Immunological and Biochemical Markers in Diagnosis COVID-19 disease and their association with clinical severity and mortality in Babylon province

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Nassar Abdalaema Mera, Safaa Hashim Abbas Alsallami, Fadhil F. Makki, Fadhil Kadhim Jassim, Amer Obaid Saud, Ali Jaber Al-Mamoori, Mohammed Dheyab Al-Beagy, Amaal Adel Hashim, Mohammed Zuhair Naji, Maher Mohammed Khadairi, Marowa Hashim Abbas, Aseel kasim kareem, Ali Fahim Mohammed

Abstract

Background: In 2019, China received the first reports of coronavirus illness. The illness has been linked to a number of cases of unusual pneumonia and is mainly spread via touch with the skin and respiratory droplets. The laboratory diagnosis of COVID-19 depends on either molecular detection of virus genes in the respiratory aspirations of patients or serological detection of antiviral antibodies in the blood of patients or biochemical detection of some changes in body physiology and hematology.


Aim of study: evaluate immunological markers including lymphocytes, neutrocytes, interleukin 6) as well as biochemical test including (blood sugar and urea, creatinine, LDH, D-Dimer) in COVID.19 patients.


Material and Methods: All patients who displayed COVID-19 symptoms between November 2 and December 30, 2020, were referred to Medical Merjan City in Babylon Province, Iraq. Real-time PCR ‘’polymerase chain reaction’’ was utilized for confirming SARS-CoV-2 infection from throat-swab samples taken from 238 patients. A serum sample was taken from each group. The XW-100 CBC analyzer from Sysmex was used to test immunological markers such as lymphocytes and neutrophils. Aspira Chemical's ELISA kit was used to test interleukin 6 (IL6). Biochemical tests, including blood urea, creatinine, LDH, and D-Dimer, were measured by their kits, which were supplied by Biogenix© for spectrophotometers.


Results: Statistical analysis revealed significant differences between all biomarkers in severity and mortality groups at levels P≤0.05. The results reveal that neutrophil count, lymphocyte count, and interleukin-6 increase mortality with decreased lymphocyte count. Also, when compared with non-ICU patients, ICU patients had considerably higher LDH and D-dimer levels, and LDH levels were connected with tissue damage and CT scan scores, reflecting the severity of the condition. The levels of kidney biomarkers, including creatinine and urea, increased in mortality compared with severe patients. Finally, the studied biomarker can be used to diagnose COVID-19 infection.


Conclusion: Depending on how severe the illness is, different biomarkers play distinct roles in COVID-19's etiology and assessment of their levels. By doing this, it provides doctors with a tool to classify patients and forecast mortality and prognosis. IL-6, lymphocytes, neutrophils, lactate dehydrogenase (LDH), D-dimers, sugar, and renal indicators are among the biomarkers.

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