Izhari Mohammad Asrar
Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha, Saudi Arabia.
Infect Drug Resist. 2024 Apr 29;17:1653-1667. doi: 10.2147/IDR.S463238. eCollection 2024.
COVID-19 modulates many serological biomarkers during the progress of disease severity. The study aimed to determine COVID-19 severity-associated perturbance in the serum profile.
A retrospective study including COVID-19-positive individuals (n = 405) was accomplished. The serum profile of COVID-19 participants was mined from laboratory records. Severity-associated alteration in the serum profile was evaluated using Pearson correlation, regression, VCramer, Bayesian posterior VCramer, and bias factor using R-base-RStudio-version-3.3.0 with a significant cut-off of p < 0.05.
Significantly different mean ± standard deviation (SD) (highly versus moderately severe) of C-reactive protein (CRP), ferritin, neutrophil-lymphocyte ratio (NLR), D-dimer, platelets, prothrombin time (PT), partial prothrombin time (PTT), troponin 1, lactate dehydrogenase (LDH), aspartate-aminotransferase (AST), alanine aminotransferase (ALT), and AST/ALT ratio was observed (p < 0.001). Highly severe COVID-19 associated with CRP, ferritin, NLR, in D-dimer, PT, PTT, troponin 1, AST/ALT ratio, AST and ALT (adjusted odds ratio (AOR): 1.346, 1.05, 1.46, 1.33, 1.42, 1.23, 4.07, 3.9, 1.24, 1.45, p < 0.001). CRP with ferritin (r = 0.743), NLR (r = 0.77), white blood cells (WBC) (r = 0.8), troponin1 with LDH (r = 0.757), and D-dimer with platelets (r = -0.81) were highly correlated. Xpearson ( < 0.001), V (0.71), Bayesian-V (0.7), and bias-factor (-125) for troponin 1 indicate the strong association of troponin 1 level and with COVID-19 severity. Xpearson ( < 0.001), V (1), Bayesian-V (0.98), and bias-factor (-266.3) for NLR exhibited a very strong association of pathologic conditions with the high severity of the disease.
These biomarkers of inflammation (CRP, Ferritin, NLR), coagulation disorders (D-dimer, PT, and PTT) cardiac abnormality (troponin 1), and liver injury (AST/ALT) could be crucial in low-medical resource settings as potential prognosticator/predictors of the COVID-19 severity and clinical outcomes. Moreover, the outcome of this study could be leveraged for the early prediction of disease severity during SARS-CoV or Middle East Respiratory Coronavirus (MERS-CoV) infection.
在疾病严重程度进展过程中，新冠病毒病（COVID-19）会调节多种血清生物标志物。本研究旨在确定血清谱中与COVID-19严重程度相关的扰动情况。
完成了一项包括COVID-19阳性个体（n = 405）的回顾性研究。从实验室记录中提取COVID-19参与者的血清谱。使用Pearson相关性分析、回归分析、Vramer分析、贝叶斯后验Vramer分析以及偏差因子，通过R-base-RStudio-版本-3.3.0对血清谱中与严重程度相关的改变进行评估，显著性临界值为p < 0.05。
观察到C反应蛋白（CRP）、铁蛋白、中性粒细胞与淋巴细胞比值（NLR）、D-二聚体、血小板、凝血酶原时间（PT）、活化部分凝血活酶时间（PTT）、肌钙蛋白I、乳酸脱氢酶（LDH）、天门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）以及AST/ALT比值在均值±标准差（SD）方面存在显著差异（重度与中度重度相比）（p < 0.001）。重度COVID-19与CRP、铁蛋白、NLR、D-二聚体、PT、PTT、肌钙蛋白I、AST/ALT比值、AST和ALT相关（调整比值比（AOR）：1.346、1.05、1.46、1.33、1.42、1.23、4.07、3.9、1.24、1.45，p < 0.001）。CRP与铁蛋白（r = 0.743）、NLR（r = 0.77）、白细胞（WBC）（r = 0.8），肌钙蛋白I与LDH（r = 0.757），以及D-二聚体与血小板（r = -0.81）高度相关。肌钙蛋白I的Xpearson（< 0.001）、V（0.71）、贝叶斯-V（0.7）和偏差因子（-125）表明肌钙蛋白I水平与COVID-19严重程度密切相关。NLR的Xpearson（< 0.001）、V（1）、贝叶斯-V（0.98）和偏差因子（-266.3）显示病理状况与疾病的高严重程度之间存在非常强的关联。
这些炎症生物标志物（CRP、铁蛋白、NLR）、凝血障碍（D-二聚体、PT和PTT）、心脏异常（肌钙蛋白I）以及肝损伤（AST/ALT）在医疗资源有限的环境中可能是预测COVID-19严重程度和临床结局的关键潜在指标。此外，本研究结果可用于在严重急性呼吸综合征冠状病毒（SARS-CoV）或中东呼吸综合征冠状病毒（MERS-CoV）感染期间早期预测疾病严重程度。
