Background Coronavirus disease 2019 (COVID-19) was announced in early December 2019. The pandemic situation is declared. This study aimed to evaluate the role of biomarkers in estimating the severity and predicting the prognosis of COVID-19. Results A total of 116 confirmed patients were included in this study. The patients were evaluated clinically. The disease severity was assessed. The measured and calculated laboratory tests were done. The primary outcome is the 30-day mortality. Patients were assigned to the severe (14.7%) and non-severe (85.3%) groups. At IL-6 level of 32.3 pg/mL (the highest Youden’s index = 0.77), IL-6 can differentiate severe from non-severe patients with 82.4% sensitivity and 94.4% specificity. IL-6 can predict the severity [odds ratio of 87.7 (95% CI = 18.9-408.2) (P < 0.0001)]. After adjustment to the significant clinical and laboratory parameters, IL-6 had an adjusted odds ratio of 30.8 (95% CI = 1.1-728.3) (P = 0.046). A high CRP/albumin ratio of > 11.4 was associated with COVID-19 mortality [hazard ratio = 59.9 (95% CI = 7.4–488.3) (P < 0.0001)]. High CRP/albumin ratio had an adjusted hazard ratio of 26.5 (95% CI = 2.6-270.7) after adjustment of age and presence of co-morbidities (P = 0.006). Conclusion IL-6 level could effectively discriminate COVID-19 severity. CRP/albumin ratio was an independent risk factor for 30-day mortality rate in patients with COVID-19. IL-6 and CRP/albumin ratio seem to be valuable biomarkers in evaluating the severity and prognosis of COVID-19, respectively.

Background Given its global spread, the COVID-19 virus infection itself may be experienced as a traumatic and stressful event among survivors. The post-traumatic stress symptoms (PTSS) among those surviving the disease were under evaluated. This study aimed to identify and compare PTSS and associated correlates among COVID-19 survivors and control subjects. A cross-sectional design with a convenience sampling included a total of 85 adults who survived COVID-19 virus infection and 85 control subjects (matched for age, sex, education, and socioeconomic level) who were recruited from Zagazig University Hospitals, Sharkia Province, Egypt. The participants were interviewed using a semistructured demographic and clinical checklist, Structured Clinical Interview for DSM-5 Axis I Disorders (SCID-5), the Impact of Event Scale-Revised (IES-R), and the Hospital Anxiety Depression Scale (HADS). Results Approximately, 72% of COVID-19 survivors experienced moderate-to-severe PTSS (compared to 53% of control subjects). Individuals who survived the COVID-19 virus infection were more likely to have intensified hyperarousal symptoms (OR: 2.7, 95% CI: 1.7–4.4), with higher total IES-R scoring (OR: 1.03, 95% CI: 1.01–1.05). Among COVID-19 survivors, those who reported moderate-to-severe PTSS were likely to experience severe COVID-19 symptoms during their illness (OR: 4.1, 95% CI: 1.4–11.9). Conclusions PTSS was prevalent among COVID-19 survivors in Egypt. The hyperarousal symptoms were the most experienced ones. The symptom severity of COVID-19 virus infection predicted PTSS in COVID-19 survivors.

