Introduction The COVID-19 pneumonia is a heterogeneous disease with variable effect on lung parenchyma, airways, and vasculature leading to long-term effects on lung functions. Materials and methods Multicentric, prospective, observational, and interventional study conducted during July 2020 to May 2021, in the MIMSR Medical College and Venkatesh Hospital Latur India, included 1000 COVID-19 cases confirmed with RT-PCR. All cases were assessed with lung involvement documented and categorized on HRCT thorax, oxygen saturation, inflammatory marker, ferritin at entry point, and follow-up during hospitalization. Age, gender, comorbidity, and use of BIPAP/NIV and outcome as with or without lung fibrosis as per CT severity were key observations. CT severity scoring is done as per universally accepted standard scoring tool as score < 7 as mild, 7–14 as moderate, and score > 15 as severe affection of the lung. Statistical analysis is done by using chi-square test. Observations and analysis In study of 1000 COVID-19 pneumonia cases, age (< 50 and > 50 years) and gender (male versus female) have significant association with ferritin in predicting severity of COVID-19 pneumonia (p < 0.00001) and (p < 0.010), respectively. CT severity score at entry point with ferritin level has significant correlation in severity scores < 8, 8–15, and > 15 documented in normal and abnormal ferritin level as in 190/110, 90/210, and 40/360, respectively (p < 0.00001). Ferritin level has significant association with duration of illness, i.e., DOI < 7 days, 8–15 days, and > 15 days of onset of symptoms documented normal and abnormal ferritin levels in 30/310, 160/300, and 130/70 cases, respectively (p < 0.00001). Comorbidity as diabetes mellitus, hypertension, COPD, IHD, and obesity has significant association in COVID-19 cases with normal and abnormal ferritin level respectively (p < 0.00001). Ferritin level has significant association with oxygen saturation in COVID-19 pneumonia cases; cases with oxygen saturation > 90%, 75–90%, and < 75% are observed as normal and abnormal ferritin level in 110/100, 150/340, and 60/240 cases, respectively (p < 0.00001). BIPAP/NIV requirement during the course of COVID-19 pneumonia in critical care setting has significant association with ferritin level; cases received BIPAP/NIV during hospitalization were documented normal and abnormal ferritin level in 155/445 and 165/235 cases, respectively (p < 0.00001). Timing of BIPAP/NIV requirement during course of COVID-19 pneumonia in critical care setting has significant association with ferritin level; cases received BIPAP/NIV at entry point < 1 day, 3–7 days, and after 7 days of hospitalization were documented significance in fourfold raised ferritin level in 110/70, 150/160, and 30/80 cases, respectively (p < 0.00001). Follow-up of ferritin titer during hospitalization as compared to entry point abnormal ferritin has significant association in post-COVID lung fibrosis (p < 0.00001). Follow-up of ferritin titer during hospitalization as compared to entry point normal ferritin has significant association in post-COVID lung fibrosis (p < 0.00001). Conclusion Ferritin is easily available, sensitive and reliable, cost-effective, and universally acceptable inflammatory marker in COVID-19 pandemic. Ferritin has very crucial role in COVID-19 pneumonia in predicting severity of illness and assessing response to treatment during hospitalization. Follow-up of ferritin titer during hospitalization and at discharge can be used as early predictor of post-COVID lung fibrosis.

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Introduction: Robust data of CRP is available in bacterial infection, and now it can be utilized in Covid- 19 pneumonia pandemic initial assessment of severity and planning of treatment. Materials and Methods: Multicentric, prospective, observational and interventional study conducted during July 2020 to May 2021 included 1000 Covid-19 cases confirmed with RT PCR. All cases were assessed with lung involvement documented and categorized on HRCT thorax, oxygen saturation, inflammatory marker as CRP at entry point and follow up. Age, gender, Comorbidity and use BIPAP/NIV and outcome as with or without lung fibrosis as per CT severity were key observations. Statistical analysis is done by using Chi square test. Observations and analysis: Age (<50 and >50 years) and gender (male versus female) has significant association with CRP in predicting severity [p<0.00001] & [p<0.010] respectively. CT severity score at entry point with CRP level has significant correlation [p<0.00001] CRP level has significant association with duration of illness (Doi) [p<0.00001] Comorbidities has significant association with CRP level. [p<0.00001] CRP level has significant association with oxygen saturation [p<0.00001] BIPAP/NIV requirement during hospitalization has significant association with CRP level. [p<0.00001] Timing of BIPAP/NIV requirement has significant association with CRP level. [p<0.00001] Follow-up CRP titer during hospitalization as compared to entry point normal and abnormal CRP has significant association in post-covid lung fibrosis [p<0.00001] Conclusion: CRP is easily available and universally acceptable inflammatory marker in Covid-19 pandemic and ‘serial titer’ documented very crucial role in predicting severity of illness, need of ventilatory support and help in predicting post-covid lung fibrosis. J MEDICINE 2022; 23: 112-120

