European Journal of Cardiovascular Medicine

Background: Covid-19 is a public health emergency of international concern.  It is prudent to identify patients with a high risk of acute respiratory distress syndrome by using systemic inflammatory biomarkers. Objectives: The study aims to evaluate serum biomarkers (C- reactive protein, Lactate dehydrogenase, Ferritin & D-dimer) for detecting covid19 severity and define cutoff of biomarkers for risk stratification of hospitalized patients. Methods: A retrospective observational study done at Mamata Academy of medical sciences, Hyderabad, during a period from June 2020 to December 2020. There were total of 212 cases (66 ICU & 146 Non ICU) of COVID19 diagnosed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) by using nasopharyngeal swabs. Details on their demographics, diagnosis, and the values of biomarkers were obtained. Data was analyzed by Independent sample t-test, Receiver operating characteristics curve at maximum sensitivity & specificity and cutoff value using SPSS version 20.0. Results: The Mean age of ICU patient (65.06±13.47years) was higher than non ICU patient (44.66±11.97).The mean value of biomarkers in ICU patients such as CRP(40.79±27.40mg/lt), LDH(359.08±13.22U/lt), D-dimer(1545.27±1586.29µg/lt) and ferritin (538.41±441.70µg/lt) was higher than  non-ICU and difference is statistically significant (p <0.001). Receiver operating characteristics curve revealed that D- dimer (AUC = 0.87; 95% CI: 0.83–0.92) had the best predictive accuracy followed by CRP (AUC = 0.84; 95% CI: 0.78–0.90), LDH (AUC=0.75; 95% CI: 0.68-0.82) and ferritin (AUC = 0.68; 95% CI: 0.60–0.77). The cut off value for d-dimer & CRP in identifying ICU patient as compared to NON ICU is 357 µg/L & 16mg/L respectively. Conclusion: Inflammatory markers correlate well with COVID-19 severity and helps to devise best possible treatment protocols  for critical care patients to avoid preventable mortality. D-dimer followed by CRP, LDH & Serum ferritin accurately predict patients developing severe COVID-19 infections.