Background: Sequelae from COVID-19 are increasingly being reported, but sleep disturbances after recovery from the disease have had little attention. Aims: This study aimed to identify and compare sleep disturbances and associated correlates among adults who have recovered from COVID-19 with those who have never been infected with the disease. Methods: The sample included 85 adults who have recovered from COVID-19 and 85 adults who have never been infected (matched on age, sex, education and socioeconomic level). Individuals were recruited from Zagazig University Hospitals, Egypt from 1 September to 29 November 2020. Participants were interviewed using a sociodemographic and clinical checklist, the Pittsburgh Sleep Quality Index and the Hospital Anxiety Depression Scale. Results: Most (77%) of the recovered cases had experienced sleep disturbances, compared with 46% of controls. Individuals who had recovered from COVID-19 were more likely to have poor subjective sleep quality (odds ratio (OR) 1.5, 95% confidence interval (CI): 1.1–2.1), prolonged sleep latency (OR 1.8, 95% CI: 1.3–2.6), shorter sleep duration (OR 1.6, 95% CI: 1.1–2.2), reduced sleep efficiency (OR 3.8, 95% CI: 2.0–7.1), frequent daytime dysfunction (OR 1.9, 95% CI: 1.2–3.1) and poor global Pittsburgh Sleep Quality Index score (OR 3.0, 95% CI: 1.5–6.0). Depressive (P = 0.002) and anxiety (P = 0.003) symptoms were associated with a poor global Pittsburgh Sleep Quality Index score among recovered female participants (P = 0,034) who had low-to-medium education level (P = 0.004). Conclusions: Further studies (e.g. population-based longitudinal studies) are needed on sleep disturbances as a potential sequelae of COVID-19, because it can impair mental and physical well-being

<abstract> <p>LncRNA HULC regulates inflammation in vascular endothelial cells resulting in their dysfunction. Endothelial dysfunction contributes to severe COVID-19. lncRNA HULC targets miRNA-9 that play roles in the pathogenesis and progression of COVID-19 through the acute inflammatory response mediated by IL-6. This study aimed to evaluate the role of lncRNA HULC, miRNA-9, and IL-6 in estimating the severity and predicting the prognosis of COVID-19. There were 38 non-severe, 38 severe COVID-19 patients, and 38 healthy controls enrolled in this study. Expression of lncRNA HULC and miRNA-9 was performed using RT-qPCR. ELISA was utilized to measure serum IL-6. Expression of lncRNA HULC and IL-6 level were increased in severe patients compared to non-severe patients and controls (p &lt; 0.001). MiRNA-9 showed the lowest expression levels in the severe patients in comparison with non-severe patients and controls (p &lt; 0.001) lncRNA HULC was negatively correlated with miRNA-9 (p &lt; 0.001, r = −0.582) and positively correlated with IL-6 (p &lt; 0.001, r = 0.567). Furthermore, miRNA-9 showed a negative correlation with IL-6 (p &lt; 0.001, r = −0.0466). For severity prediction, lncRNA HULC expression had an adjusted OR of 52.5 (95% CI: 1.43−192.2, p = 0.031). The lncRNA HULC had an adjusted mortality hazard ratio of 1.9 (95% CI: 1.02−3.56, p = 0.043) after the adjustment of IL-6. So, in COVID-19 patients, the lncRNA HULC had a positive correlation with IL-6 and a negative correlation with miRNA-9. The COVID-19 severity and mortality appear to be predicted independently by the lncRNA HULC.</p> </abstract>

Introduction: COVID-19 severity and mortality predictors could determine admission criteria and reduce mortality. We aimed to evaluate the clinical-laboratory features of hospitalized patients with COVID-19 to develop a novel score of severity and mortality. Methodology: This retrospective cohort study was conducted using data from patients with COVID-19 who were admitted to five Egyptian university hospitals. Demographics, comorbidities, clinical manifestations, laboratory parameters, the duration of hospitalization, and disease outcome were analyzed, and a score to predict severity and mortality was developed. Results: A total of 1308 patients with COVID-19, with 996 (76.1%) being moderate and 312 (23.9%) being severe cases, were included. The mean age was 46.5 ± 17.1 years, and 61.6% were males. The overall mortality was 12.6%. Regression analysis determined significant predictors, and a ROC curve defined cut-off values. The COVEG severity score was defined by age ≥ 54, D-dimer ≥ 0.795, serum ferritin ≥ 406, C-reactive protein ≥ 30.1, and neutrophil: lymphocyte ratio ≥ 2.88. The COVEG mortality score was based on COVEG severity and the presence of cardiac diseases. Both COVEG scores had high predictive values (area under the curve 0.882 and 0.883, respectively). Conclusions: COVEG score predicts the severity and mortality of patients with COVID-19 accurately.