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1. Elevated C-reactive protein in early COVID-19 predicts worse survival among hospitalized geriatric patients.

Author

Adeline Villoteau, Marine Asfar, Marie Otekpo, Jocelyne Loison, Jennifer Gautier, Cédric Annweiler, and GERIA-COVID study group

Subjects
Medicine, Science
Abstract

BackgroundThe objective of this cohort study was to determine whether elevated CRP in early COVID-19 was associated with 14-day mortality in geriatric patients.MethodsPlasma CRP levels at hospital admission and 14-day all-cause mortality were assessed in geriatric inpatients hospitalized for COVID-19. Potential confounders were age, sex, functional abilities, history of malignancies, hypertension, cardiomyopathy, albuminemia, number of acute health issues, use of antibiotics and respiratory treatments.ResultsNinety-five participants (mean±SD 88.0±5.5years; 49.5%women; mean CRP, 76.7±77.5mg/L; mean albuminemia, 32.9±6.0g/L) were included. Sixteen participants who did not survive at day 14 exhibited higher CRP level at baseline than the others (120.3±71.2 versus 67.9±76.1 mg/L, P = 0.002). There was no difference in albuminemia (P = 0.329). Plasma CRP level was directly associated with 14-day mortality (fully adjusted HR = 1.11, P = 0.025). The cut-off for CRP associated with 14-day mortality was set at 35mg/L (sensitivity = 0.88; specificity = 0.56). Those with CRPConclusionsElevated CRP levels were associated with poorer 14-day survival in hospitalized geriatric COVID-19 patients.

Published
2021
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2. Diagnostic Performances of Urinary Methylmalonic Acid/Creatinine Ratio in Vitamin B12 Deficiency

Author

Maximilien N’Guyen, Valentin Lacombe, Sopak Supakul, Guillaume Valarche, Steve Genebrier, Arthur Derieppe, Geoffrey Urbanski, Floris Chabrun, and Adeline Villoteau

Subjects
renal impairment, medicine.medical_specialty, Urinary system, Methylmalonic acid, lcsh:Medicine, Renal function, 030204 cardiovascular system & hematology, Gastroenterology, Article, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Urinary excretion, urinary methylmalonic acid, Internal medicine, polycyclic compounds, Medicine, Vitamin B12, vitamin B12 deficiency, 030304 developmental biology, 0303 health sciences, Creatinine, business.industry, plasma methylmalonic acid, lcsh:R, nutritional and metabolic diseases, General Medicine, chemistry, Plasma homocysteine, Biomarker (medicine), biomarker, business, plasma homocysteine
Abstract

Sole measurement of plasma vitamin B12 is no longer enough to identify vitamin B12 (B12) deficiency. When plasma vitamin B12 is in the low-normal range, especially between 201 and 350 ng/L, B12 deficiency should be assessed by measurements of plasma homocysteine and/or plasma methylmalonic acid (MMA). However, these biomarkers also accumulate during renal impairment, leading to a decreased specificity for B12 deficiency. In such cases, urinary methylmalonic acid/creatinine ratio (uMMA/C) could be of interest, due to the stable urinary excretion of MMA. The objectives were to evaluate the influence of renal impairment on uMMA/C compared to plasma homocysteine and plasma methylmalonic acid, and to determine the diagnostic performances of uMMA/C in the diagnosis of B12 deficiency. We prospectively studied 127 patients with a plasma B12 between 201 and 350 ng/L. We noticed that uMMA/C was not dependent on renal function (p = 0.34), contrary to plasma homocysteine and plasma methylmalonic acid. uMMA/C showed a perspective diagnostic performance (AUC 0.71 [95% CI: 0.62&ndash, 0.80]) and the threshold of 1.45 umol/mmol presented a high degree of specificity (87.9% [95% CI: 72.0&ndash, 98.9]). In conclusion, uMMA/C is a promising biomarker to assess vitamin B12 status in doubtful cases, notably during renal impairment.

Published
2020

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