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. 2020 Jun:95:332-339.
doi: 10.1016/j.ijid.2020.04.041. Epub 2020 Apr 22.

Clinical value of immune-inflammatory parameters to assess the severity of coronavirus disease 2019

Zhe Zhu  1 , Ting Cai  2 , Lingyan Fan  3 , Kehong Lou  4 , Xin Hua  5 , Zuoan Huang  6 , Guosheng Gao  7
Affiliations

Clinical value of immune-inflammatory parameters to assess the severity of coronavirus disease 2019

Zhe Zhu et al. Int J Infect Dis. 2020 Jun.

Abstract

Objective: To explore the clinical value of immune-inflammatory markers to assess the severity of coronavirus disease 2019 (COVID-19).

Methods: 127 consecutive hospitalized patients with confirmed COVID-19 were enrolled in this study, and classified into non-severe and severe groups. Demographics, symptoms, underlying diseases and laboratory data were collected and assessed for predictive value.

Results: Of 127 COVID-19 patients, 16 cases (12.60%) were classified into the severe group. High level of interleukin-6 (IL-6), C-reaction protein (CRP) and hypertension were independent risk factors for the severity of COVID-19. The risk model based on IL-6, CRP and hypertension had the highest area under the receiver operator characteristic curve (AUROC). Additionally, the baseline IL-6 was positively correlated with other immune-inflammatory parameters and the dynamic change of IL-6 in the severe cases were parallel to the amelioration of the disease.

Conclusion: Our study showed that high level of IL-6, CRP and hypertension were independent risk factors for assessing the severity of COVID-19. The risk model established upon IL-6, CRP and hypertension had the highest predictability in this study. Besides, IL-6 played a pivotal role in the severity of COVID-19 and had a potential value for monitoring the process of severe cases.

Keywords: COVID-19; Cytokine storm; IL-6; Immune-inflammatory parameters; SARS-CoV-2.

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Figures

Fig. 1
Fig. 1
ROC curves of risk model and other single immune-inflammatory parameters for the severity of COVID-19. COVID-19: coronavirus disease 2019; ROC: Receiver operator characteristic; NLR: neutrophil-to-lymphocyte ratio.
Fig. 2
Fig. 2
Correlations between interleukin-6 and neutrophil% (A), lymphocyte%(B), lymphocyte count (C), platelet count (D), NLR (E), fibrinogen (F), sialic acid (G), C-reaction protein (H), interleukin-10 (I), interferon-γ (J) in patients with COVID-19. The levels of interleukin-6 in COVID-19 patients with and without hypertension (K). COVID-19: coronavirus disease 2019; NLR: neutrophil-to-lymphocyte ratio.
Fig. 3
Fig. 3
The dynamic changes of interleukin-6 in patients with COVID-19. COVID-19: coronavirus disease 2019. *P< 0.05 between non-severe and severe groups.
See this image and copyright information in PMC

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