Document Type
Research Article
Abstract
Backgrounds: COVID-19, a new health challenge, can be diagnosed by many laboratory biomarkers. Biomarkers became valuable for prognosis; identifying the severity and mortality of the disease in COVID-19 patients. This study aims to determine the association of clinical, demographics, and laboratory biomarkers (CRP, D-dimer, lymphocyte, and platelet) with the severity and mortality of COVID-19. Methods: Between June 1st and November 1st, 2020, 34 healthy controls and 104 COVID-19 cases were enrolled in this study. SARS-CoV-2 infection was confirmed using the real-time RT-PCR technique. All cases were analyzed for clinical, epidemiological, and laboratory biomarkers. COVID-19 cases were regrouped into mild (n=40), moderate (n=32), and severe (n=32) groups depending on the severity of the disease; it was also re-categorized into survivor (n=85) and non-survivor (n=19) groups depending on mortality. After collecting blood from participants, hematological parameters (lymphocyte and platelet) and other biomarkers (CRP and D-dimer) were measured by colter and Cobas c111, respectively. Results: For age categories and comorbidities, Statistical significance was found among COVID-19 groups. Regarding ABO, Rh, and gender, a non-significant difference was found among groups of COVID-19 patients. Cough and headache i the most common symptom in our population. SpO2 depressed more significantly in severe and moderate groups than in mild groups. Severe and moderate groups exhibit higher CRP, D-dimer, and lymphocyte percentages than control while there was a non-significant change for platelets and absolute lymphocyte counts among studies groups. All studied laboratory biomarkers were higher in non-survivors than in survivor COVID-19 groups. A significant correlation was found between D-dimer and other laboratory biomarkers. Conclusion: Gender, ABO, and Rh were not associated but age and comorbidities were associated with the severity of COVID-19. All studied laboratory biomarkers were associated with mortality.
Keywords
COVID-19, mortality, laboratory biomarkers, and SARS-CoV-2.
How to Cite This Article
Ghareeb, Asma Ameen and Abdulaziz, Sazan Moffaq
(2023)
"Clinical & Laboratory markers as predictors for severity and mortality in COVID-19,"
Polytechnic Journal: Vol. 13:
Iss.
1, Article 20.
DOI: https://doi.org/10.59341/2707-7799.1746
References
ALRADDADI, B. M., WATSON, J. T., ALMARASHI, A., ABEDI, G. R., TURKISTANI, A., SADRAN, M., HOUSA, A., ALMAZROA, M. A., ALRAIHAN, N. & BANJAR, A. J. E. I. D. 2016. Risk factors for primary Middle East respiratory syndrome coronavirus illness in humans, Saudi Arabia, 2014. 22, 49.
ASAI, Y., NOMOTO, H., HAYAKAWA, K., MATSUNAGA, N., TSUZUKI, S., TERADA, M., OHTSU, H., KITAJIMA, K., SUZUKI, K., SUZUKI, T., NAKAMURA, K., MORIOKA, S., SAITO, S., SAITO, F. & OHMAGARI, N. 2022. Comorbidities as Risk Factors for Severe Disease in Hospitalized Elderly COVID-19 Patients by Different Age-Groups in Japan. Gerontology, 68, 1027-1037.
BADAWI, A. & RYOO, S. G. 2016. Prevalence of comorbidities in the Middle East respiratory syndrome coronavirus (MERS-CoV): a systematic review and meta-analysis. International Journal of Infectious Diseases, 49, 129- 133.
BALLAZ, S. J., PULGAR-SÁNCHEZ, M., CHAMORRO, K., FERNÁNDEZ-MOREIRA, E., RAMÍREZ, H., MORA, F. X., FORS, M. J. C. C. & MEDICINE, L. 2021. Common laboratory tests as indicators of COVID-19 severity on admission at high altitude: a single-center retrospective study in Quito (ECUADOR). 59, e326- e329.
BAREK, M. A., AZIZ, M. A. & ISLAM, M. S. J. H. 2020. Impact of age, sex, comorbidities and clinical symptoms on the severity of COVID-19 cases: a meta-analysis with 55 studies and 10014 cases. 6, e05684. Bermejo-Martin, J.F., González-Rivera, M., Almansa, R., Micheloud, D., Tedim, A.P., Domínguez-Gil, M., Resino, S., Martín-Fernández, M., Ryan Murua, P., Pérez-García, F. and Tamayo, L., 2020. Viral RNA load in plasma is associated with critical illness and a dysregulated host response in COVID-19. Critical Care, 24(1), 1-13.
