Prognostic value of interleukin-6, C-reactive protein, and procalcitonin in patients with COVID-19

J Clin Virol. 2020 Jun:127:104370. doi: 10.1016/j.jcv.2020.104370. Epub 2020 Apr 14.

Abstract

Background: The inflammatory response plays a critical role in coronavirus disease 2019 (COVID-19), and inflammatory cytokine storm increases the severity of COVID-19.

Objective: To investigate the ability of interleukin-6 (IL-6), C-reactive protein (CRP), and procalcitonin (PCT) to predict mild and severe cases of COVID-19.

Study design: This retrospective cohort study included 140 patients diagnosed with COVID-19 from January 18, 2020, to March 12, 2020. The study population was divided into two groups according to disease severity: a mild group (MG) (n = 107) and a severe group (SG) (n = 33). Data on demographic characteristics, baseline clinical characteristics, and the levels of IL-6, CRP, and PCT on admission were collected.

Results: Among the 140 patients, the levels of IL-6, CRP, and PCT increased in 95 (67.9 %), 91 (65.0 %), and 8 (5.7 %) patients on admission, respectively. The proportion of patients with increased IL-6, CRP, and PCT levels was significantly higher in the SG than in the MG. Cox proportional hazard model showed that IL-6 and CRP could be used as independent factors to predict the severity of COVID-19. Furthermore, patients with IL-6 > 32.1 pg/mL or CRP > 41.8 mg/L were more likely to have severe complications.

Conclusion: The serum levels of IL-6 and CRP can effectively assess disease severity and predict outcome in patients with COVID-19.

Keywords: C-reactive protein; COVID-19; Interleukin-6; Procalcitonin; Prognosis.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Betacoronavirus
  • Biomarkers / blood
  • C-Reactive Protein / analysis*
  • COVID-19
  • China
  • Coronavirus Infections / blood*
  • Coronavirus Infections / diagnosis*
  • Female
  • Humans
  • Interleukin-6 / blood*
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / blood*
  • Pneumonia, Viral / diagnosis*
  • Procalcitonin / analysis*
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • SARS-CoV-2
  • Severity of Illness Index
  • Young Adult

Substances

  • Biomarkers
  • IL6 protein, human
  • Interleukin-6
  • Procalcitonin
  • C-Reactive Protein