Interleukin-6 and C-reactive protein/albumin ratio as predictors of COVID-19 severity and mortality

Springer Science and Business Media LLC - Tập 15 Số 1 - 2021
Mohamed El-Shabrawy1, Maha E. Alsadik1, Maher El-Shafei2, Ahmed Abdelmoaty3, Ahmed S. Alazzouni4, Marwa M. Esawy5, Marwa A. Shabana5
1Chest Medicine Department, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
2Medical Microbiology and Immunology Department, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
3Tropical Medicine Department, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
4Histology and Histochemistry, Faculty of Science, Helwan University, Helwan, Egypt
5Clinical Pathology Department, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt

Tóm tắt

Abstract Background Coronavirus disease 2019 (COVID-19) was announced in early December 2019. The pandemic situation is declared. This study aimed to evaluate the role of biomarkers in estimating the severity and predicting the prognosis of COVID-19. Results A total of 116 confirmed patients were included in this study. The patients were evaluated clinically. The disease severity was assessed. The measured and calculated laboratory tests were done. The primary outcome is the 30-day mortality. Patients were assigned to the severe (14.7%) and non-severe (85.3%) groups. At IL-6 level of 32.3 pg/mL (the highest Youden’s index = 0.77), IL-6 can differentiate severe from non-severe patients with 82.4% sensitivity and 94.4% specificity. IL-6 can predict the severity [odds ratio of 87.7 (95% CI = 18.9-408.2) (P < 0.0001)]. After adjustment to the significant clinical and laboratory parameters, IL-6 had an adjusted odds ratio of 30.8 (95% CI = 1.1-728.3) (P = 0.046). A high CRP/albumin ratio of > 11.4 was associated with COVID-19 mortality [hazard ratio = 59.9 (95% CI = 7.4–488.3) (P < 0.0001)]. High CRP/albumin ratio had an adjusted hazard ratio of 26.5 (95% CI = 2.6-270.7) after adjustment of age and presence of co-morbidities (P = 0.006). Conclusion IL-6 level could effectively discriminate COVID-19 severity. CRP/albumin ratio was an independent risk factor for 30-day mortality rate in patients with COVID-19. IL-6 and CRP/albumin ratio seem to be valuable biomarkers in evaluating the severity and prognosis of COVID-19, respectively.

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