Can Dynamic Changes in Inflammatory Markers Predict Outcomes in COVID-19 Infection?

Umama Tahir; Siraj Muhammad; Abdul Rehman Arshad; Muhammad Azam Mallhi; Yumna Tahir

doi:10.51253/pafmj.v74i3.7222

Authors

Umama Tahir Department of Medicine, Combined Military Hospital Peshawar/National University of Medical Sciences (NUMS) Pakistan
Siraj Muhammad Department of Medicine, Combined Military Hospital Peshawar/National University of Medical Sciences (NUMS) Pakistan
Abdul Rehman Arshad Department of Medicine, Combined Military Hospital Peshawar/National University of Medical Sciences (NUMS) Pakistan
Muhammad Azam Mallhi Department of Medicine, Rawalpindi Medical University Pakistan
Yumna Tahir Department of Medicine, Rawalpindi Medical University Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i3.7222

Keywords:

COVID-19, Biomarker, Ferritin, Mortality

Abstract

Objective: To determine the role of dynamic changes in inflammatory markers over initial 48 hours after admission in predicting outcomes of COVID-19 infection.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Medicine, Combined Military Hospital, Peshawar Pakistan, from Sep to Dec 2020.

Methodology: Indoor patients with positive polymerase chain reaction test for SARS-CoV-2 were included in the study. Serum C-reactive protein, Ferritin and LDH levels were tested within 60 minutes of admission and the course of these markers was monitored over 48 hrs. In-hospital mortality was also recorded.

Results: There were 92 patients in this study, having a mean age of 53.80±16.20 years. In-hospital, 14 patients (15.22%) died whereas the rest were discharged. Median and interquartile ranges for changes in Serum CRP, Ferritin and LDH over the first 48 hours of admission were -10.00(-56.35–2.68) mg/L, -5.50(-100.00–193.50) ng/ml and -23.50(-162.00–81.50) U/L respectively. Increase in Serum Ferritin ≥128.5 ng/ml had 64.29% sensitivity and 74.36% specificity for predicting in- hospital mortality. Changes in C-reactive protein and Lactate Dehydrogenase did not have a predictive role in our study.

Conclusion: Rise in Serum Ferritin levels over first two days of admission was associated with increased risk of death.

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