Inflammation as Prognostic Hallmark of Clinical Outcome in Patients with SARS-CoV-2 Infection

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is often characterized by a life-threatening interstitial pneumonia requiring hospitalization. The aim of this retrospective cohort study is to identify hallmarks of in-hospital mortality in patients affected by Coronavirus Disease 19 (COVID-19). A total of 150 patients admitted for COVID-19 from March to June 2021 to "F. Perinei" Murgia Hospital in Altamura, Italy, were divided into survivors (n = 100) and non-survivors groups (n = 50). Blood counts, inflammation-related biomarkers and lymphocyte subsets were analyzed into two groups in the first 24 h after admission and compared by Student's t-test. A multivariable logistic analysis was performed to identify independent risk factors associated with in-hospital mortality. Total lymphocyte count and CD3+ and CD4+ CD8+ T lymphocyte subsets were significantly lower in non-survivors. Serum levels of interleukin-6 (IL-6), lactate dehydrogenase (LDH), C-reactive protein (CRP) and procalcitonin (PCT) were significantly higher in non-survivors. Age > 65 years and presence of comorbidities were identified as independent risk factors associated with in-hospital mortality, while IL-6 and LDH showed a borderline significance. According to our results, markers of inflammation and lymphocytopenia predict in-hospital mortality in COVID-19.

Diana Fuzio, Angelo Michele Inchingolo, Vitalba Ruggieri, Massimo Fasano, Maria Federico, Manuela Mandorino, Lavinia Dirienzo, Salvatore Scacco, Alessandro Rizzello, Maurizio Delvecchio, Massimiliano Parise, Roberto Rana, Nicola Faccilongo, Biagio Rapone, Francesco Inchingolo, Antonio Mancini, Maria Celeste Fatone, Antonio Gnoni, Gianna Dipalma, Giovanni Dirienzo