{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T11:26:35Z","timestamp":1767180395334,"version":"build-2238731810"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2022,7,14]],"date-time":"2022-07-14T00:00:00Z","timestamp":1657756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Consejeria de salud y familia, Junta de Andalucia","award":["COVID-0005-2020"],"award-info":[{"award-number":["COVID-0005-2020"]}]},{"name":"Consejeria de salud y familia, Junta de Andalucia","award":["RH-0037-2020"],"award-info":[{"award-number":["RH-0037-2020"]}]},{"name":"Consejer\u00eda de Transformaci\u00f3n Econ\u00f3mica, Industria, Conocimiento y Universidades","award":["PY20\/01276"],"award-info":[{"award-number":["PY20\/01276"]}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["CP19\/00159"],"award-info":[{"award-number":["CP19\/00159"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["CP19\/00146"],"award-info":[{"award-number":["CP19\/00146"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["FI19\/00304"],"award-info":[{"award-number":["FI19\/00304"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["FI19\/00083"],"award-info":[{"award-number":["FI19\/00083"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["COV20\/00698"],"award-info":[{"award-number":["COV20\/00698"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Red Tem\u00e1tica de Investigaci\u00f3n Cooperativa en SIDA","award":["RD16\/0025\/0020, RD16\/0025\/0006 and RD16\/0025\/0026"],"award-info":[{"award-number":["RD16\/0025\/0020, RD16\/0025\/0006 and RD16\/0025\/0026"]}]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Infecciosas-ISCIII","award":["CB21\/13\/00020"],"award-info":[{"award-number":["CB21\/13\/00020"]}]},{"DOI":"10.13039\/501100003339","name":"Consejo Superior de Investigaciones Cient\u00edficas","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003339","id-type":"DOI","asserted-by":"publisher"}]},{"name":"INSTITUT D'INVESTIGACIO SANITARIA","award":["2019\/IISPV\/05"],"award-info":[{"award-number":["2019\/IISPV\/05"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The SARS-CoV-2 pandemic has overwhelmed hospital services due to the rapid transmission of the virus and its severity in a high percentage of cases. Having tools to predict which patients can be safely early discharged would help to improve this situation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients confirmed as SARS-CoV-2 infection from four Spanish hospitals. Clinical, demographic, laboratory data and plasma samples were collected at admission. The patients were classified into mild and severe\/critical groups according to 4-point ordinal categories based on oxygen therapy requirements. Logistic regression models were performed in mild patients with only clinical and routine laboratory parameters and adding plasma pro-inflammatory cytokine levels to predict both early discharge and worsening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>333 patients were included. At admission, 307 patients were classified as mild patients. Age, oxygen saturation, Lactate Dehydrogenase, D-dimers, neutrophil-lymphocyte ratio (NLR), and oral corticosteroids treatment were predictors of early discharge (area under curve (AUC), 0.786; sensitivity (SE) 68.5%; specificity (S), 74.5%; positive predictive value (PPV), 74.4%; and negative predictive value (NPV), 68.9%). When cytokines were included, lower interferon-\u03b3-inducible protein 10 and higher Interleukin 1 beta levels were associated with early discharge (AUC, 0.819; SE, 91.7%; S, 56.6%; PPV, 69.3%; and NPV, 86.5%). The model to predict worsening included male sex, oxygen saturation, no corticosteroids treatment, C-reactive protein and Nod-like receptor as independent factors (AUC, 0.903; SE, 97.1%; S, 68.8%; PPV, 30.4%; and NPV, 99.4%). The model was slightly improved by including the determinations of interleukine-8, Macrophage inflammatory protein-1 beta and soluble IL-2R\u03b1 (CD25) (AUC, 0.952; SE, 97.1%; S, 98.1%; PPV, 82.7%; and NPV, 99.6%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinical and routine laboratory data at admission strongly predict non-worsening during the first two weeks; therefore, these variables could help identify those patients who do not need a long hospitalization and improve hospital overcrowding. Determination of pro-inflammatory cytokines moderately improves these predictive