Serial Biomarker Changes and Clinical Outcomes in Patients Receiving Corticosteroids for Severe or Critical COVID-19

Objective

To evaluate whether serial biomarker changes during corticosteroid therapy were associated with in-hospital mortality among patients with severe or critical COVID-19. Materials and Methods: This single-center retrospective cohort included 286 adults treated with corticosteroids; 186 survived and 100 died in hospital. C-reactive protein (CRP), procalcitonin, lactate dehydrogenase (LDH), ferritin, D-dimer, neutrophils, and lymphocytes were assessed on treatment days 1, 3, 5, 7, and 9; the neutrophil-to-lymphocyte ratio and systemic immune-inflammation index were derived from these measurements. Percentage changes were examined using receiver operating characteristic (ROC) curve analysis and separate logistic regression models adjusted for age, sex, baseline intensive care unit location, any comorbidity, and the corresponding day-1 biomarker value.