The Role of CRP, Interleukin-6 and Their Derived Immune-Inflammatory Indices in Early Prediction of Severity and Mortality of COVID-19 Patients

Abstract

BackgroundIn coronavirus disease 2019 (COVID-19), finding sensitive biomarkers is critical for detecting severe cases early and intervening effectively.ObjectivesTo compare and evaluate the prognostic value of 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 COVID-19 patients.MethodsOn admission, 85 confirmed COVID-19 patients’ measured and collected laboratory data were obtained and compared.ResultsLevels of CRP, IL-6 and CRP/alb were significantly higher (P=0.001) in severe patients and in non-survivors, but L/CRP and L/IL-6 were significantly lower (P=0.001). The best predictive performance for COVID-19 severity was observed at 1.65 for CRP/alb and 260.86 for L/CRP with 84.7% diagnostic accuracy for both. The best diagnostic accuracy for COVID-19 in-hospital mortality was 87.1% by IL-6 at 120 pg/ml and 85.9% by L/IL-6 at 5.40. The performance of the combined prediction was better than the single prediction by one biomarker. 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).ConclusionsPretreatment values of CRP, IL-6 and their derived indices could be included in the diagnostic work-up of COVID-19 to stratify disease severity and predict outcomes.

C-Reactive Protein-to-Albumin Ratio and Clinical Outcomes in COVID-19 Patients: A Systematic Review and Meta-Analysis

“…Figure 2. (A) CAR values in severe vs. non-severe COVID-19 patients [19,[22][23][24][25]28,[33][34][35][36][37][38][39][40][41][47][48][49][50]. (B) Subgroup analysis according to country of origin between severe vs. non-severe COVID-19 patients [19,[22][23][24][25]28,[33][34][35][36][37][38][39][40][41][47][48][49][50]…”

“…(A) CAR values in non-survivor vs. survivor COVID-19 patients[20,21,23,26,27,[29][30][31][32]34,[43][44][45][46][47]50]. (B) Subgroup analysis according to country of origin between non-survivor vs. survivor COVID-19 patients [20,21,23,26,27,[29][30][31][32]34,[43][44][45][46][47]50[21,23,27,30,31].…”