A new modification CNN using VGG19 and ResNet50V2 for classification of COVID-19 from X-ray radiograph images

Coronavirus often called COVID-19 is a deadly viral disease that causes as a result of severe acute respiratory syndrome coronavirus-2 that needs to be identified especially at its early stages, and failure of which can lead to the further spread of the virus. Despite with the huge success recorded towards the use of the original convolutional neural networks (CNN) of deep learning models. However, their architecture needs to be modified to design their modified versions that can have more powerful feature layer extractors to improve their classification performance. This research is aimed at designing a modified CNN of a deep learning model that can be applied to interpret X-rays to classify COVID-19 cases with improved performance. Therefore, we proposed a modified convolutional neural network (shortened as modification CNN) approach that uses X-rays to classify a COVID-19 case by combining VGG19 and ResNet50V2 along with putting additional dense layers to the combined feature layer extractors. The proposed modified CNN achieved 99.24%, 98.89%, 98.90%, 99.58%, and 99.23% of the overall accuracy, precision, specificity, sensitivity, and F1-Score, respectively. This demonstrates that the results of the proposed approach show a promising classification performance in the classification of COVID-19 cases. © 2023 Institute of Advanced Engineering and Science. All rights reserved.

Systems genetics identifies miRNA-mediated regulation of host response in COVID-19.

BACKGROUND: Individuals infected with SARS-CoV-2 vary greatly in their disease severity, ranging from asymptomatic infection to severe disease. The regulation of gene expression is an important mechanism in the host immune response and can modulate the outcome of the disease. miRNAs play important roles in post-transcriptional regulation with consequences on downstream molecular and cellular host immune response processes. The nature and magnitude of miRNA perturbations associated with blood phenotypes and intensive care unit (ICU) admission in COVID-19 are poorly understood. RESULTS: We combined multi-omics profiling-genotyping, miRNA and RNA expression, measured at the time of hospital admission soon after the onset of COVID-19 symptoms-with phenotypes from electronic health records to understand how miRNA expression contributes to variation in disease severity in a diverse cohort of 259 unvaccinated patients in Abu Dhabi, United Arab Emirates. We analyzed 62 clinical variables and expression levels of 632 miRNAs measured at admission and identified 97 miRNAs associated with 8 blood phenotypes significantly associated with later ICU admission. Integrative miRNA-mRNA cross-correlation analysis identified multiple miRNA-mRNA-blood endophenotype associations and revealed the effect of miR-143-3p on neutrophil count mediated by the expression of its target gene BCL2. We report 168 significant cis-miRNA expression quantitative trait loci, 57 of which implicate miRNAs associated with either ICU admission or a blood endophenotype. CONCLUSIONS: This systems genetics study has given rise to a genomic picture of the architecture of whole blood miRNAs in unvaccinated COVID-19 patients and pinpoints post-transcriptional regulation as a potential mechanism that impacts blood traits underlying COVID-19 severity. The results also highlight the impact of host genetic regulatory control of miRNA expression in early stages of COVID-19 disease.

Festivals in the COVID Age of Crisis

This article examines the impact of COVID on festivals and the future of the industry. Analysing more than 50 items of online news, scholarly reviews and reports, and governmental guidance, this article examines the immediate effects of COVID in the industry as a whole, and particularly on its precarious artists and workforce. It also explores the changing behavioural attitudes towards festivals. Importantly, the article looks at the long-term institutional changes that might emerge in the festival industry including the future of collaborative working, artistic support, precarious working, and diversity.

The artificial intelligence (AI) role for tackling against COVID-19 pandemic.

COVID-19 gains from the research and technology component's establishment of information science, artificial intelligence, and computer understanding. The article aims to discuss the numerous facets of today's modern technology utilized to combat COVID-19 emergencies on various scales, such as medicinal picture handling, illness tracking, expected outcomes, computational science, and medications. Techniques: A complex search of the knowledge base associated with existing COVID-19 innovation is conducted. Furthermore, a concise survey of the excluded data is conducted, analyzing the various aspects of current developments for dealing with the COVID-19 pandemic. The below are the outcomes: We have a window of musings on the audit of the tech propellers used to mitigate and mask the significant impact of the upheaval. Even though several investigations into current innovation in COVID-19 have surfaced, there are still required implementations and contributions of innovation in this war. Consequently, a thorough presentation of the available data is given, and several modern technology implementations for combating the pandemic of COVID-19. Continuous advancements of advanced technologies have aided in improving the public's lives, and there is a strong belief that proven study plans utilizing AI would be of great benefit in assisting people in combating this infection.

