Inflammatory, Hematological, and Biochemical Biomarkers in COVID-19 Patients

Overview

Journal Immun Inflamm Dis

Specialties Allergy & Immunology
Infectious Diseases

Date 2024 Dec 6

PMID 39641395

Authors

Rebeccah M Ayako

Kirtika Patel

Isaac Ndede

Johan Nordgren

Marie Larrson

Simeon K Mining

Affiliations

Soon will be listed here.

Abstract

Introduction: There are few accurate prognostic indications of the illness's development and severity for COVID-19, despite certain biomarkers having been investigated. The unexpected nature of COVID-19's course, which can quickly progress from asymptomatic to life-threatening symptoms, lies at the heart of the disease's intricacy. Predicting SARS-CoV-2 pathogenicity through laboratory biomarkers and as such, identifying the patients' illness severity at the time of their initial admission would be crucial in improving patient care. In this study, we sought to evaluate the potential of hematological, biochemical, and inflammatory biomarkers in predicting the course of COVID-19 at a tertiary hospital in western Kenya.

Methods: This cross-sectional study involved 48 COVID-19 patients (16 asymptomatic; 16 moderate symptomatic; and 16 severe symptomatic) and 48 age-sex-matched COVID-19-negative clients attending the Moi Teaching and Referral Hospital, Kenya. Demographic information, self-reported chronic illnesses, symptoms, and laboratory results were collected at recruitment.

Results: Significantly, the severity of COVID-19 was associated with; hemoglobin (p < 0.0001), white blood cells (p = 0.0022), hematocrit (p < 0.0001), blood urea nitrogen (p = 0.01), blood sodium (p = 0.0002), potassium (p = 0.0483), C-reactive protein (p = 0.0002), and Lactate Dehydrogenase (p < 0.0001). Regression analysis of CRP revealed a strong positive correlation (p = 0.0006) whereas LDH revealed a weak positive correlation (p < 0.0001) with COVID-19 disease severity. Discriminative accuracy was highest when asymptomatic was compared to severe COVID-19 for CRP and LDH (AUC: 0.8867, 95% CI: 0.7532-1.000) and (AUC: 1.000, 95% CI: 1.000-1.000) respectively.

Conclusion: The hematological indices, inflammatory and biochemical biomarkers studied have the potential to predict the course of COVID-19. These parameters may be useful in helping design appropriate care for COVID-19 patients.

Citing Articles

Haematological Manifestations of SARS-CoV-2: Insights into Erythropoiesis, Hepcidin Regulation, and Cytokine Storm.

Parham E, Ahmad M, Falasca M Int J Mol Sci. 2025; 26(3).

PMID: 39940645 PMC: 11817086. DOI: 10.3390/ijms26030874.

References

Lin S, Huang A, Chiu T, Chang K, Huang T, Yang T . Clinical and laboratory predictors for disease progression in patients with COVID-19: A multi-center cohort study. Biomed J. 2022; 46(1):100-109. PMC: 9674567. DOI: 10.1016/j.bj.2022.11.002. View

Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y . Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020; 71(15):762-768. PMC: 7108125. DOI: 10.1093/cid/ciaa248. View

Smilowitz N, Kunichoff D, Garshick M, Shah B, Pillinger M, Hochman J . C-reactive protein and clinical outcomes in patients with COVID-19. Eur Heart J. 2021; 42(23):2270-2279. PMC: 7928982. DOI: 10.1093/eurheartj/ehaa1103. View

Wu M, Yao L, Wang Y, Zhu X, Wang X, Tang P . Clinical evaluation of potential usefulness of serum lactate dehydrogenase (LDH) in 2019 novel coronavirus (COVID-19) pneumonia. Respir Res. 2020; 21(1):171. PMC: 7336103. DOI: 10.1186/s12931-020-01427-8. View

Guan X, Zhong L, Zhang J, Lu J, Yuan M, Ye L . The relationship between lactate dehydrogenase to albumin ratio and all-cause mortality during ICU stays in patients with sepsis: A retrospective cohort study with propensity score matching. Heliyon. 2024; 10(6):e27560. PMC: 10944236. DOI: 10.1016/j.heliyon.2024.e27560. View

Causton H . SARS-CoV2 Infection and the Importance of Potassium Balance. Front Med (Lausanne). 2021; 8:744697. PMC: 8578622. DOI: 10.3389/fmed.2021.744697. View

