Inflammatory Markers as Predictors of COVID-19 Severity: A Review of Literature

Abstract

Background: COVID‑19 (severe acute respiratory syndrome [SARS] COV‑2), which is now a global pandemic, continues to spread across
countries and continents, bringing along with it untold economic hardship and a high mortality rate. Many biochemical changes have been
associated with COVID‑19. This study is aimed to establish an association between various inflammatory markers and the severity of
COVID‑19 to provide knowledge for the clinicians and help professionals that manage the disease.

Methods: A search in PubMed/Medline, Google scholar, and Journal Storage (JSTOR) databases was conducted from May 15, 2020 to June 15, 2020, for studies that reported serum levels of inflammatory markers in COVID‑19. Search terms included a combination of “medical laboratory diagnosis, inflammatory  markers, cytokines, acute‑phase reactants, biomarkers and COVID‑19, SARS‑COV‑2, and coronavirus.”

Results: Four hundred and twelve (412) articles were retrieved following the removal of duplicates, of which 15 articles were included in this study after meeting the study inclusion criteria. The included studies comprised 2828 COVID‑19 positives made of 1472 (52.1%) male and 1356 (47.9%) female patients. The most prevalent laboratory finding was increased interleukin‑6 (IL) (100%), erythrocyte  sedimentation rate (88.9%), and procalcitonin (63.6%). Levels of ferritin, IL‑2, tissue necrotic factor (TNF)‑α, TNF-γ, serum amyloid A, interferon gamma, IL‑4, IL‑8, and IL‑10 were also increased.

Conclusion: This study provides enough evidence that inflammatory markers are associated with the severity and prognosis of COVID‑19.
Inflammatory markers are, therefore, necessary if not the most important assays in the management of COVID‑19 patients. Patients with
elevated inflammatory markers should be given adequate attention and proper management to avert deterioration.

Keywords: Acute‑phase reactants, biomarkers, COVID 19, cytokines, immune‑inflammatory markers, medical laboratory diagnosis, severe
acute respiratory syndrome CoV‑2 and coronavirus