Interpretation of Hematological, Biochemical, and Immunological Findings of COVID-19 Disease: Biomarkers Associated with Severity and Mortality

Abstract

The severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) spread rapidly all over the world in late 2019 and caused critical illness and death in some infected patients. This study aimed at examining several laboratory factors, especially inflammatory and immunological mediators, to identify severity and mortality associated biomarkers. Ninety-three hospitalized patients with confirmed coronavirus disease 2019 (COVID-19) were classified based on disease severity. The levels of biochemical, hematological, immunological, and inflammatory mediators were assessed, and their association with severity and mortality were evaluated. Hospitalized patients were mostly men (77.4%) with an average (standard deviation) age of 59.14 (14.81) years. The mortality rate was significantly higher in critical patients (85.7%). Increased serum levels of blood sugar, urea, creatinine, uric acid, phosphorus, total bilirubin, serum glutamic-oxaloacetic transaminase, serum glutamic-oxaloacetic transaminase, lactic dehydrogenase, C-reactive protein, ferritin, and procalcitonin were significantly prevalent (p=0.002, p<0.001, p<0.001, p=0.014, p=0.047, p=0.003, p<0.001, p<0.001, p<0.001, p<0.001, P<0.001, and p<0.001, respectively) in COVID-19 patients. Decreased red blood cell, hemoglobin, and hematocrit were significantly prevalent among COVID-19 patients than healthy control subjects (p<0.001 for all). Troponin-I, interleukin-6, neutrophil/lymphocyte ratio (NLR), procalcitonin, and D-dimer showed a significant association with the mortality of patients with specificity and sensitivity more than 60%. Age, sex, underlying diseases, blood oxygen pressure, complete blood count along with C-reactive protein, lactic dehydrogenase, procalcitonin, D-dimer, and interleukin-6 evaluation help to predict the severity and required management for COVID-19 patients. Further investigations are highly recommended in a larger cohort study for validation of the present findings.

The Impact of Neutrophil-Lymphocyte Count Ratio in COVID-19: A Systematic Review and Meta-Analysis

“…A total of 90 studies 22 – 111 (82 retrospectives, 5 prospective, 3 cross-sectional) out of 7352 identified publications were included after satisfying the inclusion criteria ( Figure 1 ). While 44 articles 41 , 42 , 44 , 46 , 47 , 49 , 50 – 71 , 73 – 76 , 78 – 80 , 101 , 103 – 106 , 108 – 111 assessed baseline NLR as a predictor for determining only severity, 32 articles 24 , 25 , 29 – 34 , 38 – 40 , 43 , 45 , 48 , 77 , 82 – 93 , 96 – 98 , 100 , 102 assessed only mortality, 14 studies 22 , 23 , 26 – 28 , 35 – 37 , 72 , 81 , 94 , 95 , 99 , 107 addressed both sur...…”

U-shaped association between abnormal serum uric acid levels and COVID-19 severity: reports from the Japan COVID-19 Task Force

“…Approximately 30% of men in their 30s and 40s and 25% of those in their 50s and 60s suffer from hyperuricemia; thus, it is a common condition that can also affect younger individuals ( Japan Preventive Association of Life-style related Disease, 2021 ). A history of hyperuricemia and abnormal serum uric acid levels are associated with several types of lifestyle-related diseases and have been hypothesized to be associated with COVID-19 severity ( Ghazanfari et al, 2021 ;Ishii et al, 2020 ;Zheng et al, 2021 ).…”

Value of the Neutrophil-Lymphocyte Ratio in Predicting COVID-19 Severity: A Meta-analysis

“…The diagnosis of COVID-19 was confirmed in all cases. The studies were conducted in China [ 8 – 13 , 15 , 16 , 18 , 19 , 21 – 23 , 25 , 31 – 34 ], Pakistan [ 28 ], Argentina [ 20 ], Turkey [ 14 , 17 , 33 , 35 ], Saudi Arabia [ 24 ], Iran [ 27 , 36 ], and Egypt [ 29 , 30 ]. The studies were conducted at a single center, with the exception of two multicenter studies [ 12 , 13 , 24 , 34 ].…”