Accuracy Of Serum Ferritin, C-Reactive Protein, Lactate Dehydrogenase And D. Dimers In Assessing Severity And Outcome Of COVID-19 Infection

Abstract

ABSTRACT: Introduction: Covid-19 emerged as pandemic. In the beginning, due to the rapid spread of virus it was difficult to understand fully its pathogenesis but various inflammatory markers were found to be raised. Along with the detection of virus by polymerase reaction (PCR), studies of these markers not only help in diagnosis but also in assessing the prognosis of covid-19 infection. Material and methods: This cross sectional study was conducted in the Capital Hospital, CDA Islamabad from December to June 2022. After taking consent various inflammatory markers were recorded on a proforma. Patients were followed and outcome was also recorded. The data collected was analyzed by percentage/ frequency distribution. T-test was applied and p-values were calculated (significant p-value=<0.05).  Sensitivity, specificity, positive and negative predictive values, area under curve (AUC) and accuracy were calculated by using SPSS, version 23. Results: A total of 185 covid-19 PCR positive patients were included in the study. 112(60.5%) were men and 73 (39.5%) were women. 165(89.2%) patients were > 40 years of age. 117 (63.2%) patients had mild /moderate disease and 68(36.8%) had severe disease.  162 (87.5%) patients were discharged and 23 (23.4%) expired. AUC in relation to severity of disease was 0.603 for C- reactive protein (CRP), 0.543 for lactate dehydrogenase (LDH), 0.525 for D. dimers and 0.619 for ferritin. Accuracy in relation to disease severity was as following: CRP 57.4%, D. dimers 52.4 %, ferritin 57.9% and LDH 55.7%.  AUC in relation to outcome of covid-19 was 0.699 for CRP, 0.668 for LDH, 0.742 for D. dimers and 0.677 for ferritin. Accuracy of inflammatory markers in relation to outcome was as following: CRP 45.9%, D. dimers 61.2%, LDH 48.1% and ferritin 46.9%. Conclusion: Serum ferritin showed the highest accuracy (57.9%) in assessing the covid-19 severity and D. dimer came up with highest accuracy (61.2%) in assessing disease outcome.