Evaluation of the association between inflammatory markers and the prognosis of Covid-19

Abstract

ABSTRACT Introduction: Coronavirus disease 2019 (COVID-19) triggers the immune system and causes changes in the serum level of inflammatory markers such as erythrocyte sedimentation rate (ESR), C-reactive protein, ferritin, interleukin-6, LDH, D-dimer, and procalcitonin (PCT); in this study, we investigate the association between the serum level of inflammatory markers and the prognosis of COVID-19, which included mortality and intensive care unit (ICU) admission of patients Methods: This cross-sectional study was conducted on 200 COVID-19 patients hospitalized at Ayatollah Rouhani Hospital, Babol, from March 2020 to March 2021. Demographic indicators and inflammatory markers were recorded in the questionnaire and were investigated based on disease outcome, length of hospitalization, need for non-invasive ventilation (NIV), and need for hospitalization in the ICU and ventilator. Patients who died or were discharged within the first 24 hours of hospitalization (before the test) were excluded from the study. Finally, the data were recorded in SPSS Statistics 26.0 and then analyzed. Results: The average age of patients with COVID-19 hospitalized in the hospital was 57.92 ± 16.18. The prevalence of death due to coronavirus disease in hospitalized patients was 8.5%. Besides, 23.5% of patients were hospitalized in the ICU and 28.5% required NIV. Based on the disease’s outcome, a significant difference was found in the neutrophil-to-lymphocyte ratio (NLR), so the NLR was significantly higher in patients who died due to coronavirus. Moreover, the levels of erythrocyte sedimentation rate (ESR), D-dimer, LDH, and PCT in deceased individuals were considerably higher compared to those who recovered. Conclusion: NLR, ESR, D-dimer level, LDH, and PCT are among the markers that affect COVID-19 patient outcomes. The increment of any of these markers will lead to an increase in the risk of death and also the need for ICU admission.