes.ConclusionsClinical biochemical monitoring COVID-19 progression treatment response should interpreted context background.