capacities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0269875","type":"journal-article","created":{"date-parts":[[2022,7,14]],"date-time":"2022-07-14T13:43:48Z","timestamp":1657806228000},"page":"e0269875","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical, laboratory data and inflammatory biomarkers at baseline as early discharge predictors in hospitalized SARS-CoV-2 infected patients"],"prefix":"10.1371","volume":"17","author":[{"given":"Mar\u00eda","family":"Trujillo-Rodriguez","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esperanza","family":"Mu\u00f1oz-Muela","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Serna-Gallego","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Manuel","family":"Praena-Fern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"P\u00e9rez-G\u00f3mez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Gasca-Capote","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joana","family":"Vitall\u00e9","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joaquim","family":"Peraire","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zaira R.","family":"Palacios-Baena","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge Julio","family":"Cabrera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ezequiel","family":"Ruiz-Mateos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Poveda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9347-527X","authenticated-orcid":true,"given":"Luis Eduardo","family":"L\u00f3pez-Cort\u00e9s","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Rull","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3445-1574","authenticated-orcid":true,"given":"Alicia","family":"Gutierrez-Valencia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis Fernando","family":"L\u00f3pez-Cort\u00e9s","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,7,14]]},"reference":[{"key":"pone.0269875.ref001","unstructured":"COVID-19 Map. Johns Hopkins Coronavirus Resource Center. Available: https:\/\/coronavirus.jhu.edu\/map.html"},{"key":"pone.0269875.ref002","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/S0140-6736(20)30211-7","article-title":"Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study","volume":"395","author":"N Chen","year":"2020","journal-title":"Lancet"},{"key":"pone.0269875.ref003","doi-asserted-by":"crossref","first-page":"2052","DOI":"10.1001\/jama.2020.6775","article-title":"Presenting Characteristics, Comorbidities, and Outcomes among 5700 Patients Hospitalized with COVID-19 in the New York City Area","volume":"323","author":"S Richardson","year":"2020","journal-title":"JAMA"},{"key":"pone.0269875.ref004","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","article-title":"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study","volume":"395","author":"F Zhou","year":"2020","journal-title":"Lancet"},{"key":"pone.0269875.ref005","doi-asserted-by":"crossref","first-page":"e0239532","DOI":"10.1371\/journal.pone.0239532","article-title":"The changes of the peripheral CD4+ lymphocytes and inflammatory cytokines in Patients with COVID-19","volume":"15","author":"HB Sun","year":"2020","journal-title":"PLoS One"},{"key":"pone.0269875.ref006","doi-asserted-by":"crossref","first-page":"1421","DOI":"10.1007\/s00277-020-04103-5","article-title":"Hematological findings in coronavirus disease 2019: indications of progression of disease","volume":"99","author":"X Liu","year":"2020","journal-title":"Ann Hematol"},{"key":"pone.0269875.ref007","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1111\/jth.14820","article-title":"Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia","volume":"18","author":"DRJ Arachchillage","year":"2020","journal-title":"J Thromb Haemost"},{"key":"pone.0269875.ref008","first-page":"e19080","article-title":"Dynamics of Inflammatory Markers in Predicting Mortality in COVID-19","volume":"13","author":"A Parimoo","year":"2021","journal-title":"Cureus"},{"key":"pone.0269875.ref009","doi-asserted-by":"crossref","first-page":"108435","DOI":"10.1016\/j.intimp.2021.108435","article-title":"Prognostic role of Interleukin-6\/lymphocytes ratio in SARS-CoV2 related pneumonia","volume":"103","author":"L Masotti","year":"2022","journal-title":"Int Immunopharmacol"},{"key":"pone.0269875.ref010","doi-asserted-by":"crossref","first-page":"2877","DOI":"10.1007\/s11010-021-04122-4","article-title":"The most important biomarker