D-dimer, BNP/NT-pro-BNP, and creatinine are reliable decision-making biomarkers in life-sustaining therapies withholding and withdrawing during COVID-19 outbreak

• DOI: 10.3389/fcvm.2022.935333
• Publication Date: 2022-09-06T06:31:48Z
• Authors: David M. Smadja; Benjamin A. Fellous; Guillaume Bonnet; Caroline Hauw-Ber...; Willy Sutter; Agathe Beauvais; Charles Fauvel; Aurélien Philippe; Orianne Weizman; Delphine Mika; Philippe Juvin; Victor Waldmann; Jean-Luc Diehl; Ariel Cohen; Richard Chocron
• Keywords: COVID-19; biomarkers; Cardiovascular Medicine; ethics; withholding or withdrawing; 3. Good health; [SDV] Life Sciences [q-bio]; 03 medical and health sciences; 0302 clinical medicine; life-sustaining therapies; RC666-701; Diseases of the circulatory (Cardiovascular) system; claeys-léonetti law

The decision for withholding and withdrawing of life-sustaining treatments (LSTs) in COVID-19 patients is currently based on a collegial mainly clinical assessment. In the context global pandemic overwhelmed health system, question LST support using prognostic biomarkers arises.In multicenter study 24 French hospitals, 2878 hospitalized medical departments from 26 February to 20 April 2020 were included. propensity-matched population, we compared clinical, biological, management characteristics survival with without Student's t-test, chi-square test, Cox model, respectively.An was decided 591 (20.5%). These secondarily matched (1:1) age, sex, body mass index, cancer history no decision. had significantly more cardiovascular diseases, such as high blood pressure (72.9 vs. 66.7%, p = 0.02), stroke (19.3 11.1%, < 0.001), renal failure (30.4 17.4%, heart disease (22.5 14.9%, 0.001). Upon admission, severely attested by qSOFA score ≥2 (66.5 58.8%, 0.03). Biologically, higher values D-dimer, markers (BNP NT-pro-BNP), damage (creatinine) (p Their evolutions often unfavorable (in-hospital mortality) than (41.5 10.3%, By combining three (D-dimer, BNP and/or NT-proBNP, creatinine), proportion increased number abnormally (24, 41.3, 48.3, 60%, respectively, none, one, two, biomarkers, trend 0.01).The concomitant increase BNP/NT-proBNP, creatinine during admission patient could represent reliable helpful tool Circulating biomarker might potentially provide additional information COVID-19.