A study to evaluate the role of biomarkers in assessing the severity of COVID-19

Abstract

Objectives: COVID-19 is a systemic multiorgan disease caused by severe acute respiratory syndrome coronavirus 2, a beta-type RNA coronavirus. Different laboratory markers are implicated as an indicator of disease severity, progression, and outcome. The objectives of the study are as follows: To study the role of laboratory biomarkers in assessing the severity of COVID-19. (1) To compare the values of various biomarkers (interleukin-6 [IL-6], C-reactive proteins [CRPs], D-Dimer, S. Ferritin) in clinically categorized mild-moderate and severe COVID-19 patients. (2) To compare clinical severity with computed tomography (CT) severity score in COVID-19 patients. (3) To determine association between laboratory markers and CT severity score in COVID-19 patients. Materials and Methods: A hospital-based, retrospective, and observational study was conducted at our tertiary care center on 200 patients to assess the role of different laboratory biomarkers in COVID-19 patients. Values of laboratory markers, serum urea, serum creatinine, serum sodium, and serum potassium were compared between clinically categorized mild/moderate and severe COVID-19 patients. Non-contrast CT chest was performed and CT severity score (mild ≤ 7, moderate 8–17, and severe ≥ 18) was assessed in COVID-19 patients. Results: Levels of total leukocyte count (TLC), D-dimer, CRP, lactate dehydrogenase (LDH), S. ferritin, CK-MB, IL-6, urea, sodium, and potassium were significantly elevated in severe COVID-19 group as compared to mild/ moderate group. Chest CT Severity Score ≥18 was found in 37.1% of patients in severe group; while only in 4.2% patients in mild-to-moderate group and chest CT Severity Score and clinical severity of COVID-19 showed statistically significant agreement (P < 0.001). CRP, LDH, NTPROBNP, S. Ferritin, and CPK showed statistically significant positive correlation with CT severity score whereas sodium and potassium levels showed significant negative correlation. Conclusion: Elevated levels of TLC, D-dimer, CRP, LDH, S. ferritin, CK-MB, and IL-6 were associated with severe COVID-19 cases. NTPROBNP, CRP, LDH, D-dimer, IL-6, and S. Ferritin demonstrated better ability to predict the severity of COVID-19 in comparison to other laboratory biomarkers.