Zhao N, Di B, Xu L . The NLRP3 inflammasome and COVID-19: Activation, pathogenesis and therapeutic strategies. Cytokine Growth Factor Rev. 2021; 61:2-15. PMC: 8233448. DOI: 10.1016/j.cytogfr.2021.06.002. View

Engelhardt L, Balzer F, Muller M, Grunow J, Spies C, Christopher K . Association between potassium concentrations, variability and supplementation, and in-hospital mortality in ICU patients: a retrospective analysis. Ann Intensive Care. 2019; 9(1):100. PMC: 6728107. DOI: 10.1186/s13613-019-0573-0. View

Peng J, Qi D, Yuan G, Deng X, Mei Y, Feng L . Diagnostic value of peripheral hematologic markers for coronavirus disease 2019 (COVID-19): A multicenter, cross-sectional study. J Clin Lab Anal. 2020; 34(10):e23475. PMC: 7404368. DOI: 10.1002/jcla.23475. View

10.

Anai M, Akaike K, Iwagoe H, Akasaka T, Higuchi T, Miyazaki A . Decrease in hemoglobin level predicts increased risk for severe respiratory failure in COVID-19 patients with pneumonia. Respir Investig. 2020; 59(2):187-193. PMC: 7682330. DOI: 10.1016/j.resinv.2020.10.009. View

11.

Yasari F, Akbarian M, Abedini A, Vasheghani M . The role of electrolyte imbalances in predicting the severity of COVID-19 in the hospitalized patients: a cross-sectional study. Sci Rep. 2022; 12(1):14732. PMC: 9424795. DOI: 10.1038/s41598-022-19264-8. View

12.

Mukoma G, Bosire E, Klingberg S, Norris S . Healthy eating and physical activity: Analysing Soweto's young adults' perspectives with an intersectionality lens. PLOS Glob Public Health. 2023; 3(7):e0001429. PMC: 10355453. DOI: 10.1371/journal.pgph.0001429. View

13.

Tiwari A, Lipponen A, Hokajarvi A, Luomala O, Sarekoski A, Rytkonen A . Detection and quantification of SARS-CoV-2 RNA in wastewater influent in relation to reported COVID-19 incidence in Finland. Water Res. 2022; 215:118220. PMC: 8865022. DOI: 10.1016/j.watres.2022.118220. View

14.

Birindelli S, Tarkowski M, Gallucci M, Schiuma M, Covizzi A, Lewkowicz P . Definition of the Immune Parameters Related to COVID-19 Severity. Front Immunol. 2022; 13:850846. PMC: 8971756. DOI: 10.3389/fimmu.2022.850846. View

15.

Chen W, Zheng K, Liu S, Yan Z, Xu C, Qiao Z . Plasma CRP level is positively associated with the severity of COVID-19. Ann Clin Microbiol Antimicrob. 2020; 19(1):18. PMC: 7227180. DOI: 10.1186/s12941-020-00362-2. View

16.

Avihai B, Sundel E, Lee E, Greenberg P, Cook B, Altomare N . CRP Monitoring in Early Hospitalization: Implications for Predicting Outcomes in Patients with COVID-19. Pathogens. 2023; 12(11). PMC: 10675493. DOI: 10.3390/pathogens12111315. View

17.

Sharafi F, Esfehani R, Moodi Ghalibaf A, Jarahi L, Shamshirian A, Mozdourian M . Leukopenia and leukocytosis as strong predictors of COVID-19 severity: A cross-sectional study of the hematologic abnormalities and COVID-19 severity in hospitalized patients. Health Sci Rep. 2023; 6(10):e1574. PMC: 10533955. DOI: 10.1002/hsr2.1574. View

18.

Bergamaschi G, Borrelli de Andreis F, Aronico N, Lenti M, Barteselli C, Merli S . Anemia in patients with Covid-19: pathogenesis and clinical significance. Clin Exp Med. 2021; 21(2):239-246. PMC: 7790728. DOI: 10.1007/s10238-020-00679-4. View

19.

Habas E, Ali E, Habas A, Rayani A, Ghazouani H, Khan F . Hyponatremia and SARS-CoV-2 infection: A narrative review. Medicine (Baltimore). 2022; 101(32):e30061. PMC: 9370252. DOI: 10.1097/MD.0000000000030061. View

20.

Chen L, Deng H, Cui H, Fang J, Zuo Z, Deng J . Inflammatory responses and inflammation-associated diseases in organs. Oncotarget. 2018; 9(6):7204-7218. PMC: 5805548. DOI: 10.18632/oncotarget.23208. View