Evaluation of the Predictive Value of C-reactive Protein, Interleukin-6 and Their Derived Immune-Inflammatory Indices in COVID-19 Egyptian Patients

Abstract

Background:In coronavirus disease 2019 , finding sensitive biomarkers is critical for detecting severe cases early and intervening effectively. Aim of the work: To compare and evaluate the value of pretreatment c-reactive protein (CRP), interleukin-6 (IL-6), and their derived immune-inflammatory indices (CRP/albumin (CRP/alb), lymphocyte/CRP (L/CRP), and lymphocyte/IL-6 (L/IL-6)) in the prediction of COVID-19 severity and in-hospital mortality. Methods: This cross-sectional study included 85 confirmed COVID-19 patients, their complete blood count with differential, as well as albumin and IL-6 levels on the day of their hospital admission, were assessed and compared. We followed all patients till their inhospital death or discharge from the hospital. Results: On admission levels of CRP, IL-6, and CRP/alb were significantly higher (p=0.001) in severe patients and non-survivors, but L/CRP and L/IL-6 were significantly lower (p=0.001) compared to non-severe patients and nonsurvivors. CRP/alb and L/CRP at cut-offs of 1.65 and 260.86, respectively, were the best predictors for COVID-19 severity, while IL-6 and L/IL-6 at cut-offs of 120 pg/ml and 5.40, respectively, were the best predictors for COVID-19 in-hospital mortality. IL-6 was an independent risk factor associated with severe disease development (odds ratio (OR): 1.033; 95% confidence interval (CI): 1.002-1.066). Conclusions: Pretreatment levels of CRP, IL-6, and their derived indices should be included in the diagnostic work-up of COVID-19 to determine the severity and predict the outcome.

Do CRP levels predict severity in COVID-19 hospitalized Egyptian patients?

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patients possibly acquire life-threatening complications that involve septic shock, coagulation dysfunction, and multiple organ failure [6]. According to previous several previous studies, COVID-19 progression may be aided by an abnormal immune-inflammatory response and cytokine storm [7,8].C-reactive protein (CRP) is a pentameric acute-phase reactant produced by the liver, and its level rises in response to the action of cytokines like

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“…patients possibly acquire life-threatening complications that involve septic shock, coagulation dysfunction, and multiple organ failure [6]. According to previous several previous studies, COVID-19 progression may be aided by an abnormal immune-inflammatory response and cytokine storm [7,8].…”

Value of Interleukin 6 in Assessment of the Disease Severity in Patients with COVID-19 Infection without Preexisting Comorbidities

“…A similar result was found in a study done in 2021 (12), they found that the most common symptoms included fever, cough, fatigue, and bone ache. Moreover, a recent study done in 2022 (13) The ratio of inpatient…”

Exhaled Carbon Monoxide as a Marker of Inflammation in Hospitalized COVID-19 Patients

“…Septic shock, coagulation issues, and multiple organ failure are life-threatening consequences that could affect close to 20% of COVID-19 patients. Several earlier investigations have suggested that an aberrant immune-inflammatory response and cytokine storm may promote COVID-19 progression (2) .…”