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Iran J Allergy Asthma Immunol
. 2021 Feb 11;20(1):46-66.
doi: 10.18502/ijaai.v20i1.5412.
Interpretation of Hematological, Biochemical, and Immunological Findings of COVID-19 Disease: Biomarkers Associated with Severity and Mortality
Tooba Ghazanfari 1 , Mohammad Reza Salehi 2 , Saeed Namaki 3 , Jalil Arabkheradmand 4 , Abdolrahman Rostamian 5 , Maryam Rajabnia Chenary 6 , Sara Ghaffarpour 7 , Sussan Kaboudanian Ardestani 8 , Maryam Edalatifard 9 , Mohammad Mehdi Naghizadeh 10 , Saeed Mohammadi 11 , Maryam Mahloujirad 12 , Alireza Izadi 13 , Hossein Ghanaati 14 , Mohammad Taghi Beigmohammadi 15 , Mohammad Vodjgani 16 , Bentolhoda Mohammad Shirazi 17 , Ensie Sadat Mirsharif 18 , Alireza Abdollahi 19 , Mostafa Mohammadi 20 , Hamid Emadi Kouchak 21 , Seyed Ali Dehghan Manshadi 22 , Mohammad Saber Zamani 23 , Maedeh Mahmoodi Aliabadi 24 , Davoud Jamali 25 , Nasim Khajavirad 26 , Ali Mohammad Mohseni Majd 27 , Zahra Nasiri 28 , Soghrat Faghihzadeh 29
Affiliations
- PMID: 33639632
- DOI: 10.18502/ijaai.v20i1.5412
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.
Keywords: Biomarkers; COVID-19; Immunology; Inflammation; SARS-CoV-2.