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

Int J Infect Dis. 2020 Jun;95:332-339. doi: 10.1016/j.ijid.2020.04.041. Epub 2020 Apr 22.

Abstract

Objective: To explore the clinical value of immune-inflammatory markers to assess the severity of coronavirus disease 2019 (COVID-19).

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: COVID-19; Cytokine storm; IL-6; Immune-inflammatory parameters; SARS-CoV-2.

MeSH terms

  • Adult
  • Aged
  • Betacoronavirus*
  • C-Reactive Protein / analysis
  • COVID-19
  • Coronavirus Infections / etiology
  • Coronavirus Infections / immunology*
  • Female
  • Humans
  • Hypertension / complications
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / etiology
  • Pneumonia, Viral / immunology*
  • Risk Factors
  • SARS-CoV-2
  • Severity of Illness Index

Substances

  • Interleukin-6
  • C-Reactive Protein