Infection and disease severity in acute care: FORESEEN by clinical scoring systems and biomarkers

In this thesis we investigated the performance of different biomarkers and clinical scoring systems in the emergency department (ED) and intensive care unit (ICU) in patients with a suspected infection and patients with COVID-19. Several biomarkers, such as C-reactive protein (CRP), white blood cell count (WBC) and lactate, are already routinely used in clinical practice during the diagnostic workup in the ED. These biomarkers alone are unable to accurately differentiate between bacterial and viral infections or predict disease severity40. Therefore, we conducted different studies where we investigated biomarkers that potentially have superior performance in identifying bacterial and viral infections and predicting disease severity. The goal of this thesis was to investigate the performance of different biomarkers on identifying bacterial and viral infections and to disease severity when combined with different clinical scoring systems. This was initially done by a systematic literature review to investigate and create an overview of which biomarkers and clinical scoring systems have already been studied in previous studies. Following, we conducted multiple retrospective and prospective cohort studies where we investigated clinical scoring systems and biomarkers in different cohorts of patients with infections in the ED and ICU.