Biomarkers for Prognosis and Treatment Response in COVID-19 Patients

Ann Lab Med. 2021 Nov 1;41(6):540-548. doi: 10.3343/alm.2021.41.6.540.


During a severe infection such as coronavirus disease 2019 (COVID-19), the level of almost all analytes can change, presenting a correlation with disease severity and survival; however, a biomarker cannot be translated into clinical practice for treatment guidance until it is proven to have a significant impact. Several studies have documented the association between COVID-19 severity and circulating levels of C-reactive protein (CRP) and interleukin-6, and the accuracy of the CRP level in predicting treatment responses has been evaluated. Moreover, promising findings on prothrombin and D-dimer have been reported. However, the clinical usefulness of these biomarkers in COVID-19 is far from proven. The burst of data generation during this pandemic has led to the publication of numerous studies with several notable drawbacks, weakening the strength of their findings. We provide an overview of the key findings of studies on biomarkers for the prognosis and treatment response in COVID-19 patients. We also highlight the main drawbacks of these studies that have limited the clinical use of these biomarkers.

Keywords: Biomarkers; COVID-19; Coronavirus; Predictive value; Severity.

Publication types

  • Review

MeSH terms

  • Biomarkers / analysis*
  • Biomarkers / metabolism
  • C-Reactive Protein / analysis
  • COVID-19 / pathology*
  • COVID-19 / therapy
  • COVID-19 / virology
  • Fibrin Fibrinogen Degradation Products / analysis
  • Humans
  • Interleukin-6 / analysis
  • MicroRNAs / metabolism
  • Prognosis
  • SARS-CoV-2 / isolation & purification
  • Severity of Illness Index


  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • Interleukin-6
  • MicroRNAs
  • fibrin fragment D
  • C-Reactive Protein