Host Biomarkers Reflect Prognosis in Patients Presenting With Moderate Coronavirus Disease 2019: A Prospective Cohort Study

Abstract

Efficient resource allocation is essential for effective pandemic response. We measured host biomarkers in 420 patients presenting with moderate coronavirus disease 2019 and found that different biomarkers predict distinct clinical outcomes. Interleukin (IL)-1ra, IL-6, IL-10, and IL-8 exhibit dose-response relationships with subsequent disease progression and could potentially be useful for multiple use-cases.

Keywords: COVID-19; host biomarker; prognosis.

Figure 1.

Baseline concentration and prognostic utility of host biomarkers in participants with moderate coronavirus disease 2019. A, Concentrations plotted on log₂ scale and expressed in pg/mL (Ang-2, CXCL-10, IL-1ra, IL-6, IL-8, IL-10, PCT, sTREM-1), ng/mL (D-dimer, suPAR), mg/L (CRP), or × 10⁹ cells/L (platelets). B, Biomarkers ordered from left to right by ascending mean c-statistic across the 3 severity outcomes. Abbreviations: Ang-2, angiopoietin-2; AUC, area under the receiver operating characteristic curve; CRP, C-reactive protein; IL, interleukin; MV, mechanical ventilation; NIV, noninvasive ventilation; NLR, neutrophil-to-lymphocyte ratio; O₂, oxygen; PCT, procalcitonin; sTREM-1, soluble triggering receptor expressed on myeloid cells 1; suPAR, soluble urokinase plasminogen activator receptor.