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Dynamic Monitoring of Seroconversion using a Multianalyte Immunobead Assay for Covid-19
Published on: February 16, 2022
Serum biomarker panel for disease severity and prognosis in patients with COVID-19
Jing Li1, Mingyang Tang2, Didi Liu1
1Department of Clinical Laboratory, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China.
Insights
Monitoring inflammatory markers like CRP, LDH, and NLR, along with CT scans, aids in assessing COVID-19 severity and predicting patient outcomes. Sputum testing also shows higher viral detection rates than throat swabs.
Area of Science:
- Infectious Diseases
- Immunology
- Medical Diagnostics
Background:
- COVID-19 poses a global health crisis, with inflammatory factors playing a dual role in immune response and organ damage.
- Understanding inflammatory markers is crucial for managing COVID-19 progression and preventing severe outcomes.
Purpose of the Study:
- To investigate the role of inflammatory factors and serum markers in COVID-19 disease progression.
- To identify reliable indicators for assessing disease severity and predicting prognosis.
Main Methods:
- Studied 54 COVID-19 patients, assessing severity via clinical evaluation, lab tests, and CT scans.
- Collected data at multiple time points, including viral RNA negativity and composite endpoints.
- Compared sputum and throat swab sample efficacy for SARS-CoV-2 detection.
Main Results:
- Sputum samples yielded a higher positive rate for SARS-CoV-2 RNA compared to throat swabs.
- Elevated C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer (D-D), interleukin-6 (IL-6), and neutrophil-to-lymphocyte ratio (NLR) correlated with increased disease severity.
- LDH demonstrated high sensitivity independently, while a combination of NLR, CRP, LDH, and D-D effectively distinguished critically ill from mild cases.
Conclusions:
- Dynamic monitoring of NLR, CRP, LDH, IL-6, and D-D levels is valuable for COVID-19 severity assessment.
- Integrating these markers with CT imaging and sputum viral RNA detection can improve prognosis prediction.
- These insights can facilitate more effective COVID-19 treatment strategies.
Background:
Coronavirus disease-2019 (COVID-19) has become a worldwide emergency and has had a severe impact on human health. Inflammatory factors have the potential to either enhance the efficiency of host immune responses or damage the host organs with immune overreaction in COVID-19. Therefore, there is an urgent need to investigate the functions of inflammatory factors and serum markers that participate in disease progression.
Methods:
In total, 54 COVID-19 patients were enrolled in this study. Disease severity was evaluated by clinical evaluation, laboratory tests, and computed tomography (CT) scans. Data were collected at: admission, 3-5 days after admission, when severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detection became negative, and composite endpoint.
Results:
We found that the positive rate in sputum was three times higher than that in throat swabs. Higher levels of C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer (D-D), interleukin-6 (IL-6) and neutrophil-to-lymphocyte ratio (NLR) or lower lymphocyte counts suggested more severe disease, and the levels of cytokines and serum markers were intrinsically correlated with disease progression. When SARS-CoV-2 RNA detection became negative, the receiver operating characteristic (ROC) curve demonstrated that LDH had the highest sensitivity independently, and four indicators (NLR, CRP, LDH, and D-D) when combined had the highest sensitivity in distinguishing critically ill patients from mild ones.
Conclusions:
Monitoring dynamic changes in NLR, CRP, LDH, IL-6, and D-D levels, combined with CT imaging and viral RNA detection in sputum, could aid in severity evaluation and prognosis prediction and facilitate COVID-19 treatment.
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