Study of inflammatory markers in COVID-19 patients admitted to High Dependency Unit

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes the coronavirus disease 2019 (COVID-19) has caught on like wildfire throughout the world. There is currently no effective therapy for its treatment. It is imperative to find specific indicators in order to track the development of the disease and provide patients with an early diagnosis and disease severity. To investigate the levels of inflammatory markers in COVID-19 patients admitted to high dependency unit, and their role in tracing disease progression. This observational analysis included 1595 patients of either gender, aged ≥ 18 years with moderate and severe COVID-19. Data regarding age, gender, medical history, clinical and laboratory data was recovered from medical records of these patients. The retrieved study variables related to evaluated inflammatory markers were neutrophil/lymphocyte (N/L) ratio, D-dimer, lactate dehydrogenase (LDH), ferritin, interleukin-6 (IL-6), C-reactive protein (CRP). The outcome variables were survival or death. Statistical analysis was performed by using R software (Version. 3.6.0). Majority of patients were middle aged (56.68%) with male preponderance (male: female = 2.16: 1.0) and moderate COVID severity (62.9%). The death rate was more in severe COVID illness than moderate COVID illness (73.75% vs 26.25%). The major comorbidities noted were type 2 diabetes mellitus, hypertension, ischemic heart disease and in few cases, it was chronic kidney disease. The neutrophil count was higher and lymphocyte count, eosinophil count were lower in most patients. The values for N/L ratio (8.17), LDH (399.59 U/L), ferritin (447.64 µg/L), IL-6 (273.02 mg/L), CRP (10.10 mg/L), and D- dimer (6.54 μg/L) were high. A significant association was observed between the COVID severity level and gender of patients (p = 0.008) with males being most affected by both moderate and severe COVID, along with high level of inflammatory markers in severe COVID-19 patients. The COVID-19 severity is associated with high levels of inflammatory markers. Keeping a track of these markers might allow early identification, stratification and disease progression prediction.