Comparative Analysis of Copeptin, IL-6, and TNF-α as Predictive Biomarkers for Clinical Outcome in Moderate to Severe COVID-19 Patients

Abstract

Abstract

Background: This retrospective clinical study, aimed to evaluate the correlation of copeptin, IL-6, and TNF-α levels with the outcomes of moderate to severe COVID-19 patients.

Methods: The study included patients who met the selection criteria and provided written informed consent. The sample size was determined using power analysis, with a sample size of 41 for 80% power to detect significant correlations with a significance level of 0.05. Consecutive sampling was employed for participant selection.  The study utilized medical records of patients with moderate to severe COVID-19 who underwent copeptin, IL-6, and TNF-α tests. Correlation analyses were performed using the Bonferroni test using SPSS® ver. 21.

Results: The results revealed a moderate positive correlation between copeptin levels and patient outcomes, with a Bonferroni correlation value 0.597 (p = 0.00). A low positive correlation was observed between IL-6 levels and outcomes (Bonferroni correlation value: 0.239; p = 0.055), while a very low positive correlation was found for TNF-α levels and outcomes (Bonferroni correlation value: 0.140; p = 0.177), which was not statistically significant.  

Conclusion: Copeptin emerged as a more sensitive biomarker for predicting the outcomes of COVID-19 patients compared to IL-6 and TNF-α. Elevated copeptin levels were associated with a poorer prognosis. The emergence of copeptin as the most powerful biomarker in this study because of presence of copeptin as a surrogate biomarker for vasopressin release as evidence that a severe inflammatory response has occurred. Copeptin's in vitro stability and stable serum levels also make copeptin as the most sensitive biomarker compared to IL-6 and TNF-α.