Serum biomarker panel for disease severity and prognosis in patients with COVID‐19

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.