Correlation analysis between disease severity and inflammation-related parameters in patients with COVID-19: a retrospective study

TLDR

COVID‑19 is highly contagious with a crude mortality rate up to 49 % in critical patients, and inflammation is a key concern in disease progression. The study aimed to analyze blood inflammation indicators in mild, severe, and critical COVID‑19 patients to identify those at risk of severe or critical disease early. The authors performed a cross‑sectional analysis of 100 patients, measuring peripheral blood inflammation markers and using ROC curves to estimate cut‑off values for critical illness. Higher IL‑2 receptor (>793.5 U/mL) or CRP (>30.7 ng/mL) levels predict progression to critical COVID‑19, and IL‑6 and TNFα are potential therapeutic targets.

Abstract

COVID-19 is highly contagious, and the crude mortality rate could reach 49% in critical patients. Inflammation concerns on disease progression. This study analyzed blood inflammation indicators among mild, severe and critical patients, helping to identify severe or critical patients early.In this cross-sectional study, 100 patients were included and divided into mild, severe or critical groups according to disease condition. Correlation of peripheral blood inflammation-related indicators with disease criticality was analyzed. Cut-off values for critically ill patients were speculated through the ROC curve.Significantly, disease severity was associated with age (R = -0.564, P < 0.001), interleukin-2 receptor (IL2R) (R = -0.534, P < 0.001), interleukin-6 (IL-6) (R = -0.535, P < 0.001), interleukin-8 (IL-8) (R = -0.308, P < 0.001), interleukin-10 (IL-10) (R = -0.422, P < 0.001), tumor necrosis factor α (TNFα) (R = -0.322, P < 0.001), C-reactive protein (CRP) (R = -0.604, P < 0.001), ferroprotein (R = -0.508, P < 0.001), procalcitonin (R = -0.650, P < 0.001), white cell counts (WBC) (R = -0.54, P < 0.001), lymphocyte counts (LC) (R = 0.56, P < 0.001), neutrophil count (NC) (R = -0.585, P < 0.001) and eosinophil counts (EC) (R = 0.299, P < 0.001). With IL2R > 793.5 U/mL or CRP > 30.7 ng/mL, the progress of COVID-19 to critical stage should be closely observed and possibly prevented.Inflammation is closely related to severity of COVID-19, and IL-6 and TNFα might be promising therapeutic targets.