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Biomarkers for Prognosis and Treatment Response in COVID-19 Patients
Giulia Bivona1, Luisa Agnello1, Marcello Ciaccio1,2
1Institute of Clinical Biochemistry, Clinical Molecular Medicine and Laboratory Medicine, Department of Biomedicine, Neurosciences, and Advanced Diagnostics, University of Palermo, Palermo, Italy.
Insights
Biomarkers like C-reactive protein (CRP) and interleukin-6 show potential for predicting coronavirus disease 2019 (COVID-19) severity and treatment response. However, their clinical utility remains unproven due to study limitations.
Area of Science:
- Infectious Diseases
- Clinical Chemistry
- Biomarker Research
Background:
- Severe infections like COVID-19 alter analyte levels, correlating with disease severity and survival.
- Biomarkers require proven clinical impact for treatment guidance, a standard not yet met for many COVID-19 markers.
- Existing research shows associations between COVID-19 severity and biomarkers such as C-reactive protein (CRP), interleukin-6, prothrombin, and D-dimer.
Purpose of the Study:
- To provide an overview of key findings on biomarkers for prognosis and treatment response in COVID-19 patients.
- To highlight the limitations of current studies that hinder the clinical application of these biomarkers.
- To critically evaluate the evidence supporting the use of specific biomarkers in managing COVID-19.
Main Methods:
- Literature review of studies investigating biomarkers in COVID-19 patients.
- Analysis of reported associations between analyte levels and disease severity or survival.
- Evaluation of the methodologies and drawbacks of published research on COVID-19 biomarkers.
Main Results:
- Several biomarkers, including CRP and interleukin-6, are associated with COVID-19 severity and treatment response.
- Prothrombin and D-dimer levels have also shown promising correlations in preliminary studies.
- Numerous studies suffer from significant drawbacks, weakening the evidence for clinical utility.
Conclusions:
- The clinical usefulness of currently studied biomarkers for COVID-19 prognosis and treatment guidance is not yet definitively established.
- Limitations in study design and data interpretation impede the translation of biomarker findings into clinical practice.
- Further rigorous research is needed to validate biomarkers and overcome existing methodological challenges.
Abstract:
During a severe infection such as coronavirus disease 2019 (COVID-19), the level of almost all analytes can change, presenting a correlation with disease severity and survival; however, a biomarker cannot be translated into clinical practice for treatment guidance until it is proven to have a significant impact. Several studies have documented the association between COVID-19 severity and circulating levels of C-reactive protein (CRP) and interleukin-6, and the accuracy of the CRP level in predicting treatment responses has been evaluated. Moreover, promising findings on prothrombin and D-dimer have been reported. However, the clinical usefulness of these biomarkers in COVID-19 is far from proven. The burst of data generation during this pandemic has led to the publication of numerous studies with several notable drawbacks, weakening the strength of their findings. We provide an overview of the key findings of studies on biomarkers for the prognosis and treatment response in COVID-19 patients. We also highlight the main drawbacks of these studies that have limited the clinical use of these biomarkers.
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