Correlation analysis between disease severity and inflammation-related parameters in patients with COVID-19: a retrospective study

• Published in: BMC infectious diseases Vol. 20; no. 1; pp. 963 - 7
• Main Authors: Gong, Jing, Dong, Hui, Xia, Qing-Song, Huang, Zhao-yi, Wang, Ding-kun, Zhao, Yan, Liu, Wen-hua, Tu, Sheng-hao, Zhang, Ming-min, Wang, Qi, Lu, Fu-er
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 21.12.2020; BioMed Central; BMC
• Subjects: Adult; Age; Aged; Area Under Curve; Biomarkers; Blood; Blood cell count; C-reactive protein; C-Reactive Protein - metabolism; Coronaviruses; Correlation analysis; COVID-19; COVID-19 - diagnosis; COVID-19 - immunology; Cross-Sectional Studies; Cytokine; Cytokines; Disease severity; Female; Humans; Illnesses; Indicators; Infectious diseases; Inflammation; Inflammation - complications; Inflammation - immunology; Interleukin 10; Interleukin 2; Interleukin 2 receptors; Interleukin 6; Interleukin 8; Interleukin-10 - blood; Interleukin-6 - blood; Interleukin-8 - blood; Interleukins; Laboratories; Leukocyte Count; Leukocytes (eosinophilic); Lymphocyte Count; Lymphocytes; Male; Middle Aged; Normal distribution; Peripheral blood; Procalcitonin; Procalcitonin - blood; Prognosis; Retrospective Studies; ROC Curve; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Statistics; Therapeutic targets; Tumor Necrosis Factor-alpha - blood; Tumor necrosis factor-α; Taiwan; COVID-19; Disease severity; Inflammation; Blood cell count; Cytokine
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-020-05681-5

COVID-19 is highly contagious, and the crude mortality rate could reach 49% in critical patients. Inflammation concerns on disease progression. This study analyzed blood inflammation indicators among mild, severe and critical patients, helping to identify severe or critical patients early. In this cross-sectional study, 100 patients were included and divided into mild, severe or critical groups according to disease condition. Correlation of peripheral blood inflammation-related indicators with disease criticality was analyzed. Cut-off values for critically ill patients were speculated through the ROC curve. Significantly, disease severity was associated with age (R = -0.564, P < 0.001), interleukin-2 receptor (IL2R) (R = -0.534, P < 0.001), interleukin-6 (IL-6) (R = -0.535, P < 0.001), interleukin-8 (IL-8) (R = -0.308, P < 0.001), interleukin-10 (IL-10) (R = -0.422, P < 0.001), tumor necrosis factor α (TNFα) (R = -0.322, P < 0.001), C-reactive protein (CRP) (R = -0.604, P < 0.001), ferroprotein (R = -0.508, P < 0.001), procalcitonin (R = -0.650, P < 0.001), white cell counts (WBC) (R = -0.54, P < 0.001), lymphocyte counts (LC) (R = 0.56, P < 0.001), neutrophil count (NC) (R = -0.585, P < 0.001) and eosinophil counts (EC) (R = 0.299, P < 0.001). With IL2R > 793.5 U/mL or CRP > 30.7 ng/mL, the progress of COVID-19 to critical stage should be closely observed and possibly prevented. Inflammation is closely related to severity of COVID-19, and IL-6 and TNFα might be promising therapeutic targets.