Department of Clinical Biochemistry, Hamadan University of Medical Science, Hamadan, Iran.
Viral Vaccine Research Center, Pasteur Institute of Iran, Tehran.
J Clin Lab Anal. 2022 Jan;36(1):e24162. doi: 10.1002/jcla.24162. Epub 2021 Dec 7.
Most patients infected with the novel coronavirus (SARS-CoV-2), as the causative agent of COVID-19 disease, show mild symptoms, but some of them develop severe illness. The purpose of this study was to analyze the blood markers of COVID-19 patients and to investigate the correlation between serum inflammatory cytokines and the disease severity.
In this prospective cross-sectional study, 50 patients with COVID-19 and 20 patients without COVID-19 were enrolled. According to ICU admission criteria, patients were divided into two groups of non-severe and severe. Differences in the serum levels of C-reactive protein (CRP), IL-6, and TNF-α, as well as erythrocyte sedimentation rate (ESR), lymphocytes (LYM) count, and neutrophils (NEU) count between the two groups were determined and analyzed.
Out of the 50 patients with COVID-19, 14 were diagnosed as severe cases. There was no significant difference between the two groups of COVID-19 patients in terms of gender and age. Blood tests of COVID-19 patients showed a significant decrease and increase in NEU and LYM counts, respectively. There were significant differences in the serum levels of IL-6, TNF-α, and CRP between the severe and non-severe groups, which were higher in the severe group. Also, there was a significant correlation between the disease severity and CRP with ESR (r = 0.79), CRP with IL-6 (r = 0.74), LYM with NEU (r = -0.97), and ESR with TNF-α (r = 0.7).
The findings of this study, as the first study in Iran, suggest that the levels of IL-6, TNF-α, ESR, and CRP could be used to predict the severity of COVID-19 disease.
大多数感染新型冠状病毒（SARS-CoV-2）的 COVID-19 患者症状较轻，但部分患者病情严重。本研究旨在分析 COVID-19 患者的血液标志物，并探讨血清炎症因子与疾病严重程度的相关性。
本前瞻性病例对照研究纳入了 50 例 COVID-19 患者和 20 例非 COVID-19 患者。根据 ICU 收治标准，将患者分为非重症组和重症组。比较两组患者 C 反应蛋白（CRP）、白细胞介素 6（IL-6）和肿瘤坏死因子-α（TNF-α）的血清水平以及红细胞沉降率（ESR）、淋巴细胞（LYM）计数和中性粒细胞（NEU）计数的差异。
50 例 COVID-19 患者中，14 例为重症患者。COVID-19 患者两组在性别和年龄方面无统计学差异。COVID-19 患者的血液检查显示 NEU 和 LYM 计数分别显著下降和增加。重症组患者血清 IL-6、TNF-α和 CRP 水平与非重症组比较差异有统计学意义，重症组水平较高。此外，CRP 与 ESR（r=0.79）、CRP 与 IL-6（r=0.74）、LYM 与 NEU（r=-0.97）、ESR 与 TNF-α（r=0.7）之间存在显著相关性。
作为伊朗的第一项研究，本研究结果表明，IL-6、TNF-α、ESR 和 CRP 水平可用于预测 COVID-19 疾病的严重程度。
