Association of Inflammatory Markers with COVID-19 Outcome among Hospitalized Patients: Experience from a Tertiary Healthcare Center in Western India

Abstract

Introduction: COVID-19 is a highly infectious disease and varies in the severity of presentation as well as survival outcome due to varied inflammatory responses. Hence, the present study is aimed to evaluate the role of inflammatory markers in predicting the outcome of COVID-19 in hospitalized patients. Methods: A total of 272 confirmed COVID-19 patients were included in the study. Clinical and demographic data were collected. Biochemical, hematological, and inflammatory markers were assessed in all patients. Disease severity and primary outcome as survival and or mortality were recorded. Results:Hematological indices and inflammatory markers were significantly higher among the non-survivors. Interleukin-6 (IL-6) can differentiate non-survivors from survivors with 100% sensitivity and 70.2% specificity, with a cut-off value of 79.6 in the receiver operator curve (ROC). As disease severity was increasing, IL-6 and C-reactive protein (CRP) were significantly increased among patients. Survival analysis showed that an elevated level of IL-6 was significantly associated with mortality and Cox regression analysis showed the hazard ratio (HR) of IL-6 was 0.996 (P<0.007). Conclusion:The results of the present study implicate that increased levels of IL-6 and CRP were significantly correlated with severity and mortality in COVID-19 patients. In addition, the dynamic measurement of neutrophil-to-lymphocyte (N/L) ratio, IL-6, and CRP in COVID-19 might be used as predictors of prognosis and outcome.

TABLE 1.

Basic characteristics of COVID-19 patientsBasic characteristics of COVID-19 patients

TABLE 2.

Predictors of mortality among COVID-19 patients

TABLE 3.

Inflammatory profile and biochemical parameters among survivors and non-survivors

TABLE 4.

Performance criteria of inflammatory markers in discriminating the outcome of COVID-19

FIGURE 1.

ROC curve of laboratory markers as predictors of COVID-19 outcome

FIGURE 2.

ROC curve of laboratory markers as predictors of COVID-19 outcome

FIGURE 3.

Cox proportional hazard ratio showing the relation between mortality and COVID-19 based on levels of interleukin-6 (IL-6) and C-reactive protein (CRP)