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Laboratory biomarkers associated with COVID-19 severity and management.
medRxiv - Allergy and Immunology Pub Date : 2020-08-21 , DOI: 10.1101/2020.08.18.20168807
Stephen Keddie , Oliver J Ziff , Michael KL Chou , Rachel L Taylor , Amanda Heslegrave , Edmund Garr , Neghat Lakdawala , Andrew Church , Dalia Ludwig , Jessica Manson , Marie Scully , Eleni Nastouli , Miles D Chapman , Melanie Hart , Michael P Lunn

The heterogeneous disease course of COVID-19 is unpredictable, ranging from mild self-limiting symptoms to cytokine storms, acute respiratory distress syndrome (ARDS), multi-organ failure and death. Identification of high-risk cases will enable appropriate intervention and escalation. This study investigates the routine laboratory tests and cytokines implicated in COVID-19 for their potential application as biomarkers of disease severity, respiratory failure and need of higher-level care. From analysis of 203 samples, CRP, IL-6, IL-10 and LDH were most strongly correlated with the WHO ordinal scale of illness severity, the fraction of inspired oxygen delivery, radiological evidence of ARDS and level of respiratory support (p≤0.001). IL-6 levels of >3.27pg/ml provide a sensitivity of 0.87 and specificity of 0.64 for a requirement of ventilation, and a CRP of >37mg/L of 0.91 and 0.66. Reliable stratification of high-risk cases has significant implications on patient triage, resource management and potentially the initiation of novel therapies in severe patients.

中文翻译:

与COVID-19严重程度和管理相关的实验室生物标志物。

从轻度的自限症状到细胞因子风暴,急性呼吸窘迫综合征(ARDS),多器官衰竭和死亡,COVID-19的异质性病程是无法预测的。识别高危病例将使适当的干预和升级成为可能。这项研究调查了常规实验室检测和涉及COVID-19的细胞因子在疾病严重性,呼吸衰竭和需要更高级别护理方面的生物标志物的潜在应用。通过对203个样品的分析,CRP,IL-6,IL-10和LDH与WHO疾病严重程度的顺序等级,吸入氧气的比例,ARDS的放射学证据和呼吸支持水平之间的相关性最强(p≤0.001 )。IL-6含量> 3.27pg / ml时,需要通气,灵敏度为0.87,特异性为0.64,CRP> 37mg / L分别为0.91和0.66。高危病例的可靠分层对患者分类,资源管理以及重症患者可能开始采用新疗法具有重要意义。
更新日期:2020-08-22
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