associated with coagulation and inflammation among COVID-19 patients","volume":"476","author":"LZ Hong","year":"2021","journal-title":"Mol Cell Biochem"},{"key":"pone.0269875.ref011","doi-asserted-by":"crossref","first-page":"5431","DOI":"10.3390\/jcm10225431","article-title":"Predictive Modeling of Poor Outcome in Severe COVID-19: A Single-Center Observational Study Based on Clinical, Cytokine and Laboratory Profiles","volume":"10","author":"\u00d3 Gorgojo-Galindo","year":"2021","journal-title":"J Clin Med"},{"key":"pone.0269875.ref012","doi-asserted-by":"crossref","first-page":"118167","DOI":"10.1016\/j.lfs.2020.118167","article-title":"The role of cytokine profile and lymphocyte subsets in the severity of coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis","volume":"258","author":"H Akbari","year":"2020","journal-title":"Life Sci"},{"key":"pone.0269875.ref013","doi-asserted-by":"crossref","first-page":"2202","DOI":"10.1172\/JCI137647","article-title":"SARS-CoV-2: A storm is raging","volume":"130","author":"SF Pedersen","year":"2020","journal-title":"J Clin Invest"},{"key":"pone.0269875.ref014","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s13613-020-00798-x","article-title":"Elevated plasma IL-6 and CRP levels are associated with adverse clinical outcomes and death in critically ill SARS-CoV-2 patients: inflammatory response of SARS-CoV-2 patients","volume":"11","author":"J Lavillegrand","year":"2021","journal-title":"Ann Intensive Care"},{"key":"pone.0269875.ref015","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/jcm10020297","article-title":"When Does the Cytokine Storm Begin in COVID-19 Patients? A Quick Score to Recognize It","volume":"10","author":"S Cappanera","year":"2021","journal-title":"J Clin Med"},{"key":"pone.0269875.ref016","doi-asserted-by":"crossref","first-page":"182","DOI":"10.3892\/etm.2021.9613","article-title":"Application of a prediction model with laboratory indexes in the risk stratification of patients with COVID-19","volume":"21","author":"J Ye","year":"2021","journal-title":"Exp Ther Med"},{"key":"pone.0269875.ref017","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1111\/imm.13457","article-title":"The Relationship between Peripheral Immune Response and Disease Severity in SARS-CoV-2-infected Subjects: A Cross-sectional Study","volume":"165","author":"L Otto Walter","year":"2022","journal-title":"Immunology"},{"key":"pone.0269875.ref018","doi-asserted-by":"crossref","first-page":"290","DOI":"10.7150\/thno.63463","article-title":"Integrated analysis of circulating immune cellular and soluble mediators reveals specific COVID19 signatures at hospital admission with utility for prediction of clinical outcomes","volume":"12","author":"I Uranga-Murillo","year":"2022","journal-title":"Theranostics"},{"key":"pone.0269875.ref019","unstructured":"World Heath Organization. COVID-19 Therapeutic Trial Synopsis. Available: https:\/\/www.who.int\/publications\/i\/item\/covid-19-therapeutic-trial-synopsis"},{"key":"pone.0269875.ref020","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1093\/cid\/ciaa248","article-title":"Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China","volume":"71","author":"C Qin","year":"2020","journal-title":"Clin Infect Dis"},{"key":"pone.0269875.ref021","doi-asserted-by":"crossref","first-page":"7819","DOI":"10.1128\/JVI.79.12.7819-7826.2005","article-title":"Cytokine Responses in Severe Acute Respiratory Syndrome Coronavirus-Infected Macrophages In Vitro: Possible Relevance to Pathogenesis","volume":"79","author":"CY Cheung","year":"2005","journal-title":"J Virol"},{"key":"pone.0269875.ref022","doi-asserted-by":"crossref","first-page":"e11","DOI":"10.1016\/j.jinf.2020.09.023","article-title":"A quick prediction tool for unfavourable outcome in COVID-19 inpatients: Development and internal validation","volume":"82","author":"S Salto-Alejandre","year":"2020","journal-title":"J Infect"},{"key":"pone.0269875.ref023","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/S1473-3099(21)00019-0","article-title":"Identification and validation of clinical phenotypes with prognostic implications in patients admitted to hospital with COVID-19: a multicentre cohort study","volume":"21","author":"B Guti\u00e9rrez-Guti\u00e9rrez","year":"2021","journal-title":"Lancet Infect Dis"},{"key":"pone.0269875.ref024","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1016\/j.cmi.2020.07.024","article-title":"Characteristics