Inflammatory and Immune Biomarkers in Predicting the Severity in COVID-19

Aims: An early diagnosis of severity can be confidently judged by monitoring the serum biomarkers in patients with COVID-19. The study was thus aimed to explore the relationship of the inflammatory and immune biomarkers in predicting the severity of the disease.

Study design: It is a retrospective observational study.

Methodology: The study included 79 confirmed cases of COVID-19 who had complete clinical record for the analytical variables. All cases were assigned a total clinical score as per their clinical manifestations, associated co-morbidities and mortality outcome. Laboratory inflammatory and immune biomarkers at the time of admission were noted.

Results: The mean age of the study population was 55.38 (1.69) years. The percentage of admission for males (67.1%) was twice that of females (32.9%). Serum LDH (p=0.003) and ferritin (0.019) levels were remarkably raised in severe form. Total clinical score denoted a positive correlation with the inflammatory biomarkers (p<0.001). IgM exhibited a significant negative trend with increasing clinical score (p<0.001) and CRP levels (p=0.022) of the patients. The multivariate analysis reflected that the total clinical score was significantly influenced by initial SpO2 values (0.011), serum ferritin (0.027), IgM (0.001) and C3 levels (0.044) in the COVID-19 patients. Lower serum C3 values significantly influenced the hospitalization duration in moderate cases (p=0.034) and total clinical score in severe cases (p=0.01).

Conclusion: The findings of the study signified that besides serum ferritin, a serial and close monitoring of serum IgM with complement factor C3 would aid in early prediction of clinical severity and thus guide physicians to start effective management strategy.