Utility of various inflammatory markers in predicting outcomes of hospitalized patients with COVID-19 pneumonia

Marimuthu, Aishwarya K.; Anandhan, Monisha; Sundararajan, L; Chandrasekaran, Jagadeesh; Balasubramaniam, R.

doi:10.4103/lungindia.lungindia_935_20

Cited by 7 publications

(4 citation statements)

References 23 publications

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“…Supporting the theory, high levels of inflammatory markers such as CRP, PCT, and elevated levels of inflammatory cytokines and chemokines have been found in patients with severe illnesses. (Marimuthu et al, 2021) (F. Liu et al, 2020b. In our study, IL-6, CRP, and PCT levels increased considerably in 77%, 79%, and 20% of patients, respectively, confirming the idea of "cytokine storm"(F. Liu et al, 2020c) and indicated that inflammatory variables played a vital role in the disease, and the levels of IL-6, CRP, and PCT was much higher than in patients with severe disease as compared with the milder form.…”

Section: Discussionsupporting

confidence: 84%

Evaluating The Utility of Interleukin-6, C -Reactive Protein (CRP) and Procalcitonin in Predicting Disease Severity and Prognosis in Hospitalized SARS-CoV-2 Patients: A North Indian Retrospective Study

Khan

Sami

Fatima

et al. 2022

AGJSR

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Background: Coronavirus disease 2019 (COVID-19) associated inflammatory cytokine storm that worsens COVID-19, relies heavily on the inflammatory response. IL-6, a TH1 cytokine, PCT and CRP have been linked to serious illness and a higher mortality rate. We further tried to evaluate the role of these indicators and their association with clinical severity in COVID-19 patients. Material and Methods: Eighty-three consecutive patients with age ≥18 years with RT-PCR test positive for SARS-CoV-2 were included in the study. Demographic characteristics (age and sex), underlying co-morbidities, symptoms, physical findings, and laboratory tests of the patients were recorded. All patients were categorized as having mild, moderate, and severe COVID-19 disease, according to the Indian Council of Medical Research (ICMR). The levels of IL-6 and PCT were estimated by electrochemiluminescence immunoassay (ECLIA) using Cobas-e411 Immunoassay System, and Quantitative CRP was done by Unicorn-230 automated biochemistry analyzer to find out their correlation with disease severity and outcome. Multiple Regression was performed to find out factors associated with the adverse outcome of the disease. Result: Mean age of patients was 51 years. IL-6, CRP, and PCT levels increased in 73 %, 68.0 %, and 8.2 % patients on admission, respectively. The most common co-morbidity associated with the disease was hypertension (25%), followed by diabetes (24%) and respiratory disease (15%). Increased IL-6, CRP, and PCT levels were found in 77 percent, 79 percent, and 20 percent of patients, respectively. We found that IL-6 (P≤0.05), CRP (P≤0.05), and PCT (P≤0.05) were significantly raised in COVID-19 patients with increasing severity of the disease. The Area under the receiver operating characteristic (AUROC) of these parameters ranged between 0.65 and 0.8 (IL-6, 0.828; CRP, 0.809; and PCT, 0.658), indicating a reliable biomarker to assess clinical severity. Conclusion: Sequential measurement of blood levels of IL-6, CRP, and PCT levels is useful in determining the severity and predicting the outcome of the patients with severe disease. IL-6 and CRP have an independent prognostic value. On the other hand, the importance of normal PCT concentrations in patients with viral pneumonia needs to be studied further.

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Section: Discussionsupporting

confidence: 84%

Evaluating The Utility of Interleukin-6, C -Reactive Protein (CRP) and Procalcitonin in Predicting Disease Severity and Prognosis in Hospitalized SARS-CoV-2 Patients: A North Indian Retrospective Study

Khan

Sami

Fatima

et al. 2022

AGJSR

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“…13 Xiong et al several laboratory parameters, specifically the ESR, CRP and LDH, showed significant positive correlation with the severity of pneumonia quantified on initial CT. 14 A recent study was conducted by Marimuthu et al concluded that judicious use of COVID-19 biomarkers could help in disease prognostication and thereby provide guidance to device appropriate management strategies. 15 Most of the studies were conducted in western population where inflammatory biomarkers were correlated with HRCT Severity scores, there is not much data regarding Indian population, though we are one of the highest in numbers of COVID-19. Additionally, the early identification of patients who will become severely ill could facilitate the allocation of the limited medical resources to patients in need of aggressive treatment.…”

Section: Resultsmentioning

confidence: 99%

Correlation between chest CT severity score and C-reactive protein in COVID-19 positive patients admitted in a tertiary care hospital: a retrospective study

