1887
6 The Anbar 2nd International Medical Conference (AIMCO 2022)
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Since the outbreak of COVID-19, healthcare professionals suggested a wide range of recommendations in the fields of diagnosis, treatment, and prevention. Laboratory biomarkers are considered one of the crucial diagnostic tools for COVID-19, assessing its severity and progress predictor. Owing to the lack of consensus regarding changes in biomarkers and their correlations, researchers are encouraged to detect more interesting findings. A few studies were conducted in Iraq considering this aspect. This study aimed to investigate certain biomarkers in patients with severe COVID-19 and their relations to mortality outcomes. Also, this study aimed to identify the correlation between these markers in severe disease.

A cross-sectional study was conducted at the Fallujah Teaching Hospital, west of Iraq, which included all admittance with severe COVID-19 between September 20, 2021, and February 30, 2022. A questionnaire was designed to collect socio-clinical characteristics and in-hospital outcomes (recovery/death). Procalcitonin (PCT) and certain biomarkers were analyzed, based on that outcome, and correlations between these markers were assessed.

For 75 patients who were enrolled in this study, the mean age was 62.3 ± 14.3 years, of which females constituted 62%. The most preponderance age was ≥60 years with a statistically significant higher rate of death (37.3%) when compared to other ages ( = 0.007), while other socio-clinical characteristics revealed nonsignificant differences. High PCT levels were found in 34.7% of the enrolled patients, while neutrophilia, lymphopenia, and elevated levels of troponin, ferritin, and C-reactive protein (CRP) were the prominent abnormal biomarker findings. However, only ferritin and troponin mean levels revealed significant differences in relation to the outcomes ( = 0.019 and 0.010, respectively). A moderate positive correlation was found between PCT and interleukin-6 (IL-6) ( = 0.586, = 0.005), and also PCT correlates positively with CRP ( = 0.49, = 0.005) and troponin ( = 0.41, = 0.001). Additionally, there were significant positive correlations of troponin with IL-6 ( = 0.41, = 0.005) and PCT ( = 0.37, = 0.001). Also, IL-6 correlates positively with troponin ( = 0.62, = 0.005).

We found an elevated level of PCT in almost three-quarters of patients with severe COVID-19, with a non-significant difference with the specific recovery/death outcomes. In addition, high troponin levels, neutrophilia, and lymphopenia regardless of the outcome were found. Also, there were valuable correlations between certain biomarkers in patients with COVID-19.

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2022-12-06
2023-02-09
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References

