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. 2024 Oct 25:17:4895-4906.
doi: 10.2147/IJGM.S488968. eCollection 2024.

Role of Biomarkers Diagnostic Tools in Patients with COVID-19: Stratification Made Easy

Ahmed Abdallah Salman  1 , Heba Mohamed Abdallah  2 , Sami Eldahdouh  3 , Sally Waheed Elkhadry  4 , Samah Mohamed Awad  5 , Ghada M K Gaballah  6 , Eman Kamal Awaad  7 , Mohammed Gaber Saad  8 , Ahmed E Taha  9 , Nahla K Gaballa  7
Affiliations

Role of Biomarkers Diagnostic Tools in Patients with COVID-19: Stratification Made Easy

Ahmed Abdallah Salman et al. Int J Gen Med. .

Abstract

Background and aims: In coronavirus disease 2019 (COVID-19) patients, several serum biomarkers have been identified. Upon intensive care unit (ICU) admission, these laboratory markers become more crucial to distinguish between patients with severe cases of COVID-19. It might assist doctors in predicting the course of illnesses and treating patients appropriately. This work was to investigate the role of biomarkers in patients with COVID-19 classification admitted to the hospital and identified by reverse transcription polymerase chain reaction (RT-PCR).

Methods: Peripheral blood sample was taken from COVID-19 cases isolated on admission to determine C-reactive protein (CRP), D-dimer, Fibrinogen, neutrophil-lymphocyte ratio (NLR), leukocytes CRP ratio (LeCR), lymphocyte-CRP ratio (LCR), interleukin-6 (IL6), leukocytes interleukin 6 ratio (LeIL6), systemic inflammatory index (SII), platelet-to-lymphocyte ratio (PLR), and tissue plasminogen activator inhibitor one (tPAI-1). Follow-up for IL6, Ferritin, D-dimer, and tPAI-1 were determined on the 3rd and 7th days.

Results: Comparisons of severity revealed that hypertension, chronic obstructive pulmonary disease (COPD), and Ischemia were major risk factors in COVID-19 patients. There was a statistically significant difference between the test groups for fibrinogen (p < 0.000), IL6 (p < 0.009), LeCR (p < 0.006), and LCR (p < 0.011).

Conclusion: Based on laboratory test findings at the time of ICU admission, we can distinguish severe cases of COVID-19.

Keywords: COVID-19; RT- PCR; intensive care unit; risk factors; serum biomarkers.

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Conflict of interest statement

The authors declare no competing interests in this work.

Figures

Figure 1
Figure 1
Flowchart of the studied groups.
Figure 2
Figure 2
Receiver- operating characteristic curve (ROC) for biomarkers in prediction of severity of COVID-19 patients: tPAIS1: Tissue plasminogen activator inhibitor-1, measured in nanograms per milliliter (ng/mL); D-dimer: D-dimer level, measured in nanograms per milliliter (ng/mL); Fibrinogen: Fibrinogen level, measured in milligrams per deciliter (mg/dL); Ferritin: Ferritin level, measured in nanograms per milliliter (ng/mL); SII: Systemic immune-inflammation index, measured in billions per liter (10^9/L); PLR: Platelet–lymphocyte ratio; NLR: Neutrophil-lymphocyte ratio.
Figure 3
Figure 3
Receiver- operating characteristic curve (ROC) for biomarkers in prediction of severity of COVID-19 patients: IL-6: Interleukin-6, measured in picograms per milliliter (pg/mL); Lymphocyte: Lymphocyte count, measured in billions per lite r (10^9/L); Platelets: Platelet count, measured in billions per liter (10^9/L); LeCR: Leukocyte–CRP ratio; LeIL-6: Leukocyte-Interleukin-6 ratio; LCR: Lymphocyte–CRP ratio.
Figure 4
Figure 4
Effect of IV NAC on inflammation assessed by serum levels of IL6 (ng/l) and ferritin (ng/mL), t PAI.1 (ng/mL), D. Dimer and clinical outcome of COVID-19 infection patients.
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