Role of biomarkers in predicting prognosis of Coronavirus disease 2019 (COVID-19): A retrospective cross-sectional study: Perspective of a tertiary care hospital in India

Abstract

Background: COVID-19 is a novel disease triggered by the SARS-CoV-2 virus, a beta coronavirus similar to MERS-CoV and SARS CoV. Inflammatory markers have a vital role in the pathogenesis of nCOVID 19; understanding the importance of these inflammatory markers in determining disease status is essential given the impact of the disease on healthcare. Thus, being able to triage cases with minimal tests is momentous to capture, which we have investigated as per our study guidelines of the role of inflammatory markers such as D-dimer, CRP (C - reactive protein), Ferritin, LDH (Lactate Dehydrogenase) in patients with COVID 19. In addition, limited data is available comparing the utility of these inflammatory markers to predict the following parameters as the need for ICU, oxygen support requirement, and duration of in-hospital stay, which can help guide the management protocol. Aim: This study aims to determine markers associated with poor prognosis in patients with Coronavirus disease 2019 (COVID-19). Objectives: 1) To assess the inflammatory markers that are routinely investigated in COVID- 19 patients. 2) To determine the most probable factor to estimate severity in COVID- 19 and thus predict prognosis. Methods: This is a retrospective cross-sectional observational study of patients who tested SARS COV 2 positive by RT PCR. The laboratory inflammatory markers, namely Lactate Dehydrogenase, C reactive protein, D-dimer, Ferritin, were assessed in the selected patients, and their clinical data and demographic details were taken into account. The parameters considered for contributing to the severity included the number of days of stay in the hospital, oxygen requirement, and ICU needs. Analyses relied upon analysis of variance for cross-sectional study design and a P< 0.05 statistical significance criterion. Results: There was a statistically significant difference found between oxygen requirement and D dimer (p<0.001), LDH (p= 0.002), and CRP (p= 0.024). There was a statistically significant difference found between admission to ICU and D Dimer (p= 0.001). Conclusion: A statistically significant association between the increasing D-dimer levels and all the outcome measures considered was found. The D-dimer, LDH, and CRP help predict oxygen requirement, and all the inflammatory markers can predict the number of days of stay in the hospital.