Inflammatory Biomarkers as Early Predictors of Complications in Infectious Diseases

Abstract

We assessed inflammatory biomarkers on admission to predict infectious complications within 3 days. Between October 2024 and July 2025, we recruited 95 patients between the ages of 18 and 65 at three EDs in Pakistan. Biomarkers (CRP, PCT, ferritin, and neutrophil to lymphocyte ratio) were measured within 2 hours of ED arrival. We assessed the development of infectious complications using the SOFA score and defined criteria for shock and Acute Respiratory Distress Syndom (ARDS). We compared the groups, performed correlation analysis and assessed the biomarkers using Receiver Operating Characteristic Curves (ROC). About 37.9% of the study population developed an infectious complication. Participants with complications had a significantly higher level of all 4 biomarkers (p<0.001). The area under the ROC curve was 0.91 (95% CI 0.85-0.97) for PCT and 0.85 (95% CI 0.77-0.93) for CRP. An area under the ROC curve of 0.94 (95% CI 0.89-0.98) was observed for the two biomarkers together. A positive correlation was found between the maximum SOFA score and PCT (r=0.785). Our study showed that all 4 biomarkers had prognostic value, and the value was highest for PCT.