Clinical and Neurophysiological Evidence of Mononeuritis Multiplex During the COVID-19 Era.

Infection with the novel coronavirus that causes coronavirus disease 2019 (COVID-19) results in a variety of clinical symptoms, including various neurological abnormalities. Peripheral nervous system symptoms, such as peripheral neuropathies, were often recorded in the medical literature, primarily as Guillain-Barré syndrome. Mononeuropathy multiplex is a multifocal axonal neuropathy commonly associated with vasculitis or connective tissue disease. Recent evidence about its associations with severe COVID-19 infection and intensive care unit hospitalization is being considered. A 58-year-old man with clinical and electrophysiological confirmation of mononeuropathy multiplex was reported during the peri-COVID-19 illness. He was treated with steroids and achieved a satisfactory response. Therefore, clinical and neurophysiological evaluation is recommended for any patient presenting with neurological manifestations following COVID-19 infection.

Virtual Screening of Potential Therapeutic Inhibitors Against Spike, Heli-case, and Polymerase of SARS-CoV-2 (COVID-19)

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected around 13 million people and has caused more than 5.7 lakh deaths worldwide since December 2019. In the absence of FDA approved drugs for its treatment, only symptomatic management is done. Method(s): We attempted to uncover potential therapeutic targets of spike, helicase, and RNA dependent RNA polymerase (RdRp) proteins of the SARS-CoV-2 employing a computational approach. The PDB structure of spike and RdRp and predicted structure of helicase proteins were docked with 100 approved anti-viral drugs, natural compounds, and some other chemical compounds. Result(s): The anti-SARS ligands EK1 and CID 23631927, and NCGC00029283 are potential entry in-hibitors as they showed affinity with immunogenic Receptor Binding Domain (RBD) of the spike pro-tein. This RBD interacts with Angiotensin Converting Enzyme (ACE2) receptor, facilitating the entry of virion in the host cells. The FDA approved drugs, including Nelfinavir, Saquinavir, Tipranavir, Setrobu-vir, Indinavir, and Atazanavir, showed potential inhibitory activity against targeted domains and thus, may act as entry or replication inhibitor or both. Furthermore, several anti-HCoV natural compounds, including Amentoflavone, Rutin, and Tannin, are also potential entry and replication inhibitors as they showed affinity with RBD, P-loop containing nucleoside triphosphate hydrolase, and the catalytic domain of the respective protein. Dithymoquinone showed significant inhibitory potential against the fusion peptide of S2 domain. Importantly, Tannin, Dithymoquinone, and Rutin can be extracted from Nig-ella sativa seeds and thus, may prove to be one of the most potential anti-SARS-CoV-2 inhibitors. Conclusion(s): Several potential ligands were identified with already known anti-HCoVs activities. Fur-thermore, as this study showed that some of the ligands acted as both entry and replication inhibitors against SARS-CoV-2, it is envisaged that a combination of either inhibitor with a dual mode of action would prove to be a much desired therapeutic option against this viral infection.Copyright © 2021 Bentham Science Publishers.

