Abstract
Early detection of severe forms of COVID-19 is absolutely essential for timely triage of patients. We longitudinally followed-up two well-characterized patient groups, hospitalized moderate to severe (n = 26), and ambulatory mild COVID-19 patients (n = 16) at home quarantine. Human D-dimer, C-reactive protein (CRP), ferritin, cardiac troponin I, interleukin-6 (IL-6) levels were measured on day 1, day 7, day 14 and day 28. All hospitalized patients were SARS-CoV-2 positive on admission, while all ambulatory patients were SARS-CoV-2 positive at recruitment. Hospitalized patients had higher D-dimer, CRP and ferritin, cardiac troponin I and IL-6 levels than ambulatory patients (p < 0.001, p < 0.001, p = 0.016, p = 0.035, p = 0.002 respectively). Hospitalized patients experienced significant decreases in CRP, ferritin and IL-6 levels from admission to recovery (p < 0.001, p = 0.025, and p = 0.001 respectively). Cardiac troponin I levels were high during the acute phase in both hospitalized and ambulatory patients, indicating a potential myocardial injury. In summary, D-dimer, CRP, ferritin, cardiac troponin I, IL-6 are predictive laboratory markers and can largely determine the clinical course of COVID-19, in particular the prognosis of critically ill COVID-19 patients.
Highlights
The outbreak of the novel coronavirus SARS-CoV-2 causing COVID-19 was first reported in Wuhan, China, and has rapidly spread around the world, causing a global pandemic
Mild COVID-19 is characterized by fever, cough, fatigue, myalgia but without signs of viral pneumonia or hypoxia, whereas a moderate manifestation is characterized by pneumonia
We investigated serum D-dimers, C-reactive protein (CRP), ferritin, cardiac troponin I, IL-6 levels during the acute phase of infection (SARS-CoV-2 RNA positive) and were monitored longitudinally in hospitalized patients with moderate to severe COVID-19 and in mild ambulatory COVID-19 patients in home quarantine
Summary
The outbreak of the novel coronavirus SARS-CoV-2 causing COVID-19 was first reported in Wuhan, China, and has rapidly spread around the world, causing a global pandemic. While most infected persons have a mild illness and recover from the disease without requiring hospitalization, about 20% of patients with moderate or severe COVID-19 are hospitalized for additional supportive c are[5]. An increase in cardiac troponin indicates myocardial injury, and elevated cardiac troponin I (cTNI) levels associated with heart arrhythmia and death are commonly observed in severe COVID-19 patients[13] and are an independent predictor of clinical outcome in critically ill COVID-19 p atients[1]. We investigated serum D-dimers, CRP, ferritin, cardiac troponin I, IL-6 levels during the acute phase of infection (SARS-CoV-2 RNA positive) and were monitored longitudinally in hospitalized patients with moderate to severe COVID-19 and in mild ambulatory COVID-19 patients in home quarantine
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