Dheas/ cortisol ratio acts as a better surrogate marker of inflammation than dheas or cortisol in patients with COVID-19

ABSTRACT

Objective: Dehydroepiandrosterone sulfate (DHEAS) was observed to be decreased in sepsis and inflammatory conditions. The severity of inflammation was found to be associated with a low DHEAS/cortisol ratio. In the present study, we compared DHEAS, cortisol, and DHEAS/cortisol ratio to assess which is a better marker for inflammation in patients with COVID-19. Methodology: This was an analytical cross-sectional pilot study conducted from April 2020 to Dec 2020. The study recruited 76 RT-PCR positive COVID-19 positive patients. The blood samples were collected were analyzed for cortisol and DHEAS. Highly sensitive C-reactive protein (hs-CRP) levels were estimated to assess the inflammation. Results: We classified the cases into two groups based on the median levels of DHEAS, cortisol, and DHEAS/cortisol ratio. We observed hs-CRP to be elevated in the groups which have the levels of DHEAS, cortisol, and DHEAS/cortisol ratio lower than the respective medians. However, a significant difference in hs-CRP levels was observed only between DHEAS/cortisol ratio (p value= 0.0204) and not between DHEAS and cortisol groups. Conclusion: The present study is the first of its kind comparing the DHEAS levels and DHEAS/ cortisol ratio in COVID-19. The study concludes DHEAS/cortisol ratio to be a better marker than individual DHEAS or cortisol in the assessment of inflammation in COVID-19 patients.