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 ≥3.27 pg/ml provide a sensitivity of 0.87 and specificity of 0.64 for a requirement of ventilation, and a CRP of ≥37 mg/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.

COVID-19 的异质性病程不可预测，从轻度自限性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。识别高风险案例将能够进行适当的干预和升级。本研究调查了与 COVID-19 相关的常规实验室测试和细胞因子，以了解它们作为疾病严重程度、呼吸衰竭和需要更高级别护理的生物标志物的潜在应用。

通过对 203 个样本的分析，CRP、IL-6、IL-10 和 LDH 与 WHO 疾病严重程度的顺序量表、吸入氧气输送的分数、ARDS 的放射学证据和呼吸支持水平的相关性最强 ( p  ≤ 0.001 ) ). ≥3.27 pg/ml 的 IL-6 水平对通气要求的敏感性为 0.87，特异性为 0.64，CRP ≥37 mg/l 为 0.91 和 0.66。

高风险病例的可靠分层对患者分诊、资源管理以及可能在重症患者中启动新疗法具有重要意义。