and predictors of death among 4035 consecutively hospitalized patients with COVID-19 in Spain","volume":"26","author":"J Berenguer","year":"2020","journal-title":"Clin Microbiol Infect"},{"key":"pone.0269875.ref025","doi-asserted-by":"crossref","first-page":"155804","DOI":"10.1016\/j.cyto.2022.155804","article-title":"Cytokine profiles in the detection of severe lung involvement in hospitalized patients with COVID-19: The IL-8\/IL-32 axis","volume":"151","author":"Bergantini L","year":"2022","journal-title":"Cytokine"},{"key":"pone.0269875.ref026","doi-asserted-by":"crossref","first-page":"798338","DOI":"10.3389\/fimmu.2021.798338","article-title":"Cytokine Elevation in Severe COVID-19 From Longitudinal Proteomics Analysis: Comparison With Sepsis","volume":"12","author":"T Ebihara","year":"2022","journal-title":"Front Immunol"},{"key":"pone.0269875.ref027","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s41232-019-0101-5","article-title":"The role of interleukin-1 in general pathology","volume":"39","author":"N Kaneko","year":"2019","journal-title":"Inflamm Regen"},{"key":"pone.0269875.ref028","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1111\/j.1365-2249.2004.02415.x","article-title":"Plasma inflammatory cytokines and chemokines in severe acute respiratory syndrome","volume":"136","author":"CK Wong","year":"2004","journal-title":"Clin Exp Immunol"},{"key":"pone.0269875.ref029","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1038\/s41392-020-0211-1","article-title":"Temporal profiling of plasma cytokines, chemokines and growth factors from mild, severe and fatal COVID-19 patients","volume":"5","author":"ZS Xu","year":"2020","journal-title":"Signal Transduct Target Ther"},{"key":"pone.0269875.ref030","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1038\/s41586-020-2588-y","article-title":"Longitudinal analyses reveal immunological misfiring in severe COVID-19","volume":"584","author":"C Lucas","year":"2020","journal-title":"Nature"},{"key":"pone.0269875.ref031","doi-asserted-by":"crossref","first-page":"e144455","DOI":"10.1172\/jci.insight.144455","article-title":"An immune-based biomarker signature is associated with mortality in COVID-19 patients","volume":"6","author":"MS Abers","year":"2021","journal-title":"JCI Insight"},{"key":"pone.0269875.ref032","doi-asserted-by":"crossref","first-page":"2259","DOI":"10.3390\/microorganisms9112259","article-title":"Elevated Anti-SARS-CoV-2 Antibodies and IL-6, IL-8, MIP-1, Early Predictors of Severe COVID-19","volume":"9","author":"H Codina","year":"2021","journal-title":"Microorganisms"},{"key":"pone.0269875.ref033","doi-asserted-by":"crossref","first-page":"6290","DOI":"10.1172\/JCI140335","article-title":"COVID-19 severity associates with pulmonary redistribution of CD1c+ DCs and inflammatory transitional and nonclassical monocytes","volume":"130","author":"I S\u00e1nchez-Cerrillo","year":"2020","journal-title":"J Clin Invest"},{"key":"pone.0269875.ref034","first-page":"842","article-title":"Single-cell landscape of bronchoalveolar immune cells in patients with COVID-19","volume":"26","author":"M Liao","year":"2020","journal-title":"Nat Med 2020 266"},{"key":"pone.0269875.ref035","first-page":"1824","article-title":"Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19): A Review","volume":"323","author":"JM Sanders","year":"2020","journal-title":"JAMA"},{"key":"pone.0269875.ref036","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1056\/NEJMoa2021436","article-title":"Dexamethasone in Hospitalized Patients with Covid-19","volume":"384","author":"P Horby","year":"2021","journal-title":"N Engl J Med"}],"updated-by":[{"DOI":"10.1371\/journal.pone.0314574","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:00:00Z","timestamp":1732147200000}}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0269875","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,14]],"date-time":"2022-07-14T13:44:53Z","timestamp":1657806293000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0269875"}},"subtitle":[],"editor":[{"given":"Muhammad Tarek","family":"Abdel Ghafar","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,7,14]]},"references-count":36,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7,14]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0269875","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,14]]}}}