Assessment of some Physiological Biomarkers in COVID-19 Patients in Thi-Qar, Iraq

Document Type : Original Articles

Authors

1 Department of Biology, College of Sciences, Mustansiriyah University, Baghdad, Iraq

2 Department of Medical Basic Sciences, College of Nursing, University of Thi-Qar, Thi-Qar, Iraq

3 Biological Health Department, Infertility Unit, Imam Hussein Teaching Hospital, Thi-Qar, Iraq

Abstract

It is believed that many biomarkers and factors could be linked to the prognosis of coronavirus disease 2019 (COVID-19). Therefore, this study aimed to evaluate the association of lactate dehydrogenase (LDH), D-Dimer, vitamin D, and ferritin statuses with the prognosis of COVID-19; moreover, it was attempted to investigate its prevalence according to age, employment status, body mass index (BMI), and place of residency in a population sample of hospitalized patients in Thi-Qar, Iraq. This study evaluated 200 COVID-19 patients and 100 controls. The BMI of all individuals was calculated, and such demographic characteristics as age, gender, place of residency, and occupational status were collected from all participants. Blood samples were taken and used to estimate D-Dimer, LDH, vitamin D, ferritin, oxygen, and pulse rate. The mean age of the patients approached the fifth decade, and 72% of the cases were more than 40 years of age. In addition, 60% of the patients were living in the countryside, and 52% of the participants were employed, compared to only 8% of the cases who were students. The BMI of the patients was obtained at 31.44±10.2 kg/m2; accordingly, 47% and 40% of the cases were obese and overweight, respectively, compared to only 12% of the patients who had normal weight (P˂0.05). There were significantly lower vitamin D levels in the patients; however, the concentrations of LDH, serum ferritin, and D-Dimer were significantly higher in the patients, compared to the control group (P˂0.05). Not only age and body weight but also employment status and place of residency maybe also the important risk factors for COVID-19 distribution. LDH, D-dimer, vitamin D, and ferritin statuses could be used as good biomarkers for this disease and its severity.

