# Prediction of Clinical Severity of COVID‐19 Using a Combination of Heparin‐Binding Protein, Interleukin‐6, and C‐Reactive Protein: A Retrospective Study

## TL;DR

This study shows that combining three inflammation markers can accurately predict how severe a COVID-19 case will be and the risk of death.

## Contribution

The study introduces a novel combination of HBP, IL-6, and CRP as a more accurate predictor of severe COVID-19 outcomes.

## Key findings

- Severe COVID-19 cases had significantly higher HBP, IL-6, and CRP levels compared to nonsevere cases.
- Combined use of HBP, IL-6, and CRP achieved 85.10% sensitivity and 95.70% specificity in predicting severity.
- Elevated levels of these biomarkers were linked to increased mortality risk and organ failure.

## Abstract

Systemic inflammation stands as a pivotal factor tightly interwoven with the progression of COVID‐19. This study endeavors to elucidate the significance of three key inflammatory molecules, that is, heparin‐binding protein (HBP), interleukin‐6 (IL‐6), and C‐reactive protein (CRP), in assessing the severity and prognostic implications of COVID‐19.

The demographic, clinical, and laboratory data were retrospectively collected from a cohort of 214 adult patients diagnosed with COVID‐19. Patients were divided into two groups: nonsevere (n = 93; 43.5%) and severe (n = 121; 56.5%). Additionally, based on their organ function, patients were categorized into nonorgan failure (n = 137) and organ failure (n = 77) groups. The levels of inflammation‐related cytokines were then compared among these defined groups.

The severe group was characterized by a higher proportion of males, older age, and longer hospital stays compared to nonsevere cases. Additionally, severe cases exhibited a higher prevalence of underlying diseases and organ failure. Statistical analysis revealed significantly elevated levels of HBP, IL‐6, and CRP in the severe group. HBP, IL‐6, and CRP were identified as independent risk factors for severe COVID‐19. Furthermore, a combined assessment of these biomarkers demonstrated superior diagnostic sensitivity (85.10%) and specificity (95.70%) for predicting COVID‐19 severity. A positive relationship between elevated HBP, IL‐6, and CRP levels and impaired organ function was also observed. The predictive efficiency significantly increased (hazard ratio = 3.631, log‐rank p = 0.003) when two or more of them were combinedly used. Notably, elevated levels of HBP, IL‐6, and CRP were associated with an increased risk of mortality.

In conclusion, the combined assessment of HBP, IL‐6, and CRP offers enhanced accuracy and specificity in predicting the severity, organ failure, and mortality risk associated with COVID‐19.

The combined assessment of HBP, IL‐6, and CRP offers enhanced accuracy and specificity in predicting the severity, organ failure, and mortality risk associated with COVID‐19. Utilizing these biomarkers in combination can provide valuable prognostic information for severe COVID‐19 cases, enabling timely intervention to reduce mortality and improve patient outcomes.