Role of biomarkers in prognostication of moderate and severe COVID-19 cases

Santasmita Pal; Suvendu Sengupta; Subhayan Lahiri; Amrita Ghosh; Kaushik Bhowmick

doi:10.4103/jfmpc.jfmpc_423_23

Role of biomarkers in prognostication of moderate and severe COVID-19 cases

J Family Med Prim Care. 2023 Dec;12(12):3186-3193. doi: 10.4103/jfmpc.jfmpc_423_23. Epub 2023 Dec 21.

Authors

Santasmita Pal¹, Suvendu Sengupta², Subhayan Lahiri³, Amrita Ghosh⁴, Kaushik Bhowmick⁵

Affiliations

¹ Department of Biochemistry, R. G. Kar Medical College, Kolkata, West Bengal, India.
² Department of Pathology, Medical College Kolkata, Kolkata, West Bengal, India.
³ Department of Biochemistry, Medical College Kolkata, Kolkata, West Bengal, India.
⁴ Department of Biochemistry, Midnapore Medical College, Paschim Medinipur, West Bengal, India.
⁵ Department of Biochemistry, Tamralipto Government Medical College and Hospital, Tamluk, West Bengal, India.

Abstract

Background: COVID-19 pandemic demanded upgrading of laboratory medicine to limit morbidity, disability and mortality from moderate and severe SARS-COV-2 infections.

Objective: To assess among moderate and severe COVID-19 patients, C-reactive protein (CRP), procalcitonin (PCT), ferritin, D-dimer, interleukin 6 (IL-6), lactate dehydrogenase (LDH), total and differential leucocyte count (TLC and DLC), neutrophil-to-lymphocyte ratio (NLR), absolute platelet count (APC), prothrombin time (PT), activated partial thromboplastin time (APTT) and international normalized ratio (INR) to find their interdependence and role in prognosis.

Methods: This open label analytical cross-sectional noninterventional study evaluated array of independent biochemical, haematological and coagulopathy markers, viz. CRP, PCT, ferritin, D-dimer, IL-6, LDH, TLC, DLC, NLR, absolute platelet count, PT, APTT and INR on consecutive 100 patients with diagnosis of moderate and severe COVID-19 from July to August 2021.

Results: In our study, on consecutive designated 100 cases (55 cases moderate and 45 cases severe), more severity were reported as the age progressed; gender difference was not noted. Among independent markers, CRP, PCT, ferritin, D-dimer, IL-6 and LDH had statistically significant relation in comparison with severity of the disease as Chi-square calculated value (P < 0.05). TLC, DLC and APC showed no significant relation in comparison with severity of the disease; NLR had highly significant relation. PT showed significant relation in comparison with severity, though APTT and INR did not show significant relation.

Conclusion: Our research group felt that CRP, PCT, ferritin, D-dimer, IL-6, LDH and NLR should be in included in clinical practice guidelines to prognosticate COVID-19 cases. Furthermore, translational researches are needed at all levels of healthcare to improve validity for practices of primary care physicians.

Keywords: COVID-19; SARS-COV-2; moderate; prognostic marker; severe.