Keywords


  1. Zhao J, Yang Y, Huang H, Li D, Gu D, Lu X, et al. Relationship between the ABO Blood Group and the COVID-19 Susceptibility. Clin Infect Dis. 2020.
  2. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506.
  3. Ad’hiah AH, Abdullah MH, Alsudani MY, Shnawa RMS, Al-Sa’ady AJR, Allami RH, et al. Association between ABO blood groups and susceptibility to COVID-19: profile of age and gender in Iraqi patients. Egypt J Med Hum Genet. 2020;21(76):1-10.
  4. Liu K, Fang YY, Deng Y, Liu W, Wang MF, Ma JP, et al. Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province. Chin Med J. 2020;133(9):1025-31.
  5. Bwire GM. Coronavirus: Why Men are More Vulnerable to Covid-19 Than Women? SN Compr Clin Med. 2020:1-3.
  6. Myers LC, Parodi SM, Escobar GJ, Liu VX. Characteristics of Hospitalized Adults With COVID-19 in an Integrated Health Care System in California. J Am Med Assoc. 2020;323(21):2195-8.
  7. Chen CY, Lee CH, Liu CY, Wang JH, Wang LM, Perng RP. Clinical features and outcomes of severe acute respiratory syndrome and predictive factors for acute respiratory distress syndrome. J Chin Med Assoc. 2005;68(1):4-10.
  8. Henry BM, de Oliveira MHS, Benoit S, Plebani M, Lippi G. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clin Chem Lab Med. 2020;58(7):1021-8.
  1. Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. J Thromb Haemost. 2020;18(5):1094-9.
  2. Salomone T, Tosi P, Palareti G, Tomassetti P, Migliori M, Guariento A, et al. Coagulative disorders in human acute pancreatitis: role for the D-dimer. Pancreas. 2003;26(2):111-6.
  3. Ali N. Role of vitamin D in preventing of COVID-19 infection, progression and severity. J Infect Public Health. 2020;13(10):1373-80.
  4. Cereda E, Bogliolo L, de Stefano L, Caccialanza R. A brief discussion of the benefit and mechanism of vitamin D supplementation on coronavirus disease 2019. Curr Opin Clin Nutr Metab Care. 2021;24(1):102-7.
  5. Cereda E, Bogliolo L, Lobascio F, Barichella M, Zecchinelli AL, Pezzoli G, et al. Vitamin D supplementation and outcomes in coronavirus disease 2019 (COVID-19) patients from the outbreak area of Lombardy, Italy. Nutrition. 2021;82:111055.
  6. File TM, Jr., Tsang KW. Severe acute respiratory syndrome: pertinent clinical characteristics and therapy. Treat Respir Med. 2005;4(2):95-106.
  7. Drosten C, Seilmaier M, Corman VM, Hartmann W, Scheible G, Sack S, et al. Clinical features and virological analysis of a case of Middle East respiratory syndrome coronavirus infection. Lancet Infect Dis. 2013;13(9):745-51.
  8. Kappert K, Jahic A, Tauber R. Assessment of serum ferritin as a biomarker in COVID-19: bystander or participant? Insights by comparison with other infectious and non-infectious diseases. Biomarkers. 2020;25(8):616-25.
  9. WHO. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Report of a WHO Expert Consultation. . Geneva: World Health Organization.2004.
  10. de Souza WM, Buss LF, Candido DDS, Carrera JP, Li S, Zarebski AE, et al. Epidemiological and clinical characteristics of the COVID-19 epidemic in Brazil. Nat Hum Behav. 2020;4(8):856-65.
  11. Schiefer WC. statistics for the biological sciences. 2 ed. California, London.: Addison Wesley publComp; 1980.
  12. Santesmasses D, Castro JP, Zenin AA, Shindyapina AV, Gerashchenko MV, Zhang B, et al. COVID-19 is an emergent disease of aging. Aging Cell. 2020;19(10):e13230.
  13. Mueller AL, McNamara MS, Sinclair DA. Why does COVID-19 disproportionately affect older people? Aging. 2020;12(10):9959-81.
  14. Kovacs EJ, Boe DM, Boule LA, Curtis BJ. Inflammaging and the Lung. Clin Geriatr Med. 2017;33(4):459-71.
  15. Weaver LK, Behrens EM. Weathering the storm: Improving therapeutic interventions for cytokine storm syndromes by targeting disease pathogenesis. Curr Treatm Opt Rheumatol. 2017;3(1):33-48.
  16. Caussy C, Pattou F, Wallet F, Simon C, Chalopin S, Telliam C, et al. Prevalence of obesity among adult inpatients with COVID-19 in France. Lancet Diabetes Endocrinol. 2020;8(7):562-4.
  17. Umbrello M, Fumagalli J, Pesenti A, Chiumello D. Pathophysiology and Management of Acute Respiratory Distress Syndrome in Obese Patients. Semin Respir Crit Care Med. 2019;40(1):40-56.
  18. Pietri L, Giorgi R, Begu A, Lojou M, Koubi M, Cauchois R, et al. Excess body weight is an independent risk factor for severe forms of COVID-19. Metabolism. 2021;117:154703.
  19. Stapleton RD, Suratt BT. Obesity and nutrition in acute respiratory distress syndrome. Clin Chest Med. 2014;35(4):655-71.
  20. Sattar N, McInnes IB, McMurray JJV. Obesity Is a Risk Factor for Severe COVID-19 Infection: Multiple Potential Mechanisms. Circulation. 2020;142(1):4-6.
  21. Daher A, Balfanz P, Aetou M, Hartmann B, Muller-Wieland D, Muller T, et al. Clinical course of COVID-19 patients needing supplemental oxygen outside the intensive care unit. Sci Rep. 2021;11(1):2256.
  22. Martinez-Outschoorn UE, Prisco M, Ertel A, Tsirigos A, Lin Z, Pavlides S, et al. Ketones and lactate increase cancer cell "stemness," driving recurrence, metastasis and poor clinical outcome in breast cancer: achieving personalized medicine via Metabolo-Genomics. Cell Cycle. 2011;10(8):1271-86.
  23. Assiri A, Al-Tawfiq JA, Al-Rabeeah AA, Al-Rabiah FA, Al-Hajjar S, Al-Barrak A, et al. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study. Lancet Infect Dis. 2013;13(9):752-61.
  24. Zhang T, Chen H, Liang S, Chen D, Zheng C, Zeng C, et al. A non-invasive laboratory panel as a diagnostic and prognostic biomarker for thrombotic microangiopathy: development and application in a Chinese cohort study. PLoS One. 2014;9(11):e111992.
  1. Lippi G, Plebani M, Henry BM. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis. Clin Chim Acta. 2020;506:145-8.
  2. Zou Y, Guo H, Zhang Y, Zhang Z, Liu Y, Wang J, et al. Analysis of coagulation parameters in patients with COVID-19 in Shanghai, China. Biosci Trends. 2020;14(4):285-9.
  3. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62.
  4. Spiezia L, Boscolo A, Poletto F, Cerruti L, Tiberio I, Campello E, et al. COVID-19-Related Severe Hypercoagulability in Patients Admitted to Intensive Care Unit for Acute Respiratory Failure. Thromb Haemost. 2020;120(6):998-1000.
  5. Luo Y, Yuan X, Xue Y, Mao L, Lin Q, Tang G, et al. Using a diagnostic model based on routine laboratory tests to distinguish patients infected with SARS-CoV-2 from those infected with influenza virus. Int J Infect Dis. 2020;95:436-40.
  6. Rostami M, Mansouritorghabeh H. D-dimer level in COVID-19 infection: a systematic review. Expert Rev Hematol. 2020;13(11):1265-75.
  7. Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, Aliano JL, et al. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients. 2020;12(4).
  1. Reijven PLM, Soeters PB. Vitamin D: A magic bullet or a myth? Clin Nutr. 2020;39(9):2663-74.
  2. Garcia-Casal MN, Pasricha SR, Martinez RX, Lopez-Perez L, Pena-Rosas JP. Are Current Serum and Plasma Ferritin Cut-offs for Iron Deficiency and Overload Accurate and Reflecting Iron Status? A Systematic Review. Arch Med Res. 2018;49(6):405-17.
  3. Crayne CB, Albeituni S, Nichols KE, Cron RQ. The Immunology of Macrophage Activation Syndrome. Front Immunol. 2019;10:119.
  4. Sandler RD, Tattersall RS, Schoemans H, Greco R, Badoglio M, Labopin M, et al. Diagnosis and Management of Secondary HLH/MAS Following HSCT and CAR-T Cell Therapy in Adults; A Review of the Literature and a Survey of Practice Within EBMT Centres on Behalf of the Autoimmune Diseases Working Party (ADWP) and Transplant Complications Working Party (TCWP). Front Immunol. 2020;11:524.
  5. Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020;130(5):2620-9.
  6. Sun Y, Dong Y, Wang L, Xie H, Li B, Chang C, et al. Characteristics and prognostic factors of disease severity in patients with COVID-19: The Beijing experience. J Autoimmun. 2020;112:102473.
  7. Cohen LA, Gutierrez L, Weiss A, Leichtmann-Bardoogo Y, Zhang DL, Crooks DR, et al. Serum ferritin is derived primarily from macrophages through a nonclassical secretory pathway. Blood. 2010;116(9):1574-84.