A case series of compulsive hair pulling (trichotillomania) in children and young people presenting at a tertiary paediatric psychodermatology clinic

Globally, 14% of 10-19 year olds experience psychological difficulties. Evidence shows that some children/young people's (CYP) psychological wellbeing has been substantially affected during the pandemic. With the prevalence of social media and necessity of online teaching, CYP self- and otherfocused awareness has increased, leading to lowered mood and potential stigmatization from peers around visible differences, including hair loss. CYP struggling with compulsive hair pulling are often referred to dermatology clinics, which can cause considerable distress for them and their families. We present a case series focusing on CYP with compulsive hair pulling who attended a tertiary paediatric psychodermatology service. Owing to the COVID-19 pandemic, this clinic was run using a hybrid model of online and face-to-face appointments. We will discuss how applying a systemic family intervention that has been implemented in the psychodermatology clinic, run by a consultant dermatologist and paediatric clinical psychologist, has enabled optimal outcomes and a reduction of distress. To date, seven CYPs have presented and most (57%) were adolescents, supporting existing literature that compulsive hair pulling arises during this time and that this is the ideal time to focus interventions on. CYPs were seen on average for three appointments (range 1-5) prior to discharge from the service and/or a positive resolution of hair pulling. Several themes have also emerged as a result of this case series and these include stress and anxiety (57%), sexuality (14%) and challenges as a result of family discord or dynamics including family communication (29%). These will be explored in greater detail, including the underlying function and consequences of hair pulling and how a systemic family-based intervention has been beneficial. This case review also highlights the importance of having a multidisciplinary approach to managing cases within paediatrics and how differential diagnoses should always be considered prior to any treatment. We found that a family model of care was successful in treatment of hair pulling and henceforth we will also discuss learning points and best practice guidance for managing such cases.

Fluid balance as an independent prognostic indicator of in-hospital mortality in heart failure patients with Covid19

Introduction: Fluid resuscitation confers protection against in-hospital mortality in heart failure (HF) patients with severe sepsis. SARS COV-2 infection leads to cytokine storm that is clinically similar to severe sepsis. We aim to evaluate if positive fluid balance is associated with in-hospital mortality in HF patients with Covid-19. Method(s): This single center retrospective cohort study was conducted in patients admitted in the ICU for Covid 19 from 10/2020 to 3/2021 in a community hospital in Newark. The primary outcome was survival to discharge. Clinical SAS 9.4 was used to obtain summary statistics, perform chi-squared test and multivariable logistic regression analysis. Result(s): We included 91 patients admitted in the ICU with covid 19, of which 33 were diagnosed with HF. Out of 33 people, majority were males. Most of the patients were hispanic. Diabetes and hypertension were the most common comorbidities. 60.61% of HF patients had multiple comorbidities. Odds of negative survival outcome in those with positive fluid balance after adjusting for HF as compared to those with negative fluid balance in patients of COVID 19 was 12.958 (P value= 0.0183). Conclusion(s): Positive fluid balance in HF patients admitted with Covid 19 may be associated with adverse outcomes. Larger, prospective studies are needed to investigate the correlation between covid 19 and fluid balance in HF patients.

Adenosine deaminase augments SARS-CoV-2 specific cellular and humoral responses in aged mouse models of immunization and challenge.

Despite numerous clinically available vaccines and therapeutics, aged patients remain at increased risk for COVID-19 morbidity. Furthermore, various patient populations, including the aged can have suboptimal responses to SARS-CoV-2 vaccine antigens. Here, we characterized vaccine-induced responses to SARS-CoV-2 synthetic DNA vaccine antigens in aged mice. Aged mice exhibited altered cellular responses, including decreased IFNγ secretion and increased TNFα and IL-4 secretion suggestive of TH2-skewed responses. Aged mice exhibited decreased total binding and neutralizing antibodies in their serum but significantly increased TH2-type antigen-specific IgG1 antibody compared to their young counterparts. Strategies to enhance vaccine-induced immune responses are important, especially in aged patient populations. We observed that co-immunization with plasmid-encoded adenosine deaminase (pADA)enhanced immune responses in young animals. Ageing is associated with decreases in ADA function and expression. Here, we report that co-immunization with pADA enhanced IFNγ secretion while decreasing TNFα and IL-4 secretion. pADA expanded the breadth and affinity SARS-CoV-2 spike-specific antibodies while supporting TH1-type humoral responses in aged mice. scRNAseq analysis of aged lymph nodes revealed that pADA co-immunization supported a TH1 gene profile and decreased FoxP3 gene expression. Upon challenge, pADA co-immunization decreased viral loads in aged mice. These data support the use of mice as a model for age-associated decreased vaccine immunogenicity and infection-mediated morbidity and mortality in the context of SARS-CoV-2 vaccines and provide support for the use of adenosine deaminase as a molecular adjuvant in immune-challenged populations.