CHANNAPPANAVAR, R., FETT, C., MACK, M., TEN EYCK, P. P., MEYERHOLZ, D. K. & PERLMAN, S. 2017. Sex-based differences in susceptibility to severe acute respiratory syndrome coronavirus infection. The Journal of Immunology, 198, 4046-4053.
CHEN, N., ZHOU, M., DONG, X., QU, J., GONG, F., HAN, Y., QIU, Y., WANG, J., LIU, Y. & WEI, Y. 2020. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The lancet, 395, 507-513.
CICERI, F., BERETTA, L., SCANDROGLIO, A. M., COLOMBO, S., LANDONI, G., RUGGERI, A., PECCATORI, J., D'ANGELO, A., DE COBELLI, F. & ROVERE-QUERINI, P. 2020. Microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome (MicroCLOTS): an atypical acute respiratory distress syndrome working hypothesis. Critical care and resuscitation, 22, 95.
DEB, S., MONDAL, R., LAHIRI, D., GANGULY, U. & SHOME, G. J. I. J. O. R. I. M. S. 2022. Diverse immunopathological manifestations and immunogenomic predispositions in COVID-19: summarizing the evidence. 10, 1390.
DU, R.-H., LIANG, L.-R., YANG, C.-Q., WANG, W., CAO, T.-Z., LI, M., GUO, G.-Y., DU, J., ZHENG, C.-L. & ZHU, Q. J. E. R. J. 2020. Predictors of mortality for patients with COVID19 pneumonia caused by SARS-CoV-2: a prospective cohort study. 55.
FAJGENBAUM, D. C. & JUNE, C. H. 2020. Cytokine Storm. N Engl J Med, 383, 2255-2273.
GAUTIER, J. F. & RAVUSSIN, Y. J. O. 2020. A new symptom of COVID‐19: loss of taste and smell. 28, 848-848.
GOLINELLI, D., BOETTO, E., MAIETTI, E. & FANTINI, M. P. J. P. O. 2020. The association between ABO blood group and SARS-CoV-2 infection: A meta-analysis. 15, e0239508.
GONG, J., OU, J., QIU, X., JIE, Y., CHEN, Y., YUAN, L., CAO, J., TAN, M., XU, W. & ZHENG, F. 2020. Multicenter development and validation of a novel risk nomogram for early prediction of severe 2019-novel coronavirus pneumonia.
GÖRLINGER, K., DIRKMANN, D., GANDH I, A., SIMIONI, P. J. A. & ANALGESIA 2020. COVID-19 associated coagulopathy and inflammatory response: what do we know already and what are the knowledge gaps?
GROMMES, J., ALARD, J.-E., DRECHSLER, M., WANTHA, S., MÖRGELIN, M., KUEBLER, W. M., JACOBS, M., VON HUNDELSHAUSEN, P., MARKART, P., WYGRECKA, M. J. A. J. O. R. & MEDICINE, C. C. 2012. Disruption of platelet-derived chemokine heteromers prevents neutrophil extravasation in acute lung injury. 185, 628-636.
GUAN, W.-J., NI, Z.-Y., HU, Y., LIANG, W.-H., OU, C.-Q., HE, J.- X., LIU, L., SHAN, H., LEI, C.-L. & HUI, D. S. 2020. Clinical characteristics of coronavirus disease 2019 in China. New England journal of medicine, 382, 1708- 1720.
HU, B., HUANG, S. & YIN, L. 2021. The cytokine storm and COVID‐19. Journal of medical virology, 93, 250-256.
HUANG, C., WANG, Y., LI, X., REN, L., ZHAO, J., HU, Y., ZHANG, L., FAN, G., XU, J. & GU, X. 2020. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The lancet, 395, 497-506.
ISHAQ, S. E., ABDULQADIR, S. Z., KHUDHUR, Z. O., OMAR, S. A., QADIR, M. K., AWLA, H. K., RASUL, M. F., BAPIR, A. A., ZANICHELLI, A., MANSOOR, M. K., KALEEM, M., RIZWAN, M. A., SMAIL, S. W. & BABAEI, E. 2021. Comparative study of SARS-CoV-2 antibody titers between male and female COVID-19 patients living in Kurdistan region of Iraq. Gene Reports, 25, 101409.
