Value of various inflammatory markers combined with lymphocyte subsets on clinical diagnosis of different clinical types of COVID-19

Abstract:

Objective：To investigate the change law and the clinical significance of various inflammatory markers in COIVD-19 pa－tients with different clinical types. Methods：A total of 110 patients diagnosed with COVID-19 who were hospitalized in the Hubei Provincial Hospital of Integrated Chinese and Western Medicine from January 28 to March 3，2020 were collected as study objects and were divided into three groups of the ordinary group，the severe group and the critically ill group according to the diagnostic criteria from Diagnostic and Therapeutic Protocols for COVID-19（The trial 7）. General data，serum albumin（ALB），C-reactive protein （CRP），procalcitonin（PCT） and cytokines interleukin-1β（IL-1β），interleukin-6（IL-6），interleukin-8（IL-8），interleukin-10（IL-10），CD4+ T lymphocyte count（CD4+ T） and CD8+ T lymphocyte count（CD8+ T） in each group were retrospectively analyzed and com－pared. The expression data of inflammatory indicators in each group was not consistent with the normal distribution as the median（quartile）. Kruskal-wallis rank sum test was used for detecting data differences among three groups，and Mann-Whitney U test was used for the pairwise comparison between the groups. The re－ceiver operator characteristic curve（ROC curve） was used for the diagnostic value of inflammatory indicators with statistical significance，and the best diagnostic inflammatory index was se－lected according to the area under the curve（AUC）. Results：Levels of serum IL-6，IL-10，CRP and PCT were the highest in the critically ill group，following the severe group and the ordi－nary group；levels of ALB，CD4+ T，CD8+ T were the highest in the ordinary group，following the severe group and the critically ill group，with statistically significant differences（P<0.001）. Levels of serum IL-1β and IL-8 did not change significantly in each clini－cal group and P values were 0.388 and 0.128，without statistical significance（P>0.05）. AUC of serum IL-6 and CRP/ALB was 0.931，the sensitivity was 0.885，and the specificity was 0.825. Conclusion：Real-time detection of various serum inflammatory markers combined with T lymphocyte subsets can contribute to judging the prognosis of patients with COVID-19，which can be regarded as a vital reference to evaluate effectiveness，e severity and prognosis. The combined detection of serum IL-6 and CRP/ALB will greatly improve the accuracy of predicting the severity of COVID-19.