The Role of serum biomarkers to assess disease severity and outcome of COVID-19 patients in intensive care unit

Abstract

Objective: To determine the role of serum biomarkers to assess disease serverity and outcome of COVID-19 critical patients in intensive care unit (ICU).

Material and Methods: In this cross-sectional study, all the admitted patients who had positive SARS-CoV2 PCR tests during period of 1st April 2020 to 31st July 2020 were included. Their biochemical and inflammatory markers were analyzed and assessed for severity and outcome of disease. 

Results: Out of the total 523 COVID PCR Positive cases, total 303 patients admitted during these four months, who presented with moderate (193), severe (59) and critical (51) disease. 110 patients were kept in ICU depending upon their supplemental oxygen requirements or mechanical ventilation support to keep their oxygen saturation as per desired clinical standards. Among them, 225 patients were male and 78 were females with median age 39.37 ± 15.45. Mostly patients belonged to age group ≥ 50 yrs. Critical patients in ICU showed dramatically changes in serum ferritin, C-Reactive Protein (CRP) and Lactate Dehydrogenase (LDH) levels. 75 (24.75%) Patients were on maximum oxygen support while 35(11.5%) on mechanical ventilation with 221(72.9%).  Out of these 303 patients,29(9.57%) died, 175 (57.75%) recovered and discharged while 99(32.67%) were still under treatment but stable.

Conclusion: To conclude our findings following parameters should be monitored for the prognosis of acutely ill Covid 19 patients like age > 50 years, CRP > 50mg/L, Serum ferritin >1000 ng/ml, LDH > 400 U/L, CK ≥ 500 ul/L especially in resource poor settings. This can help in assessing disease severity and may also possibly prevent further morbidity with early intervention and effective management among admitted patients.

Key Words:  Ferritin, CRP, LDH, COVID-19, Prognosis.