Role of Inflammatory Markers in Predicting Severity and Outcome in COVID-19 Patients Attending a Tertiary Care Institute of Tamil Nadu

Abstract

Background:Severe acute respiratory syndrome Coronavirus 2 (SARS-COV 2) infection elicits an inflammatory response which is responsible for severe clinical manifestations, disease progression and, poor outcomes.Objectives: This study aims to assess the pattern of elevation of inflammatory markers in COVID-19 and to determine their association with clinical, radiological severity and outcome of COVID 19.Methodology: This is a retrospective single-center cross-sectional study conducted at Chettinad Hospital and Research Institute, a tertiary care Hospital in Tamil Nadu, India, encompassing a cohort of 1220 patients. The source population was all cases of COVID-19 admitted at the hospital with a confirmed diagnosis of COVID-19 using RT PCR. The data was obtained from the patient’s case sheets and laboratory investigations and from the electronic data management system. The patient’s clinical severity on admission, baseline characteristics, co-morbid illnesses, presenting complaints, vitals, and inflammatory markers like D-dimer, C-reactive protein IL-6, Serum ferritin, and Lactate dehydrogenase were collected. The data for radiological severity and outcome were coded and analysed.Results: Diabetes and hypertension were found to be the most common comorbidities in the study population; females more affected than males. Fever and cough are the most common presenting symptoms. The clinical severity of patients was found to have a significant association with radiological severity. D-dimer is having a strong correlation with disease severity and outcome at any point in time. IL-6, CRP, Serum ferritin also showed a strong correlation with outcome in COVID-19.Conclusion:Our study suggests D-dimer at any point of time in a hospitalized COVID-19 patient as a promising marker for the same. IL-6 is the next best inflammatory marker followed by CRP and Serum ferritin. LDH is the least significant one among these.