2022

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Background: COVID-19 has developed into a worldwide pandemic. The early identification of patients who will become severely ill could facilitate the allocation of the limited medical resources to patients in need of aggressive treatment. Aim of the current study was to determine the correlation between COVID-19 severity with inflammatory marker CRP and CT severity score on HRCT thoraxMethods: A retrospective observational study was done in 502 hospitalized COVID‑19 patients in a tertiary care hospital BMCRI, Bangalore from August 2021 to September 2021. Clinical and laboratory data of patients were collected. The correlation between clinical severity with chest CT score and CRP were determined by ANOVA test and independent sample t-test was applied among survivors and non survivors. Correlation between CTSS and CRP was analyzed by Pearson correlation analysis.Results: In our present study we found that, out of 502 patients who fulfilled the inclusion criteria 158 patients (31.5%) were triaged as mild cases, 228 patients (45.4%) were moderate case, and 116 patients (23.1%) severe cases. There was statistical significance between CRP values and CTSS among the mild, moderate, severe cases (p<0.001). Both CTSS and CRP values had explicit association with clinical condition of patients. By using independent sample t-test we could derive that CRP and CTSS had strong and significant correlation with the disease severity and mortality. Pearson correlation analysis revealed strong positive correlation between CRP and CTSS in COVID-19 patients. Hence an increase in CRP caused an increase in CTSS with significant p values.Conclusions: In our study we conclude that there is a strong positive clinical correlation between CRP and CTSS in COVID-19 patients reflecting disease severity and mortality.

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“…Nutrients 2022, 14, x FOR PEER REVIEW 18 of 25 Figure 12. Galbraith plot for the contribution of results from the different studies [8,[10][11][12][13]30,[38][39][40][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64] about mortality for ferritin to the heterogeneity. This analysis was based on the relevant data listed in Table1 and the number orders in the plot were same to the reference list.…”

Section: Figure 12mentioning

confidence: 99%

“…Figure 2.Forest plot of standard mean difference (SMD) with corresponding 95% confidence intervals (CIs) of studies[8,[10][11][12][13]30,[38][39][40][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64] on ferritin levels in non-survivors and survivors. The solid diamond and horizontal line represent the study-specific effect and 95%CI, respectively; the size of the grey square is positively correlated with the weight distributed to each study in the meta-analysis.The center of open diamond with the vertical dashed line expresses the pooled SMD, and the width expresses the pooled 95%CI.…”

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confidence: 99%

The Associations of Iron Related Biomarkers with Risk, Clinical Severity and Mortality in SARS-CoV-2 Patients: A Meta-Analysis

Zhou

2022

Nutrients

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The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading rapidly around the world and has led to millions of infections and deaths. Growing evidence indicates that iron metabolism is associated with COVID-19 progression, and iron-related biomarkers have great potential for detecting these diseases. However, the results of previous studies are conflicting, and there is not consistent numerical magnitude relationship between those biomarkers and COVID-19. Thereby, we aimed to integrate the results of current studies and to further explore their relationships through a meta-analysis. We searched peer-reviewed literature in PubMed, Scopus and Web of Science up to 31 May 2022. A random effects model was used for pooling standard mean difference (SMD) and the calculation of the corresponding 95% confidence interval (CI). I2 was used to evaluate heterogeneity among studies. A total of 72 eligible articles were included in the meta-analysis. It was found that the ferritin levels of patients increased with the severity of the disease, whereas their serum iron levels and hemoglobin levels showed opposite trends. In addition, non-survivors had higher ferritin levels (SMD (95%CI): 1.121 (0.854, 1.388); Z = 8.22 p for Z < 0.001; I2 = 95.7%, p for I2 < 0.001), lower serum iron levels (SMD (95%CI): −0.483 (−0.597, −0.368), Z = 8.27, p for Z < 0.001; I2 = 0.9%, p for I2 =0.423) and significantly lower TIBC levels (SMD (95%CI): −0.612 (−0.900, −0.324), Z = 4.16, p for Z < 0.001; I2 = 71%, p for I2 = 0.016) than survivors. This meta-analysis demonstrates that ferritin, serum iron, hemoglobin and total iron banding capacity (TIBC) levels are strongly associated with the risk, severity and mortality of COVID-19, providing strong evidence for their potential in predicting disease occurrence and progression.

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Utility of various inflammatory markers in predicting outcomes of hospitalized patients with COVID-19 pneumonia

Cited by 7 publications

References 23 publications

Evaluating The Utility of Interleukin-6, C -Reactive Protein (CRP) and Procalcitonin in Predicting Disease Severity and Prognosis in Hospitalized SARS-CoV-2 Patients: A North Indian Retrospective Study

Evaluating The Utility of Interleukin-6, C -Reactive Protein (CRP) and Procalcitonin in Predicting Disease Severity and Prognosis in Hospitalized SARS-CoV-2 Patients: A North Indian Retrospective Study

Correlation between chest CT severity score and C-reactive protein in COVID-19 positive patients admitted in a tertiary care hospital: a retrospective study

The Associations of Iron Related Biomarkers with Risk, Clinical Severity and Mortality in SARS-CoV-2 Patients: A Meta-Analysis

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