Correlation of olfactory dysfunction with lung involvement and severity of COVID-19.

BACKGROUND: Olfactory dysfunction (OD) is a significant symptom of COVID-19 and may be the earliest symptom, or it may sometimes be the only manifestation of the disease. AIMS: To investigate whether OD is correlated with chest computed tomography (CT) findings, blood test parameters, and disease severity in COVID-19 patients. METHODS: The files of COVID-19 patients were retrospectively reviewed, and the ones who had information about smelling status and CT were taken into consideration. A total of 180 patients were divided into two groups: the OD group consisted of 89 patients with self-reported OD, and the No-OD group consisted of 91 subjects who did not complain of OD. The two groups were compared for the amount of lung consolidation on CT, intensive care unit (ICU) admission, and blood test parameters (complete blood count, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), ferritin, D-dimer, interleukin-6 (IL-6)). RESULTS: The amount of lung consolidation and ICU admission were significantly higher in the No-OD group (p < 0.001 for both). White blood cell (p = 0.06), monocyte (p = 0.26), and platelet (p = 0.13) counts and hemoglobin (p = 0.63), ALT (p = 0.89), and D-dimer (p = 0.45) levels of the two groups were similar. Lymphocyte count (p = 0.01), neutrophil count (p = 0.01), and AST (p = 0.03), CK (p = 0.01), LDH (p < 0.001), CRP (p < 0.001), ESR (p < 0.001), ferritin (p < 0.001), and IL-6 (p < 0.001) levels were significantly higher in the No-OD group. CONCLUSIONS: The patients presenting to the hospital with self-reported OD may have less lung involvement and a milder disease course compared to patients without OD on admission.

Hesitancy and acceptance of COVID-19 vaccines among Iraqi medical students: A cross-sectional study

Background: Vaccine development against coronavirus disease 2019 (COVID-19) is vital for pandemic containment. Reluctance or fear of taking the vaccine is a significant impediment to achieving full population immunity coverage. Medical students' knowledge and education about vaccination are essential, as they will serve as healthcare providers. Objective(s): This study aimed to verify the major factors and barriers affecting vaccine acceptance. Material(s) and Method(s): A cross-sectional study was carried out in four of the main medical universities in the middle of Iraq. The survey was achieved via an online questionnaire in December 2021 from 638 medical students. Result(s): Out of 4500 medical students, there were 638 participant respondents to the survey with a response rate of 14.2%. The main factor affecting vaccine acceptance is the probability of getting infected. The vaccination rate was significantly higher in those vulnerable to infections (pvalue = 0.03). Most students (50.3%) believe that the vaccine was safe, and the vaccination rate was statistically significant in those groups (p-value = 0.0001). About 46.2% of the students believe that the vaccine is effective against the infection of COVID-19 (p-value = 0.0001), 44.8% of students were sure that the vaccine did not have major complications (p-value = 0.00001), and 41% (n = 262) of participants thought that the immunity acquired after SARS-CoV-2 infection is better than the immunity acquired by vaccination (p-value = 0.00001). Conclusion(s): Vaccine efficacy and beliefs in immunity following COVID-19 were the most influential factors in vaccine intake. The concept of vaccination is widely accepted among medical students, and there is raised awareness about how important to get vaccinated.

SARS-CoV-2 (COVID-19) Clinical Manifestations and Risk Factors among Healthcare Workers In Palestine

