The Use of Biochemical Markers in Covid-19 Infection for Detecting Disease Severity and Patient Outcome

Abstract Background Corona viridea is a family of viruses that cause illness such as respiratory diseases or gastrointestinal diseases. Respiratory diseases can range from common cold to more severe diseases such as, Middle East Respiratory Syndrome (MERS-CoV) and severe Acute Respiratory Syndrome (SARS-CoV). In December 2019, the city of Wuhan in China became the epicentre of unexplainable cases of pneumonia, which in January 2020 were identified as a new coronavirus, turning rapidly into a major problem of public health worldwide. This pathogen, corresponding to a beta coronavirus, is made up of single chains of positive RNA belonging to the large Coronaviridae subfamily and has the ability to infect mammals and other animals. Aim of the Work to use different biomarkers to evaluate if they are able to predict clinical outcomes and correlate with the severity of COVID-19 disease. Patients and Methods This retrospective study was conducted on COVID-19 infection patients who were admitted in Ain Shams University Isolation for 6 months from 1st of April 2021 to 31st of October 2021. It included hospitalized isolated patients in “Ain Shams University Isolation Hospital” with COVID-19 infection confirmed by “Polymerase chain reaction (PCR) positive for SARS-CoV2”. Results Results in the current study show that LDH was significantly increased in patients who died compared to patients who recovered (p = 0.023) indicating a good prognostic value. Procalcitonin also showed good prognostic value being higher in patients who died than in patients who recovered. This study showed no significant relation between severity or outcome of disease and liver function tests including AST and ALT (p > 0.05), nor severity or outcome of disease and kidney function tests including BUN and serum creatinine. There was also no significant relation between serum ferritin and D-dimer levels and the severity or outcome of disease. Conclusion This work suggests that there is clear evidence of how the levels of some biomarkers may alternate according to severity of COVID-19 infection. Biomarkers of prognostic significance such as LDH and PCT have shown remarkable clinical implications for ineffective management, monitoring, and assessment of the severity of disease in COVID- 19 patients. This can be used as an adjunct in clinical practice to guide treatment and admission to ICU. Doing so may improve prognosis and minimise the mortality rates.