Clinical value of immune-inflammatory parameters to assess the severity of coronavirus disease 2019

• Published in: International journal of infectious diseases Vol. 95; pp. 332 - 339
• Main Authors: Zhu, Zhe, Cai, Ting, Fan, Lingyan, Lou, Kehong, Hua, Xin, Huang, Zuoan, Gao, Guosheng
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Ltd 01.06.2020; The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases; Elsevier
• Subjects: Adult; Aged; Betacoronavirus; C-Reactive Protein - analysis; Coronavirus Infections - etiology; Coronavirus Infections - immunology; COVID-19; Cytokine storm; Female; Humans; Hypertension - complications; IL-6; Immune-inflammatory parameters; Interleukin-6 - blood; Male; Middle Aged; Pandemics; Pneumonia, Viral - etiology; Pneumonia, Viral - immunology; Risk Factors; SARS-CoV-2; Severity of Illness Index; COVID-19; SARS-CoV-2; Cytokine storm; IL-6; Immune-inflammatory parameters
• ISSN: 1201-9712; 1878-3511; 1878-3511
• DOI: 10.1016/j.ijid.2020.04.041

• Clinical characteristics and immune-inflammatory parameters were compared between non-severe and severe patients with coronavirus disease 2019 (COVID-19).• High level of interleukin-6 (IL-6), C-reactive protein (CRP) and hypertension were independent predictors for the severity of COVID-19.• IL-6 has the highest predictive value among other single immune-inflammatory parameters. The risk model based on IL-6, CRP and hypertension enlarged the predictability.• The dynamic change of IL-6 in the severe cases were parallel to the amelioration of this disease, implied a potential value for monitoring the process of severe cases. To explore the clinical value of immune-inflammatory markers to assess the severity of coronavirus disease 2019 (COVID-19). 127 consecutive hospitalized patients with confirmed COVID-19 were enrolled in this study, and classified into non-severe and severe groups. Demographics, symptoms, underlying diseases and laboratory data were collected and assessed for predictive value. Of 127 COVID-19 patients, 16 cases (12.60%) were classified into the severe group. High level of interleukin-6 (IL-6), C-reaction protein (CRP) and hypertension were independent risk factors for the severity of COVID-19. The risk model based on IL-6, CRP and hypertension had the highest area under the receiver operator characteristic curve (AUROC). Additionally, the baseline IL-6 was positively correlated with other immune-inflammatory parameters and the dynamic change of IL-6 in the severe cases were parallel to the amelioration of the disease. Our study showed that high level of IL-6, CRP and hypertension were independent risk factors for assessing the severity of COVID-19. The risk model established upon IL-6, CRP and hypertension had the highest predictability in this study. Besides, IL-6 played a pivotal role in the severity of COVID-19 and had a potential value for monitoring the process of severe cases.