Background: Healthcare workers are the White army compacted the COVID-19 epidemic, and reports worldwide have shown an increase in SARS-CoV-2 among healthcare workers due to their direct interactions with infected patients. This study aimed to examine the clinical manifestations and risk factors for SARS-CoV-2 infection among healthcare workers in Palestine and offer recommendations to ensure health workers' safety and adopt workplace safety policies. Method(s): This questionnaire-based cross-sectional observational study was conducted using an online questionnaire to collect information about SARS-CoV-2 transmission, signs, symptoms, and treatment reported by healthcare workers. Furthermore, we explored policies, protocols, and practices that make health workers vulnerable to SARS-CoV-2 infection. Result(s): A total of 389 healthcare workers were included, 216 (55.5%) were exposed to the SARS-CoV-2 virus, 173 (44.5%) were infected with the virus, and the prevalence of hospitalization was 16%. The most commonly reported symptoms are fatigue, weakness, and muscle pain. Female healthcare workers experienced a significantly extended duration of symptoms than male workers. Direct contact (working less than 1.5 m) with suspected or confirmed COVID-19 patients and lack of COVID-19 and PPE training were risk factors for COVID-19 infection among HCWs. Conclusion(s): The healthcare system must ensure a safe work environment and adopt policies and procedures to ensure HCW safety, proper training, and resource availability to cope with crises. Copyright © 2022 Abukhalil et al.

Structure-based virtual screening and molecular docking of drugs against the SARS-CoV-2 spike protein-ACE2 receptor complex

The agent responsible for the COVID-19 pandemic was the newly discovered coronavirus SARS-CoV-2. A trimeric spike protein on the SARS-CoV-2 virion binds to the ACE2 receptor on host cells. In this study we performed a structure-based virtual screening and molecular docking of existing drugs against a high-resolution structure of the SARS-CoV-2 spike protein-ACE2 receptor complex. The 2.5-A crystal structure of the C-terminal domain of the SARS-CoV-2 spike protein (residues 319-541) in complex with human ACE2 (SARS-CoV-2-S-CTD/hACE2) (PDB ID: 6LZG) was used as the target for screening 4,374 FDA-approved drugs from the ZINC15 database using PyRx software. Molecular docking was performed using BIO VIA Discovery Studio Visualizer. The top twenty highest affinity drugs had binding energies of -7.0 to -8.8 kcal/mol. The highest affinity drug was the selective vasopressin V2-receptor antagonist Tolvaptan, for which molecular docking identified drug-amino acid residue interactions with ACE2. Other drugs displaying binding energies better than -8.0 kcal/mol were Nizoral, Amaryl, Accolate, Sorafenib, Glipizide and Azelastine. The predicted interactions of these highest affinity drugs with residues in ACE2 were at positions that could disrupt the spike protein-ACE2 complex, so these drugs have the potential to be repurposed as inhibitors of the SARS-CoV-2 virus.

Molecular dual actions of hsa-miRNA and v-miRNA in oncogenic EBV

Viruses are one of the main reasons that cause healthy cells to proliferate and become cancerous. Several viruses have been identified as causative factors for various forms of cancer. Tumor occurrence can be caused by viral oncoprotein activity, persistent infection or inflammation. The molecular process is still complicated to be understood. In recent decades, Homo sapiens cell microRNA (hsa-miRNA) has been discovered by small non-coding RNAs that affect post-transcriptional gene expression. hsa-miRNA is a key control factor for several key biological processes and has a much greater impact on the target gene group. even though they occupy a small part of the genome, they play a great role in the development of cancer. Several viruses produce this tiny RNA, which can regulate their gene expression or affect the host's gene expression. A new hypothesis is that Epstein-Barr virus (EBV) is the first cancer causing virus that is found to produce microRNAs (v-miRNAs). In addition, evidence shows that miRNA encoded by EBV contributes to the occurrence and progression of EBV-related malignancies. Generally, these compounds reduce messenger RNA (mRNA) instability, such as genes that regulate tumorigenesis mechanisms like inflammation, cell cycle control, stress response, differentiation, apoptosis, invasion, and immune pathways. Therefore, EBV-miRNAs are important in the complex interaction between host, virus and EBV tumorigenesis. In terms of malignant tumors, the combinatorial process behind EBV-miRNA still needs further study. In this article, we will introduce EBV-miRNA, including the cellular processes affected by the virus, and their ability to promote cancer.

