Endogenous Carboxyhemoglobin Level Variation in COVID-19 and Bacterial Sepsis: A Novel Approach?

Bianca-Liana Grigorescu,Ariana Toncean,Irina Săplăcan,Oana Coman,Ioana Roxana Bordea,Marius Petrisor,Claudiu Ion Puiac,Raluca Stefania Fodor

doi:10.3390/microorganisms10020305

Bianca-Liana Grigorescu, Ariana Toncean + Show 6 more

Open Access

https://doi.org/10.3390/microorganisms10020305

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Abstract

Background: The increased production of carbon monoxide (CO) in sepsis has been proven, but the blood level variations of carboxyhemoglobin (COHb) as a potential evolutionary parameter of COVID-19 and sepsis/septic shock have yet to be determined. This study aims to evaluate the serum level variation of COHb as a potential evolutionary parameter in COVID-19 critically ill patients and in bacterial sepsis. Materials and method: A prospective and observational study was conducted on two groups of patients: the bacterial sepsis group (n = 52) and the COVID-19 group (n = 52). We followed paraclinical parameters on Day 1 (D1) and Day 5 (D5) of sepsis/ICU admission for COVID-19 patients. Results: D1 of sepsis: statistically significant positive correlations between: COHb values and serum lactate (p = 0.024, r = 0.316), and total bilirubin (p = 0.01, r = 0.359). In D5 of sepsis: a statistically significant positive correlations between: COHb values and procalcitonin (PCT) (p = 0.038, r = 0.402), and total bilirubin (p = 0.023, r = 0.319). D1 of COVID-19 group: COHb levels were statistically significantly positively correlated with C-reactive protein CRP values (p = 0.003, r = 0.407) and with PCT values (p = 0.022, r = 0.324) and statistically significantly negatively correlated with serum lactate values (p = 0.038, r = −0.285). Conclusion: COHb variation could provide rapid information about the outcome of bacterial sepsis/septic shock, having the advantages of a favorable cost-effectiveness ratio, and availability as a point-of-care test.

Highlights

In December 2019, a coronavirus disease epidemic was reported in Wuhan, China.The World Health Organization deemed this epidemic a serious danger to global health.COVID-19 is highly infectious and has the potential to result in catastrophic complications, most notably acute respiratory distress syndrome (ARDS) [1,2]
This study aims to evaluate the role of COHb variation as a potential evolutionary parameter in bacterial sepsis/septic shock and in COVID-19 critically ill patients
On Day 5 (D5), we found no correlations between C-reactive protein (CRP) or lactate level and COHb levels

Summary

Introduction

COVID-19 is highly infectious and has the potential to result in catastrophic complications, most notably acute respiratory distress syndrome (ARDS) [1,2]. The increased production of carbon monoxide (CO) in sepsis has been proven, but the blood level variations of carboxyhemoglobin (COHb) as a potential evolutionary parameter of COVID-19 and sepsis/septic shock have yet to be determined. This study aims to evaluate the serum level variation of COHb as a potential evolutionary parameter in COVID-19 critically ill patients and in bacterial sepsis. Results: D1 of sepsis: statistically significant positive correlations between: COHb values and serum lactate (p = 0.024, r = 0.316), and total bilirubin (p = 0.01, r = 0.359). In D5 of sepsis: a statistically significant positive correlations between: COHb values and procalcitonin (PCT)

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