Introduction: COVID-19 pneumonia is heterogeneous disease with variable effect on lung parenchyma, airways and vasculature leading to long term effects on lung functions. Materials and methods: Multicentric, prospective, observational and interventional study conducted during July 2020 to May 2021, in MIMSR Medical College and Venkatesh Hospital Latur India, included 1000 COVID-19 cases confirmed with RT PCR. All cases were assessed with lung involvement documented and categorized on HRCT thorax, oxygen saturation, inflammatory marker as IL-6 at entry point and follow up. Age, gender, Comorbidity and use BIPAP/NIV and outcome as with or without lung fibrosis as per CT severity were key observations. CT severity scoring done as per universally accepted standard scoring tool as score <7 as mild, 7-14 as moderate and score >15 as severe affection of lung. Statistical analysis is done by using Chi square test. Observations and analysis: In study of 1000 covid-19 pneumonia cases, age (<50 and >50 years) and gender (male versus female) has significant association with IL-6 in predicting severity of covid 19 pneumonia [p<0.00001] & [p<0.010] respectively. CT severity score at entry point with IL-6 level has significant correlation in severity score <8, 8- 15 and >15 documented normal and abnormal IL-6 level as in 190/110, 90/210 and 40/360 respectively. [p<0.00001] IL6 level has significant association with duration of illness i.e., Doi <7 days, 8-15 days and >15 days of onset of symptoms documented normal and abnormal IL-6 levels in 30/310, 160/300 and 130/70 cases respectively. [p<0.00001] Comorbidity as diabetes mellitus, hypertension, COPD, IHD & obesity has significant association in covid-19 cases with normal and abnormal IL-6 level respectively. [p<0.00001] IL-6 level has significant association with oxygen saturation in covid1-19 pneumonia cases; cases with oxygen saturation >90%, 75-90%, and <75% observed as normal and abnormal IL-6 level in 110/100, 150/340 and 60/240 cases respectively [p<0.00001] BIPAP/NIV requirement during course of covid-19 pneumonia in critical care setting has significant association with IL-6 level; cases received BIPAP/NIV during hospitalization were documented normal and abnormal IL-6 level in 155/445, 165/235 cases respectively [p<0.00001] Timing of BIPAP/NIV requirement during course of covid-19 pneumonia in critical care setting has significant association with IL-6 level; cases received BIPAP/NIV at entry point <1 day, 3-7 days and after 7 days of hospitalization were documented significance in four-fold raised IL-6 level in 110/70, 150/160 and 30/80 cases respectively [p<0.00001] Follow-up IL-6 titer during hospitalization as compared to entry point abnormal IL-6 has significant association in postcovid lung fibrosis [p<0.00001] Follow-up IL-6 titer during hospitalization as compared to entry point normal IL-6 has significant association in post-covid lung fibrosis [p<0.00001] Follow-up IL-6 titer during hospitalization as compared to entry point abnormal IL-6 has significant association in predicting cytokine storm irrespective normal or abnormal of IL6 at entry point [p<0.0001] Conclusion: IL-6 is sensitive, reliable, cost effective, and now universally acceptable inflammatory marker in COVID-19 pandemic. IL-6 has very crucial role in covid-19 pneumonia in predicting severity of illness, progression of illness including ‘cytokine storm’ and assessing response to treatment during hospitalization. Follow up IL-6 titer during hospitalization and at discharge can be used as early predictor of post-covid lung fibrosis.

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