JAILLON, S., BERTHENET, K. & GARLANDA, C. 2019. Sexual dimorphism in innate immunity. Clinical reviews in allergy & immunology, 56, 308-321.
JIANG, R. M., POURZANJANI, A. A., COHLEHMANN, A., PROSCH, H., ZEHETMAYER, S., GYSAN, M. R., BERNITZKY, D., VONBANK, K., IDZKO, M. & GOMPELMANN, D. J. P. O. 2021. Impact of persistent D-dimer elevation following recovery from COVID-19. 16, e0258351.
LIU, F., LI, L., XU, M., WU, J., LUO, D., ZHU, Y., LI, B., SONG, X. & ZHOU, X. J. J. O. C. V. 2020. Prognostic value of interleukin-6, C-reactive protein, and procalcitonin in patients with COVID-19. 127, 104370.EN, M. J. & PETZOLD, L. J. B. B. 2021. Associations of longitudinal D-Dimer and Factor II on early trauma survival risk. 22, 1-13.
MAREEV, V. Y., ORLOVA, Y. A., PAVLIKOVA, E., MATSKEPLISHVILI, S., KRASNOVA, T., MALAHOV, P., SAMOKHODSKAYA, L., MERSHINA, E., SINITSYN, V. & MAREEV, Y. V. J. K. 2020. Steroid pulse therapy in patients with coronavirus Pneumonia (COVID-19), systemic inflammation, and Risk of venous thrombosis and thromboembolism (WAYFARER Study). 60, 15-29.
MERTZ, D., KIM, T. H., JOHNSTONE, J., LAM, P.-P., KUSTER, S. P., FADEL, S. A., TRAN, D., FERNANDEZ, E., BHATNAGAR, N. & LOEB, M. J. B. 2013. Populations at risk for severe or complicated influenza illness: systematic review and meta-analysis. 347.
NICHOLLS, J. M., POON, L. L., LEE, K. C., NG, W. F., LAI, S. T., LEUNG, C. Y., CHU, C. M., HUI, P. K., MAK, K. L. & LIM, W. 2003. Lung pathology of fatal severe acute respiratory syndrome. The Lancet, 361, 1773-1778.
PALLADINO, M. J. B. M. 2021. Complete blood count alterations in COVID-19 patients: A narrative review. 31, 0-0. Park, S.E., 2020. Epidemiology, virology, and clinical features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; coronavirus disease-19). Pediatric Infection and Vaccine, 27(1), 1-10.
PEIRIS, J., LAI, S., POON, L., GUAN, Y., YAM, L., LIM, W., NICHOLLS, J., YEE, W., YAN, W. & CHEUNG, M. 2003a. Coronavirus as a possible cause of severe acute respiratory syndrome. The Lancet, 361, 1319-1325.
PEIRIS, J. S. M., CHU, C.-M., CHENG, V. C.-C., CHAN, K., HUNG, I., POON, L. L., LAW, K.-I., TANG, B., HON, T. & CHAN, C. J. T. L. 2003b. Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study. 361, 1767-1772.
RUAN, Q., YANG, K., WANG, W., JIANG, L. & SONG, J. 2020. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive care medicine, 46, 846-848.
SPROSTON, N. R. & ASHWORTH, J. J. 2018. Role of C-reactive protein at sites of inflammation and infection. Frontiers in immunology, 9, 754.
STOKES, E. K., ZAMBRANO, L. D., ANDERSON, K. N., MARDER, E. P., RAZ, K. M., FELIX, S. E. B., TIE, Y., FULLERTON, K. E. J. M. & REPORT, M. W. 2020. Coronavirus disease 2019 case surveillance—United States, january 22–may 30, 2020. 69, 759.
TASLEM MOUROSI, J., ANWAR, S. & HOSEN, M. J. 2022. The sex and gender dimensions of COVID-19: A narrative review of the potential underlying factors. Infection, Genetics and Evolution, 103, 105338.
THACHIL, J., LIPPI, G., FAVALORO, E. J. J. H. & THROMBOSIS 2017. D-dimer testing: laboratory aspects and current issues. 91-104.
