ABSTRACT
Coronavirus disease 2019 is an infection caused by severe acute respiratory syndrome coronavirus-2. The clinical spectrum of this illness ranges from asymptomatic infection to acute respiratory distress syndrome (ARDS), circulatory shock, multiorgan failure, and ultimately death. The aims of this study are to assess of lymphocyte count, to study of acute phase proteins inflammatory biomarker which include ferritin, lactate dehydrogenase, and D-dimer, and to study of renal function markers which include blood urea nitrogen and serum creatinine. The data accumulated throughout this selective case control study which were extended from September 1st, 2020, to December 1st, 2020. A total of 176 human serum samples were collected, and subdivided into four groups moderate, sever, critical and control, each group comprised of 44 individuals. Results: The data was analyzed using the SPSS-20 statistical package that was available (Statistical Packages for Social Sciences-version 20). The results showed a highly significant decrease in the mean of Lymphocyte in Covid-19 patients when compared to the control group, p.value = 0.000. But Lymphocyte showed no significant differences among moderate, severe, and critical groups p.value = 0.580, p.value = 192, p.value = 456 respectively, where all of them had low lymphocyte count. The means of lactate dehydrogenase, ferritin, and D-dimer a showed a highly significant increase in Covid-19 patients when compared to the control group, p.value = 0.000, p.value = 0.000, p.value = 0.000 respectively. The results showed a highly significant increase in BUN in COVID-19 patient when compared with control group, p.value = 0.001, but the creatinine doesn't show any significant differences in COVID-19 patient when compared with control group, p.value = 0.405. Lactate dehydrogenase showed highly significant increase in critical group when compared with moderate group, p.value = 0.004, and showed significant differences in severe group when compared with moderate group, p.value = 0.031, but did not show significant differences between severe and critical groups, p.value = 0.690. Ferritin and D-dimer showed highly significant increase in critical group when compared with moderate group, p.value = 0.009, p.value = 0.000 respectively, and severe group, p.value = 0.002, p.value = 0.000 respectively. While, showed no nay significant differences between severe and moderate groups, p.value = 0.579, p.value = 0.075 respectively. Urea showed highly significant increase in critical group when compared with sever group and moderate group, p.value = 0.000. Creatinine showed significant increase in critical group when compared with sever group and moderate group, p.value = 0.031, p.value = 0.034 respectively. Both urea and creatinine showed no significant differences between severe and moderate groups p.value = 0.747, p.value = 0.958 respectively. Conclusions: In COVID- 19 patients, lymphopenia is a prognostic factor, increase levels of acute phase protein lactate dehydrogenase, D-dimer, and ferritin associated with disease severity, and the blood urea nitrogen and serum creatinine among critical group were associated with disease severity. © 2023 Author(s).
ABSTRACT
As of January, 2021, nearly 2-million deaths worldwide have been attributed to COVID-19, which is caused by SARS-CoV-2. Much of the mortality has been associated with a cytokine storm syndrome in patients admitted to hospital with COVID-19 pneumonia. The aims of this study are to estimate the severity of disease among patients from COVID-19 units in Diyala province and to estimate serum cytokines levels of interleukin-10, Interleukine-6 and Interferon gamma among studied patient groups. The data accumulated throughout this selective case control study which were extended from September 1st, 2020, to December 1st, 2020. A total of 176 human serum samples were collected, and subdivided into four groups moderate, sever, critical and control, each group comprised of 44 individuals. Analysis of data was carried out using the available statistical package of SPSS-20 (Statistical Packages for Social Sciences- version 20). The results revealed that the rate of infection with COVID-19 is higher in male (65.1%) than female (34.8%). The result of cytokines showed highly significant increase in the mean of interleukin-10 and interferon gamma and significant increase in interlukin-6 in patients with Covid-19 when compared to the control group, p-value = 0,000, p-value = 0.003, p-value = 0.016, respectively. The comparison of cytokine results among Covid-19 patients revealed that the Interleukin-10 showed significant increase in critical group when compared with moderate group p-value = 0.041, but don't showed any significant differences when compared the sever group with critical, and moderate groups p-value = 0.643 and p-value = 0.114, respectively. Interleukin-6 showed highly significant differences it is increased in critical group compared with moderate group and also increase compared to in severe group pvalue = 0.003, p-value = 0.013, respectively. While interleukin-6 showed no significant differences between severe and moderate groups p-value = 0.616. Interferon gamma showed no significant differences among moderate, severe and critical groups p-value = 0.527, p-value = 895, p-value = 447, respectively. In conclusions, there's a significant association in disease severity and elevated of circulating levels of cytokines Interleukine-10 and Interleukine-6, the rate of infection with COVID-19 is higher in male than female.