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：

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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。