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Prognostic Role and Diagnostic Power of Seven Indicators in COVID-19 Patients
Lili Ding1, Wanwan Zhang1, Fengling Zhang1
1The Fifth Hospital of Xiamen, Xiamen, China.
Insights
Seven COVID-19 indicators show promise for diagnosing and predicting patient outcomes. A new prognostic signature using C-reactive protein and D-dimer can help classify patients and guide clinical decisions.
Area of Science:
- Infectious Diseases
- Clinical Medicine
- Biomarker Research
Background:
- The diagnostic and prognostic value of various COVID-19 indicators remains unclear.
- Understanding these markers is crucial for effective patient management and treatment strategies.
Purpose of the Study:
- To investigate the prognostic and diagnostic capabilities of oxygen saturation, leukocytes, lymphocytes, albumin, C-reactive protein (CRP), interleukin-6 (IL-6), and D-dimer in COVID-19 patients.
- To develop and validate a prognostic signature for improved risk stratification.
Main Methods:
- Comparative analysis of indicator levels across different COVID-19 severity groups (common, severe, critical).
- Development and validation of a two-indicator (CRP and D-dimer) prognostic signature using training and testing datasets.
- Kaplan-Meier and Receiver Operating Characteristic (ROC) curve analyses were employed.
Main Results:
- Significant differences in oxygen saturation, lymphocytes, and albumin levels were observed between patient groups.
- Leukocytes, CRP, IL-6, and D-dimer levels were significantly lower in common/severe cases compared to critical cases (P < 0.001).
- The seven indicators demonstrated good diagnostic and prognostic power; the CRP-D-dimer signature effectively predicted prognosis and stratified patients into high- and low-risk groups.
Conclusions:
- The seven studied indicators are potential diagnostic markers for COVID-19.
- A validated two-indicator prognostic signature (CRP and D-dimer) can enhance clinical decision-making and patient management for COVID-19.
Abstract:
The prognostic role and diagnostic ability of coronavirus disease 2019 (COVID-19) disease indicators are not elucidated, thus, the current study aimed to investigate the prognostic role and diagnostic ability of several COVID-19 disease indicators including the levels of oxygen saturation, leukocytes, lymphocytes, albumin, C-reactive protein (CRP), interleukin-6 (IL-6), and D-dimer in patients with COVID-19. The levels of oxygen saturation, lymphocytes, and albumin were significantly higher in the common and severe clinical type patients compared with those in critical type patients. However, levels of leukocytes, CRP, IL-6, and D-dimer were significantly lower in the common and severe type patients compared with those in critical type patients (P < 0.001). Moreover, the current study demonstrated that the seven indicators have good diagnostic and prognostic powers in patients with COVID-19. Furthermore, a two-indicator (CRP and D-dimer) prognostic signature in training and testing datasets was constructed and validated to better understand the prognostic role of the indicators in COVID-19 patients. The patients were classified into high-risk and low-risk groups based on the median-risk scores. The findings of the Kaplan-Meier curve analysis indicated a significant divergence between the high-risk and low-risk groups. The findings of the receiver operating curve (ROC) analysis indicated the good performance of the signature in the prognosis prediction of COVID-19. In addition, a nomogram was constructed to assist clinicians in developing clinical decision-making for COVID-19 patients. In conclusion, the findings of the current study demonstrated that the seven indicators are potential diagnostic markers for COVID-19 and a two-indicator prognostic signature identification may improve clinical management for COVID-19 patients.
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