The inflammatory biomarkers profile of hospitalized patients with COVID-19 and its association with patient’s outcome: A single centered study

Abstract

Several reports highlighted the central role of inflammation in the pathogenesis of corona virus disease-19 (COVID-19) disease. Also, the hyper-inflammatory response that is triggered by severe acute respiratory syndrom-Covid-2 (SARS-CoV-2) infection was believed to play an essential role in disease severity and adverse clinical course. For that reason, the classical inflammatory markers were proposed as a possible indicator for COVID-19 severity. However, an extensive analysis of the predictive value of inflammatory biomarkers in large patients’ cohorts is still limited and critically needed. In this study we investigated the predictive value of the classical inflammatory biomarkers in a patient cohort consists of 541 COVID-19 patients admitted to Al Kuwait Hospital, Dubai, UAE. A detailed analysis of the association between the essential inflammatory markers and clinical characteristics as well as clinical outcome of the patients were made. In addition, the correlation between those markers and a wide range of laboratory biomarkers and incidence of acute organs injury were investigated. Our results showed a significant elevation of many inflammatory markers including white cell count (WBC) count, neutrophils count, C-reactive protein (CRP), D-Dimer, ferritin, procalcitonin (PCT), and lactate dehydrogenase (LDH) levels in patients with more severe illness. Also, our results highlighted that higher levels of those markers can predict worse patient outcome including the need of ventilation, intensive care unit (ICU) admission, multiple organs dysfunction as well as death. In addition, Our results showed that the presence of lymphopenia and lower absolute lymphocyte count (ALC) at the time of admission were associated with severe to critical COVID-19 illness (P<0.0001), presence of acute respiratory distress syndrome (ARDS) (P<0.0001) and the need for ventilation and ICU admission., Moreover, our results showed a strong association between lower ALC count and multiple organs dysfunction and patient’s death (P<0.0001). In conclusion, our results highlighted the possible use of classical inflammatory biomarkers at time of admission as a potential predictive marker for more severe clinical course in COVID-19 patients that might need more aggressive therapeutic approach including the need of ventilators and ICU admission. The presence of such predictive markers might improve patient’s stratification and help in the direction of the available resources to patients in need, which in turn help in improving our response to the disease pandemic.

Factors predicting mortality among patients with COVID-19 associated hospital acquired pneumonia: Insights from a tertiary care center

“…Inflammatory biomarkers such as ferritin, LDH and D-dimers are well established indicators of the severity of COVID-19 infections [12][13][14]. However, in our study, only high serum Ferritin levels (>1000ng/mL) at the time of admission were found to be independently associated with nonsurvival on multivariate analysis.…”

Association of Inflammatory Markers with Disease Severity and Outcome in Covid-19 Patients

“…Other studies showed significantly higher CRP levels in COVID-19 patients that showed severe illness compared to mild or non-severe form of the disease [9,[15][16][17][18][19][20]. In our study, we recorded a significant increase of CRP values during hospitalization.…”

Complete blood count derived inflammatory biomarkers and the level of anti-SARS-CoV-2 NAb and S-RBD IgG among cancer survivors receiving COVID-19 vaccines

“…The WBC count is a nonspecific biomarker for inflammation and is associated with the immune system's response to infection [33]. Several studies demonstrated that the elevated WBC was associated with more critical COVID-19 and cancer prognoses [34,35]. This finding also was supported by the study [36] who stated that the NAb level also had a poor correlation with WBC and suggested that the production of the NAb did not depend on the number of immune cells.…”