The Role of Immunological and Clinical Biomarkers to Predict Clinical COVID-19 Severity and Response to Therapy-A Prospective Longitudinal Study
- Author(s)
- Copaescu, A; James, F; Mouhtouris, E; Vogrin, S; Smibert, OC; Gordon, CL; Drewett, G; Holmes, NE; Trubiano, JA;
- Journal Title
- Frontiers in Immunology
- Publication Type
- Research article
- Abstract
- BACKGROUND: The association of pro-inflammatory markers such as interleukin-6 (IL-6) and other biomarkers with severe coronavirus disease 2019 (COVID-19) is of increasing interest, however their kinetics, response to current COVID-related treatments, association with disease severity and comparison with other disease states associated with potential cytokine storm (CS) such as Staphylococcus aureus bacteraemia (SAB) are ill-defined. METHODS: A cohort of 55 hospitalized SARS-CoV-2 positive patients was prospectively recruited - blood sampling was performed at baseline, post-treatment and hospital discharge. Serum IL-6, C-reactive protein (CRP) and other laboratory investigations were compared between treatment groups and across timepoints. Acute serum IL-6 and CRP levels were then compared to those with suspected COVID-19 (SCOVID) and age and sex matched patients with SAB and patients hospitalized for any non-infectious condition (NIC). RESULTS: IL-6 was elevated at admission in the SARS-CoV-2 cohort but at lower levels compared to matched SAB patients. Median (IQR) IL-6 at admission was 73.89 pg/mL (30.9, 126.39) in SARS-CoV-2 compared to 92.76 pg/mL (21.75, 246.55) in SAB (p=0.017); 12.50 pg/mL (3.06, 35.77) in patients with NIC; and 95.51 pg/mL (52.17, 756.67) in SCOVID. Median IL-6 and CRP levels decreased between admission and discharge timepoints. This reduction was amplified in patients treated with remdesivir and/or dexamethasone. CRP and bedside vital signs were the strongest predictors of COVID-19 severity. CONCLUSIONS: Knowledge of the kinetics of IL-6 did not offer enhanced predictive value for disease severity in COVID-19 over common investigations such as CRP and vital signs.
- Keywords
- Adenosine Monophosphate/analogs & derivatives/therapeutic use; Adult; Aged; Alanine/analogs & derivatives/therapeutic use; Anti-Inflammatory Agents/therapeutic use; Antiviral Agents/therapeutic use; Bacteremia/*blood; Biomarkers/*blood; C-Reactive Protein/*metabolism; COVID-19/*blood/complications/*physiopathology; Cohort Studies; Comorbidity; Dexamethasone/therapeutic use; Female; Humans; Interleukin-6/*blood; Longitudinal Studies; Male; Middle Aged; Prospective Studies; Respiratory Distress Syndrome/*blood/complications; Severity of Illness Index; Staphylococcal Infections/*blood; COVID-19 Drug Treatment; C-reactive protein; SARS-CoV-2; Staphylococcus aureus bacteraemia; acute respiratory distress syndrome; cytokine storm; interleukin-6; sepsis
- Department(s)
- Infectious Diseases
- PubMed ID
- 33815405
- Publisher's Version
- https://doi.org/10.3389/fimmu.2021.646095
- Open Access at Publisher's Site
https://doi.org/10.3389/fimmu.2021.646095- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2025-09-05 01:45:02
Last Modified: 2025-09-05 01:46:46