Longitudinal monitoring of laboratory markers characterizes hospitalized and ambulatory COVID-19 patients
Thirumalaisamy P. Velavan, Salih Kuk, Le Thi Kieu Linh, Carlos Lamsfus Calle, Albert Lalremruata, Srinivas Reddy Pallerla, Andrea Kreidenweiss, Jana Held, Meral Esen, Julian Gabor, Eva Maria Neurohr, Parichehr Shamsrizi, Anahita Fathi, Erwin Biecker, Christoph P. Berg, Michael Ramharter, Marylyn M. Addo, Benno Kreuels, Peter G. Kremsner
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.