The Role of CRP, Interleukin-6 and Their Derived Immune-Inflammatory Indices in Early Prediction of Severity and Mortality of COVID-19 Patients
Abstract
Background
In coronavirus disease 2019 (COVID-19), finding sensitive biomarkers is critical for detecting severe cases early and intervening effectively.
Objectives
To compare and evaluate the predictive value of C-reactive protein (CRP), interleukin-6 (IL-6), and their derived immune-inflammatory indices (CRP/albumin (CRP/alb), lymphocyte/CRP (L/CRP), and lymphocyte/IL-6 (L/IL-6)) in COVID-19 patients.
Methods
On admission, 85 confirmed COVID-19 patients, their measured and collected laboratory data were obtained and compared.
Results
Levels of CRP, IL-6, and CRP/alb were significantly higher (P=0.001) in severe patients and non-survivors, but L/CRP and L/IL-6 were significantly lower (P=0.001). We observed the best predictive performance for COVID-19 severity at 1.65 for CRP/alb and 260.86 for L/CRP with 84.7% diagnostic accuracy for both. The best diagnostic accuracy for COVID-19 in-hospital mortality was 87.1% by IL-6 at 120 pg/ml and 85.9% by L/IL-6 at 5.40. The multi-marker prediction surpassed the performance of a single biomarker prediction. IL-6 was an independent risk factor associated with severe disease development (odds ratio (OR): 1.033; 95% confidence interval (CI): 1.002-1.066).
Conclusions
Pretreatment values of CRP, IL-6, and their derived indices could be included in the diagnostic work-up of COVID-19 to determine the severity and predict the outcome.
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