Creatine Kinase in SARS-CoV-2-Related Encephalopathy as a Prognostic Biomarker for Post-Acute Sequelae of COVID-19 (PASC) (P9-8.014)

Abstract

<h3>Objective:</h3> To investigate whether creatine kinase is a prognostic factor in SARS-CoV-2 related encephalopathy in development of PASC. <h3>Background:</h3> Elevated CK levels have been demonstrated as a poor prognostic factor of outcomes in acute COVID-19 infection but its role as a marker of PASC is unclear. <h3>Design/Methods:</h3> A retrospective chart review was performed on hospitalized encephalopathic patients who developed COVID-19 infection during March-May of 2020 at an urban tertiary care center. Patients were divided into two subgroups according to elevated CK levels (E-CK) vs non-elevated CK levels (N-CK) with elevated defined as &gt;200 u/L. Charts were analyzed for patients who had follow-up between 4 weeks and 1 year from initial visit to analyze subsequent development of new or persisting respiratory, cardiac, renal, or neurological symptoms to determine incidence of PASC. <h3>Results:</h3> Of the 43 encephalopathic COVID-19 infection patients reviewed, 25 and 18 patients were found to be in the E-CK and N-CK groups, respectively (average serum CK level of 1485 u/L vs 87.11 u/L, p = 0.0026). Among the E-CK group, 14 patients (56%) had follow-up at least 4 weeks post admission in the outpatient setting vs 13 patients (72.22%) in the N-CK group (p &gt; 0.05), with an average total follow up time of 477.37 days post initial admission in the E-CK group and 466.7857 days for N-CK (p &gt; 0.05). In the follow-up E-CK group, 6 patients (42.85%) reported any one of the PASC symptoms whereas in the follow-up N-CK group, 9 patients (69.23%) reported any one of the PASC symptoms. (RR = 0.73, 95% CI [0.32–1.69], p = 0.47). <h3>Conclusions:</h3> Encephalopathic patients who had elevated CK levels on COVID-19 infection admission did not have an increased risk of developing PASC. Work is in progress to confirm these findings by expanding sample size, increasing follow up time, and stratifying for confounding factors. <b>Disclosure:</b> Ms. Faiz has nothing to disclose. Miss Jaffry has nothing to disclose. Ms. Mandava has nothing to disclose. Mr. Jaffry has nothing to disclose. Mr. Trivedi has nothing to disclose. Mr. Mandava has nothing to disclose. Miss Shaikh has nothing to disclose. Mr. Jaffry has nothing to disclose. Mr. Ors has nothing to disclose. Dr. Surathi has nothing to disclose. Dr. Tofade has nothing to disclose. Mr. Huff has nothing to disclose. Dr. Redko has nothing to disclose. Dr. Souayah has received publishing royalties from a publication relating to health care.