Significance of Measuring the Proinflammatory Response Biomarkers in Covid-19 Patients

ABSTRACT

Objectives: In the management of COVID-19, bio-inflammatory cytokines (IL-6 and others) can be measured as inflammatory markers to detect conditions in response to treatment, risk assessment, monitoring disease progression, prognosis determination and treatment selection. The purpose of this study is to identify changes in inflammation markers of COVID-19 patients and to determine whether it should be used as a prognosis marker. Materials-Methods: Three groups of the patients consisting of 138 patients (12 non-survived, 35 severe and 91 mild/moderate) aged 16 to 86 years who were diagnosed with COVID-19 by real-time polymerase chain reaction were included in the study. Acute phase serum levels such as CRP, D-Dimer, Ferritin, IL-1B and IL-6 were measured and compared in serum samples taken from these patients. It was examined whether these parameters can be a biomarker that can be monitored for the course of the disease. IL-6 and ferritin were measured with CLIA, D-dimer immunassay, CRP with photometry and IL1-B was measured with flow cytometry methods. Result(s) It has been observed that all parameters, except for ferritin (P=0.94), increase significantly during the transition from mild to severe form of the disease. (CRP P0.005, D-Dimer P<0.0001, IL-1B P0.03, IL-6 P0.002). A significant difference was observed in the levels of CRP, IL-6 and D-Dimer in the patient survival. (P=0.003, P=0.03, P0,0001). According to our results, the use of IL-1B in the prognosis monitoring of patients with severe forms was not found to be significant (P0.48). ROC curve analysis showed that the area under the ROC curve (AUC) of CRP, D-Dimer and IL-6 was 0.645 (0,559 to 0,725), 0.637 (0,551 to 0,717) and 0.663 (0,577 to 0,741) respectively, and the cutoff values were >3.77 (sensitivity, 72.3%;specificity, 55%), >0.48 (sensitivity 68.1%;specificity, 57.1%) and <14.9 (sensitivity, 65,9%;specificity, 62.6%), respectively. Conclusion(s) Our results confirmed that the dynamic change in IL-6, CRP, D-Dimer can be used as a marker for disease monitoring in patients with severe COVID-19.