ABSTRACT
It has been two years since the global outbreak of the highly contagious and deadly corona virus disease (COVID-19) caused by SARS-CoV-2 first emerged in China. Since then, various diagnostic, prognostic and treatment strategies undertaken to address the pandemic have been dynamically evolving. Predictive and prognostic role of various biomarkers in COVID-19 has been a subject of intense exploration. We aimed to determine the association of Carcinoembryonic antigen (CEA) and various surrogate inflammatory biomarkers with the severity of COVID-19 disease. This retrospective cohort study was carried out on 98 patients admitted in Jaypee Hospital, Noida with COVID-19 disease. Information regarding demographics, laboratory parameters and clinical history was collected from Hospital Information System. Serum levels of CEA and other biomarkers such as Neutrophil-lymphocyte ratio (NLR), C-reactive protein (CRP), Interleukin-6 (IL-6), Ferritin, and Procalcitonin (PCT) were assessed. Correlation analyses were performed between the parameters and acute respiratory distress syndrome (ARDS) stages. Logistic regression and ROC curve analysis were performed to assess the various parameters for distinguishing COVID-19 patients requiring ICU admission. Mean hospital stay, NLR, CEA, IL-6, CRP, Ferritin (P <0.0001) and PCT (P = 0.01) were significantly higher in ICU patients when compared to general ward patients. NLR, median serum CEA, IL-6, and CRP levels were significantly higher in non-survivor compared to the survivors (P <0.0001, 0.0341 and 0.0092). CEA correlated well with disease severity based upon ARDS classification and was a better marker to differentiate patient according to ARDS stages (ARDS 0 vs 2 P = 0.0006;0 vs 3 P <0.0001;ARDS 1 vs 2 P = 0.0183;1 vs 3 P = 0.0006). The area under the Receiver operating characteristic (ROC) curve for CEA was 0.7467 (95% CI-0.64885-0.84459) which revealed the potential of CEA as a biomarker to distinguish COVID-19 patients requiring ICU admission. CEA can be used to predict the severity of COVID-19 associated ARDS as well as patients requiring ICU admission. Along with routine inflammatory biomarkers (NLR, CRP, IL-6, PCT, and ferritin), CEA should be used for early identification of critical COVID-19 positive patients and for assessing prognosis. © 2022, National Institute of Science Communication and Information Resources. All rights reserved.
ABSTRACT
Background: The 2019 novel coronavirus disease (COVID-19) is the greatest public health problem to date as number of COVID-19 patients are dramatically increasing worldwide. Clinical criteria are susceptible to subjective and objective factors, which may lead to an extended time for diagnosing and the possibility of misdiagnosing severe COVID-19. Therefore, it makes sense to find a potential biomarker that could effectively diagnose severe COVID-19. Objective: To study biochemical markers in mild and severe patients of covid-19 infection. Material and Methods: This observational study was conducted in the Department of Biochemistry, Seth G S Medical College and KEM Hospital, a tertiary care hospital of Mumbai. Our study included COVID-19 positive patients diagnosed for COVID-19 based on the results of RT-PCR conducted at our centre. Patients were categorized into 2 groups mild (n-50) and severe (n-50) on the basis of severity of clinical presentation, each between 18-80 yrs. of age. Biochemical parameters were compared between these two groups and various biochemical parameters were evaluated using independent-samples t-test. Results: The biochemical markers were compared in group-1 and group-2. Group-2 patients had significantly higher levels of serum LDH (p=0.0001), CRP (p=0.0001), BUN (p= 0.007), serum creatinine (p=0.0001), serum AST (p=0.02) and serum ALT (p=0.02). Conclusion: The biomarkers studied in the present research work, if considered together provide a brief overview on most frequent laboratory abnormalities encountered in patients with COVID-2019 infection which might be useful in indicating progression from mild to severe disease.
ABSTRACT
Use of sanitizers in diagnostic centres causes derangement in quality control values of lipase and triglycerides (TG) analytes during COVID-19. Our study provides a practical insight into the type of sanitizers to be used in a laboratory. Performance Verifier (PV) and reagents (lipase and TG) were contaminated with sanitizer and 70% isopropyl alcohol. Groups formed were-PVNet (G1), PV with Sanitizer (G2), PV with 70% Alcohol (G3), Sanitizer contaminated reagent (G4). Controls PV-1 and PV-2 were run. ANOVA and Tukey’s test among groups and between groups were compared. Significant difference in mean PV-1and PV-2 values of TG [PV-1, PV-2 (P <0.0001)] and lipase TG [PV-1 P <0.0001) PV-2 P <0.001] among all tested groups were observed. Between-group analysis showed significantly higher PV-1 and PV-2 values in sanitizer contaminated PV group (P <0.001) compared to Neat PVs (P <0.001), and PVs contaminated with 70% alcohol (P <0.001). sanitizer contaminated PV-1 values were significantly higher when compared to Neat PV-1 (P <0.001)for lipase. It is advised that isopropyl alcohol (70%) should be preferred over glycerol containing sanitizers to reduce pre-analytical errors for lipase and TG estimation. © 2020, National Institute of Science Communication and Information Resources. All rights reserved.