Inflammatory Markers upon Admission as Predictors of Outcome in COVID-19 Patients

Budhi Antariksa, Erlina Burhan, Agus Dwi Susanto, Mohamad Fahmi Alatas, Feni Fitriani Taufik, Dewi Yennita Sari, Dicky Soehardiman, Andika Chandra Putra, Erlang Samoedro, Ibrahim Nur Insan Putra Darmawan, Hera Afidjati, Muhammad Alkaff, Rita Rogayah


Background: Coronavirus disease 2019 (COVID-19) may cause dysregulation of the immune system, leading to hyperinflammation. Inflammatory markers can be used to predict in-hospital mortality in COVID-19 patients. This research was aimed to investigate the association between the levels of various inflammatory markers and mortality in COVID-19 patients.

Methods: This study was conducted at Persahabatan National Respiratory Referral Hospital, Indonesia. Blood tests were performed upon admission, measuring the C-reactive protein, PCT, leukocyte, differential counts, and platelet count. The outcome measured was the mortality of hospitalized COVID-19 patients. Statistical analysis methods included the Mann–Whitney U test, receiver operating characteristic (ROC) analysis, and area under the curve (AUC) test.

Results: Total 110 patients were included, and the laboratory values were analyzed to compare survivors and non-survivors. The non-survivor group had significantly higher leukocyte count, lower lymphocyte count, higher CRP and PCT levels, higher neutrophil-to-lymphocyte ratio (NLR), higher platelet-to-lymphocyte ratio (PLR), and lower lymphocyte-to-CRP ratio. As predictors of mortality, AUC analysis revealed that PCT, CRP, NLR, and PLR had AUCs of 0.867, 0.82, 0.791, and 0.746, respectively.

Conclusions: Routine and affordable inflammatory markers tested on admission may be useful as predictors of in-hospital mortality in COVID-19 patients requiring hospitalization.


biomarkers; COVID-19; mortality; prognosis

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Jurnal Respirologi Indonesia
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