Predictive value of heparin-binding protein, interleukin-6, and C-reactive protein in severe COVID-19, organ failure, and prognosis: a retrospective study

Background: Systemic inflammation is closely related to the progress of COVID-19.This study aimed to explore the role of combined detection of heparin-binding protein (HBP), interleukin-6 (IL6), and C-reactive protein (CRP) on the severity and clinical outcomes of COVID-19. Methods: Our hospital conducted a retrospective analysis of 214 patients with COVID-19 from 1 December 2022 to 28 February 2023. Patients were separated into non-severe and severe categories. Based on whether there was organ failure during hospitalization, patients were further split into the non-organ failure group and the organ failure group. Records on demographics, baseline, and clinical features, as well as the levels of HBP, IL6, and CRP on admission, were collected. Results: HBP, IL6, and CRP levels were positively correlated with total bilirubin, lactate dehydrogenase, serum creatinine, and D-dimer but negatively correlated with albumin. HBP, IL6, and CRP levels were remarkably higher in severe, organ failure, and non-survivor groups compared to non-severe, non-organ failure, and survivor groups (all P < 0.001). The optimal cutoff values of HBP, IL6, and CRP for predicting severe COVID-19 were 49.71 ng/mL, 11.24 pg/mL, and 39.67 mg/L, respectively. With a sensitivity and specificity of 85.10% and 95.70% for severe COVID-19, the combined detection of HBP, IL6, and CRP showed the best diagnostic effectiveness. Logistic regression revealed that HBP, IL6, and CRP were independent risk factors for severe COVID-19 and organ failure. Moreover, the risk of death predicted by any two or more of HBP, IL6, and CRP higher than the optimal cutoff value was 3.631 times that of only one of the three indicators higher than the optimal cutoff value (hazard ratio = 3.631, log-rank P = 0.003). Conclusions: A combination of HBP, IL6, and CRP has higher diagnostic efficiency of severe COVID-19; combined detection can more accurately and efficiently predict COVID-19 severity, organ failure, and prognosis, which is complementary to previous studies.