Longitudinal monitoring of laboratory markers characterizes hospitalized and ambulatory COVID-19 patients

Sci Rep. 2021 Jul 14;11(1):14471. doi: 10.1038/s41598-021-93950-x.

Abstract

Early detection of severe forms of COVID-19 is absolutely essential for timely triage of patients. We longitudinally followed-up two well-characterized patient groups, hospitalized moderate to severe (n = 26), and ambulatory mild COVID-19 patients (n = 16) at home quarantine. Human D-dimer, C-reactive protein (CRP), ferritin, cardiac troponin I, interleukin-6 (IL-6) levels were measured on day 1, day 7, day 14 and day 28. All hospitalized patients were SARS-CoV-2 positive on admission, while all ambulatory patients were SARS-CoV-2 positive at recruitment. Hospitalized patients had higher D-dimer, CRP and ferritin, cardiac troponin I and IL-6 levels than ambulatory patients (p < 0.001, p < 0.001, p = 0.016, p = 0.035, p = 0.002 respectively). Hospitalized patients experienced significant decreases in CRP, ferritin and IL-6 levels from admission to recovery (p < 0.001, p = 0.025, and p = 0.001 respectively). Cardiac troponin I levels were high during the acute phase in both hospitalized and ambulatory patients, indicating a potential myocardial injury. In summary, D-dimer, CRP, ferritin, cardiac troponin I, IL-6 are predictive laboratory markers and can largely determine the clinical course of COVID-19, in particular the prognosis of critically ill COVID-19 patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ambulatory Care
  • Biomarkers / blood
  • C-Reactive Protein / analysis
  • COVID-19 / blood*
  • COVID-19 / diagnosis*
  • Early Diagnosis
  • Ferritins / blood
  • Fibrin Fibrinogen Degradation Products / analysis
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Interleukin-6 / blood
  • Longitudinal Studies
  • Pneumonia, Viral / blood
  • Pneumonia, Viral / diagnosis
  • Precision Medicine
  • Prognosis
  • Quarantine
  • SARS-CoV-2
  • Severity of Illness Index
  • Troponin I / blood

Substances

  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • Interleukin-6
  • Troponin I
  • fibrin fragment D
  • C-Reactive Protein
  • Ferritins