‘Composite index’ in COVID-19 related ‘Dragon’ Pandemic: Novel approach to predict outcome

Abstract

COVID-19 related ‘Dragon pandemic’ caused significant mortality and its lingering effects as long covid with huge impact on morbidity and quality of life. As pandemic has waned off, still rescue breath is in doubt due to evolving mutants and variants of great concern. COVID-19 infection involves a complex interplay of the immunological and inflammatory responses. Inflammatory parameters are closely linked to the COVID-19 severity and mortality. Inflammatory parameters could be used to predict the transition from mild to severe/critical infection in patients of COVID-19. Numerous Inflammatory markers were analyzed and used as point of care test to predict severity of illness, monitoring of illness, treatment planning and predicting final outcomes such as CRP, LDH, IL-6, D-dimer and ferritin. Robust data of these inflammatory markers is available and proved crucial in predicting pathophysiological trends such as cytokine storm, coagulation abnormalities, oxygenation status and response to therapy. Isolated assessment of inflammatory markers in absence of clinical and radiological parameters were observed as ‘double edged weapon’ due to overestimation and its impact on health burden and underprediction resulting into progression of illness and resultant poor outcome and increased health care cost. Composite index is combination clinical, radiological and laboratory inflammatory marker assessment. Combination of any two abnormalities were observed crucial role in early suspicion, diagnosis, monitoring, and recognition of complications, management and disposition of patients. Composite index rather than single biomarkers may provide more reliable information. Availability and cost issues cannot be ignored. It would be impossible for clinicians to consolidate and critically analyze the enormous data that is continuously added to the COVID-19 literature to extract practically useful information for the benefit of patients. Still, as of now Composite index is sensitive and effective tool to assess COVID-19 cases at entry point and to analyze exact status of illness which will have successful treatment outcome and thus considered as ‘point of care test’ in this ‘Dragon Pandemic’.