TORRES-ALARCÓN, C. G., GARCÍA-RUÍZ, A., CAÑETE-IBÁÑEZ, C. R., MORALES-POGODA, I. I., MUÑOZ-ARCE, C. M., CIDDOMÍNGUEZ, B. E., MONTALVO-BÁRCENAS, M., MAZA-DE LA TORRE, G., SANDOVAL-LÓPEZ, C. & GAYTÁN-GUZMÁN, E. J. G. M. D. M. 2021. Antígenos del sistema sanguíneo ABO como factor de riesgo para la gravedad de la infección por SARS-CoV-2. 157, 181- 187.
WANG, D., HU, B., HU, C., ZHU, F., LIU, X., ZHANG, J., WANG, B., XIANG, H., CHENG, Z. & XIONG, Y. J. J. 2020. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. 323, 1061-1069.
WANG, H. & MA, S. 2008. The cytokine storm and factors determining the sequence and severity of organ dysfunction in multiple organ dysfunction syndrome. The American journal of emergency medicine, 26, 711- 715.
WHO 2020. Naming the coronavirus disease (COVID-19) and the virus that causes it. Brazilian Journal Of Implantology And Health Sciences, 2.
WOOL, G. D. & MILLER, J. L. 2021. The Impact of COVID-19 Disease on Platelets and Coagulation. Pathobiology, 88, 15-27.
WU, B.-B., GU, D.-Z., YU, J.-N., YANG, J., SHEN, W.-Q. J. I., GENETICS & EVOLUTION 2020. Association between ABO blood groups and COVID-19 infection, severity and demise: A systematic review and meta-analysis. 84, 104485.
WU, Z. & MCGOOGAN, J. M. 2020. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. Jama, 323, 1239-1242.
XU, H., ZHONG, L., DENG, J., PENG, J., DAN, H., ZENG, X., LI, T. & CHEN, Q. 2020. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. International journal of oral science, 12, 1-5.
YANG, X., YU, Y., XU, J., SHU, H., XIA, J., LIU, H., WU, Y., ZHANG, L., YU, Z. & FANG, M. J. D. E. D. E. H. P. N. N. N. G. 2020. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med [Internet]. 2020 [citado 03 Nov 2020]; 8 (5): 475-481.
YAYLACı, S., DHEIR, H., İŞSEVER, K., GENC, A. B., ŞENOCAK, D., KOCAYIGIT, H., GUCLU, E., SUNER, K., EKERBICER, H. & KOROGLU, M. J. R. D. A. M. B. 2020. The effect of abo and rh blood group antigens on admission to intensive care unit and mortality in patients with COVID-19 infection. 66, 86-90.
YIN, Y. & WUNDERINK, R. G. 2018. MERS, SARS and other coronaviruses as causes of pneumonia. Respirology, 23, 130-137.
YOUNG, B. E., ONG, S. W. X., KALIMUDDIN, S., LOW, J. G., TAN, S. Y., LOH, J., NG, O.-T., MARIMUTHU, K., ANG, L. W. & MAK, T. M. J. J. 2020. Epidemiologic features and clinical course of patients infected with SARS-CoV-2 in Singapore. 323, 1488-1494.
ZAIDI, F. Z., ZAIDI, A. R. Z., ABDULLAH, S. M., ZAIDI, S. Z. A. J. T. & SCIENCE, A. 2020. COVID-19 and the ABO blood group connection. 59, 102838.
ZAKI, A. M., VAN BOHEEMEN, S., BESTEBROER, T. M., OSTERHAUS, A. D. & FOUCHIER, R. A. 2012. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. New England Journal of Medicine, 367, 1814-1820. ZENG, F., HUANG, Y., GUO, Y., YIN, M., CHEN, X., XIAO, L. & DENG, G. J. I. J. O. I. D. 2020.
Association of inflammatory markers with the severity of COVID-19: a meta-analysis. 96, 467-474.
Zhu, N., Zhang, D., Wang, W., Li, X., Yang, B., Song, J., Zhao, X., Huang,B., Shi, W., Lu, R. and Niu, P., 2020. A novel coronavirus from patients with pneumonia in China, 2019. New England journal of medicine.
Publication Date
9-1-2023
Follow us: