Assessment of Serum Electrolytes, Biochemical, and Inflammatory Markers in Predicting COVID-19 Severity in COPD Patients

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Abstract
Background: Chronic obstructive pulmonary disease (COPD) is the most prevalent long-term respiratory condition. Patients with COPD experience detrimental effects of COVID-19 infection. Objective: To figure out whether COPD is a risk factor influencing the progression of COVID-19 and to explore the clinical value of laboratory biomarkers to assess the severity of COVID-19 in patients with COPD comorbidity. Methods: In total, 1572 participants aged 35 to 70 years were enrolled to a tertiary hospital in Bangladesh between March 2022 and October 2022. Participants were categorized into four groups: (1) control, (2) COPD, (3) COVID-19, and (4) COVID-19 with COPD, and blood levels of clinical laboratory markers were assessed to analyze how these markers differ among the study groups. Results: COVID-19 patients with COPD had a significantly lower level of sodium (131.81 ± 2.8 mmol/L) and calcium (1.91 ± 0.28 mmol/L), and a significantly higher level of NT-proBNP (568.45 ± 207.40 pg/mL), bilirubin (1.34 ± 0.54 mg/dL), fibrinogen (577.27 ± 145.24 mg/dL), D-dimer (2.97 ± 2.25 μg/mL), C-reactive protein (71.08 ± 62.42 mg/L), interleukin-6 (166.47 ± 174.39 pg/mL), and procalcitonin (0.25 ± 0.30 ng/mL) compared to other study groups patients (p < 0.0001). In addition, the GOLD 4 group demonstrated significantly altered clinical parameters among COVID-19 patients with COPD. Furthermore, NT-proBNP, interleukin 6, D-dimer, C-reactive protein, and fibrinogen demonstrated excellent diagnostic performance in predicting disease severity among the COVID-19 patients with COPD, with a cut-off value of 511.2 pg/mL, 51.375 pg/mL, 1.645 μg/mL, 40.2 mg/L, and 510 mg/dL, respectively. Our results also indicate that inflammatory markers had significant positive correlations with the biochemical and coagulation markers in the COVID-19 patients suffering with COPD (p < 0.0001). Conclusions: NT-proBNP, interleukin 6, D-dimer, C-reactive protein, and fibrinogen are the most potential parameters for differentiating severe cases of COVID-19.

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