  1. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected Pneumonia. N Engl J Med. 2020 Mar 26; 382:(13):1199–207.
    [Google Scholar]
  2. WHO Director-General’s remarks at the media briefing on 2019-nCoV on 11 February 2020 [Internet]. [accessed 9 October 2022]. Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020
    [Google Scholar]
  3. Pham B, Rios P, Radhakrishnan A, Darvesh N, Antony J, Williams C, et al. Comparative-effectiveness research of COVID-19 treatment: a rapid scoping review. BMJ Open. 2022 Jun; 12:(6):e045115.
    [Google Scholar]
  4. Al-Ani A. COVID-19 variants and vaccine benefits-risks balance. Al-Anbar Med J. 2021; 17:(2).
    [Google Scholar]
  5. Antonelli M, Penfold RS, Merino J, Sudre CH, Molteni E, Berry S, et al. Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID symptom study app: a prospective, community-based, nested, case-control study. Lancet Infect Dis. 2022 Jan; 22:(1):43–55.
    [Google Scholar]
  6. Watson J, Whiting PF, Brush JE. Interpreting a covid-19 test result. BMJ. 2020 May 12; 369::m1808.
    [Google Scholar]
  7. Malik P, Patel U, Mehta D, Patel N, Kelkar R, Akrmah M, et al. Biomarkers and outcomes of COVID-19 hospitalisa-tions: systematic review and meta-analysis. BMJ Evid-Based Med. 2021 Jun 1; 26:(3):107–8.
    [Google Scholar]
  8. de Oliveira Toledo SL, Nogueira LS, das Graças Carvalho M, Rios DRA, de Barros Pinheiro M. COVID-19: review and hematologic impact. Clin Chim Acta. 2020 Nov; 510::170–6.
    [Google Scholar]
  9. Catanzaro M, Fagiani F, Racchi M, Corsini E, Govoni S, Lanni C. Immune response in COVID-19: addressing a pharmacological challenge by targeting pathways triggered by SARS-CoV-2. Signal Transduct Target Ther. 2020 May 29; 5:(1):84.
    [Google Scholar]
  10. Fan BE, Chong VCL, Chan SSW, Lim GH, Lim KGE, Tan GB, et al. Hematologic parameters in patients with COVID-19 infection. Am J Hematol. 2020 Jun; 95:(6). Available from: https://onlinelibrary.wiley.com/doi/10.1002/ajh.25774
    [Google Scholar]
  11. Stegeman I, Ochodo EA, Guleid F, Holtman GA, Yang B, Davenport C, et al. Routine laboratory testing to deter-mine if a patient has COVID-19. Cochrane Database Syst Rev. 2020 Nov 19; 11::CD013787.
    [Google Scholar]
  12. Al-Ani A. Reactive lymphocytes in blood film of a COVID-19 Iraqi patient: A case report. Hematol Transfus Cell Ther. 2022; 20:(21):50.
    [Google Scholar]
  13. Ali AM, Rostam HM, Fatah MH, Noori CM, Ali KM, Tawfeeq HM. Serum troponin, D-dimer, and CRP level in severe coronavirus (COVID-19) patients. Immun Inflamm Dis. 2022 Mar; 10:(3). Available from: https://onlinelibrary.wiley.com/doi/10.1002/iid3.582
    [Google Scholar]
  14. Lardaro T, Wang AZ, Bucca A, Croft A, Glober N, Holt DB, et al. Characteristics of COVID-19 patients with bacterial coinfection admitted to the hospital from the emergency department in a large regional healthcare system. J Med Virol. 2021 May; 93:(5):2883–9.
    [Google Scholar]
  15. Müller B, Harbarth S, Stolz D, Bingisser R, Mueller C, Leuppi J, et al. Diagnostic and prognostic accura-cy of clinical and laboratory parameters in community-acquired pneumonia. BMC Infect Dis. 2007 Mar 2; 7::10.
    [Google Scholar]
  16. Han J, Gatheral T, Williams C. Procalcitonin for patient stratification and identification of bacterial co-infection in COVID-19. Clin Med. 2020 May; 20:(3):e47.
    [Google Scholar]
  17. Jakhmola S, Indari O, Baral B, Kashyap D, Varshney N, Das A, et al. Comorbidity assessment is essential during COVID-19 treatment. Front Physiol. 2020 Aug 4; 11::984.
    [Google Scholar]
  18. Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE, et al. Factors associated with COVID-19-related death using OpenSAFELY. Nature. 2020 Aug 20; 584:(7821):430–6.
    [Google Scholar]
  19. Mahamat-Saleh Y, Fiolet T, Rebeaud ME, Mulot M, Guihur A, El Fatouhi D, et al. Diabetes, hypertension, body mass index, smoking and COVID-19-related mortality: a systematic review and meta-analysis of observational studies. BMJ Open. 2021 Oct; 11:(10):e052777.
    [Google Scholar]
  20. Central Statistical Organization. Population indicators [Internet]. Baghdad, Iraq: CSO; 2021 [accessed 30 Aug 2022]. Available from: https://cosit.gov.iq/ar/?option=com_content&view=article&layout=edit&id=174&jsn_setmobile=no
    [Google Scholar]
  21. Gupta R, Agrawal R, Bukhari Z, Jabbar A, Wang D, Diks J, et al. Higher comorbidities and early death in hospital-ized African-American patients with Covid-19. BMC Infect Dis. 2021 Jan 18; 21:(1):78.
    [Google Scholar]
  22. Al-Ani A, Ghazzay HI, Shawi AFA, Al-koubaisy HNE, Al-Ani F, Aldouri M. Association of chronic diseases with mortality among hospitalized patients with COVID-19 treated with convalescent plasma: evidence from a single cen-ter–Iraq. J Emerg Med Trauma Acute Care. 2022 Mar 16; 2022:(2):13.
    [Google Scholar]
  23. Pinchoff J, Austrian K, Rajshekhar N, Abuya T, Kangwana B, Ochako R, et al. Gendered economic, social and health effects of the COVID-19 pandemic and mitigation policies in Kenya: evidence from a prospective cohort survey in Nairobi informal settlements. BMJ Open. 2021 March 1; 11:(3):e042749.
    [Google Scholar]
  24. Centers for Disease Control and Prevention. Healthcare workers [Internet]. CDC; 2022 [accessed 8 August 2022]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/underlyingconditions.html
    [Google Scholar]
  25. Global Health 50/50. The Sex, Gender and COVID-19 Project [Internet]. [Accessed 11 August 2022]. Available from: https://globalhealth5050.org/the-sex-gender-and-covid-19-project/
    [Google Scholar]
  26. Hopkinson NS, Rossi N, Moustafa JE, Laverty AA, Quint JK, Freidin M, et al. Current smoking and COVID-19 risk: results from a population symptom app in over 2.4 million people. Thorax. 2021 Jul; 76:(7):714–22.
    [Google Scholar]
  27. Nakagawa M, Terashima T, D’yachkova Y, Bondy GP, Hogg JC, van Eeden SF. Glucocorticoid-induced granulocytosis: Contribution of marrow release and demargination of intravascular granulocytes. Circulation. 1998 Nov 24; 98:(21):2307–13.
    [Google Scholar]
  28. Müller B, Becker KL, Schächinger H, Rickenbacher PR, Huber PR, Zimmerli W, et al. Calcitonin precursors are reliable markers of sepsis in a medical intensive care unit. Crit Care Med. 2000 Apr; 28:(4):977–83.
    [Google Scholar]
  29. Clerkin KJ, Fried JA, Raikhelkar J, Sayer G, Griffin JM, Masoumi A, et al. COVID-19 and cardiovascular disease. Circulation. 2020 May 19; 141:(20):1648–55.
    [Google Scholar]
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