Ahirwar Ashok Kumar, Takhelmayum Roshan, Sakarde Apurva, Rathod Bharatsing Deorao, Jha Puja Kumari, Kumawat Rajani, Gopal Niranjan
Department of Biochemistry, University College of Medical Sciences, New Delhi, 110095, India.
Department of Biochemistry, All India Institute of Medical Sciences, Nagpur, Maharashtra, 441108, India.
Horm Mol Biol Clin Investig. 2022 Mar 31;43(3):337-344. doi: 10.1515/hmbci-2021-0088. eCollection 2022 Sep 1.
The cut off values for serum high sensitivity C-reactive protein (hsCRP), ferritin, interleukin 6 (IL-6) and plasma D-dimer could be of profound help in detecting COVID-19 patients at risk of adverse outcomes. Therefore, the aim of the present study is to determine the cut off values of the serum hsCRP, ferritin, IL-6 and plasma D-dimer in predicting mortality in COVID-19 patients.
Four hundred RT-PCR confirmed cases of COVID-19 were sub divided into two groups based on their outcome during hospitalisation. Group I consisted of survivors and Group II consisted of non-survivors. The survivors were further divided into three sub-groups: mild, moderate and severe based on the severity of infection. The laboratory data of serum hsCRP, ferritin, IL-6 and plasma D-dimer for all these patients was retrieved from the Medical Record Section of the Hospital.
Mean serum hsCRP, ferritin, IL-6 and plasma D-dimer levels were significantly higher in non-survivors as compared to survivors of COVID-19. The levels of these biomarkers correlated with the severity of COVID-19 illness. ROC curve analysis revealed that plasma D-dimer is having a better predictive value as compared to other parameters in predicting mortality in COVID-19.
The serum hsCRP, ferritin, IL-6 and plasma D-dimer levels could be used in risk stratification of COVID-19 patients. The optimum cut off given by the current study could be considered in predicting adverse outcome in these patients. Amongst the many studied biomarkers, plasma D-dimer might be the best early biomarker to predict mortality in COVID-19 patients.
血清高敏C反应蛋白（hsCRP）、铁蛋白、白细胞介素6（IL-6）和血浆D-二聚体的临界值可能对检测有不良结局风险的COVID-19患者有很大帮助。因此，本研究的目的是确定血清hsCRP、铁蛋白、IL-6和血浆D-二聚体在预测COVID-19患者死亡率方面的临界值。
400例经RT-PCR确诊的COVID-19病例根据住院期间的结局分为两组。第一组为幸存者，第二组为非幸存者。根据感染严重程度，幸存者进一步分为三个亚组：轻度、中度和重度。从医院病历科检索所有这些患者的血清hsCRP、铁蛋白、IL-6和血浆D-二聚体的实验室数据。
与COVID-19幸存者相比，非幸存者的血清hsCRP、铁蛋白、IL-6和血浆D-二聚体平均水平显著更高。这些生物标志物的水平与COVID-19疾病的严重程度相关。ROC曲线分析显示，在预测COVID-19患者死亡率方面，血浆D-二聚体比其他参数具有更好的预测价值。
血清hsCRP、铁蛋白、IL-6和血浆D-二聚体水平可用于COVID-19患者的风险分层。本研究给出的最佳临界值可用于预测这些患者的不良结局。在众多研究的生物标志物中，血浆D-二聚体可能是预测COVID-19患者死亡率的最佳早期生物标志物。