Serum Procalcitonin Level and Comorbidity in Covid-19 Patients in UAE

Background: Most COVID-19 patients experience a mild form of the disease, but there is a certain percentage of patients who progress to a very severe disease state that requires intensive care and invasive ventilation. In order to ensure better patient management and improved outcomes, early identification of patients who may be at a higher risk of severe infection can play an important role. The aim of this study was to assess the association between the mean procalcitonin (PCT) level and comorbidity in hospitalized patients with COVID-19. Methods and Results: A total of 231 COVID-19-positive patients aged between 20 and 82 years (170[73.6 %] males and 61[26.4%] females) were included in this study. Serum PCT was accessed by procalcitonin assay using the Beckman Coulter UniCel DxI 800 instrument. All patients were classified into 5 groups according to age: 20-29 years-20(8.7%), 30-39 years-47(20.3%), 40-49 years-72(31.2%), 50-59 years-48(20.8%) and >60years-44(19.0%). Eighty-seven (37.7%) patients had no chronic disease, while 144(62.3%) had comorbidities: hypertension (37[16.0%]), diabetes mellitus (44[19.0%]), a combination of diabetes mellitus with hypertension (32[13.9%]), asthma (6[2.6%]), hyperlipidemia (4[1.7%]), renal disease (1[0.4%]), and COPD (1[0.4%]). COVID-19 patients with diabetes in combination with hypertension had a statistically greater PCT level than COVID-19 patients without comorbidities (P=0.0273). However, there were no statistically significant differences in the mean PCT levels between other comorbidities. There were no statistically significant differences in the mean PCT level between different age categories (P=0.7390). The serum PCT measurement could evaluate the prognosis of the disease in some COVID-19 patients. © 2022, International Medical Research and Development Corporation. All rights reserved.

The new normal in the post-pandemic world: Our experience of organising a three-part webinar series for the CST 2022 Applicants

Introduction: In The time of COVID-19, The influx in The use of The online platform has been paramount. The Surgical world is no exception with The first virtual selection process for Core Surgical Training (CST) 2021 applicants. We, The current core trainees from The Kent, Surrey and Sussex (KSS) deanery organised this three-part webinar series for CST 2022 applicants to aid our future colleagues. Material(s) and Method(s): The event poster was circulated among The Surgical tutors, medical education Department across The KSS region, all The foundation schools and to Foundation Trainees Surgical Societies (FTSS) across The UK. It was advertised on Facebook, Twitter, WhatsApp and Eventbrite. Google Workspace was used to manage registered participants and Microsoft Teams were used for The webinars. Discussion(s): A total of 526 participants registered. 69.9% of them registered through social media whereas 16.4% and 9.8% through The medical education Department and word of mouth respectively. The first part covering The CST program overview and self-assessment guidance was attended by 96 of them on 16 November 2021. The second part covering interview stations was attended by 29 participants on 14 December 2021. We received positive feedback from 42 and 8 participants following each webinar respectively. We currently have 88 participants registered for our mock interview sessions planned for late January 2022. Conclusion(s): The virtual selection process is here to stay. Well-organised events like this will help The candidates prepare well for their interview as well as helping The current trainees with their teamwork, leadership and organisation skills.

Effect of Aspirin Use on clinical Outcome among Critically Ill Patients with COVID-19

Background Critically ill COVID-19 patients are at risk of developing major complications with high mortality rate. Aspirin might have favorable effects in severe COVID-19 via various mechanisms besides inhibition of platelet aggregation. The role of aspirin as adjuvant therapy in critically ill patients with COVID-19 has not been studied. In this study, we investigated the correlation between aspirin use and the clinical outcome in critically ill COVID-19 patients. Methods This is a retrospective cohort observational study of critically ill COVID-19 Egyptian patients. Participants were divided into two groups: patients who received aspirin, 150 mg per day orally, upon admission to the intensive care unit, and those who did not. The primary outcome in this study was the shift to invasive ventilatory support. Results A total of 1190 patients were involved in the study, 660 patients received aspirin, while 530 patients did not. Among aspirin group compared to non-aspirin group, invasive ventilatory support, DVT, PE, stroke, ACS, ARDS, AKI, septic shock, and mortality were less frequent, and the differences were significant except for ACS, AKI, and septic shock. Major bleeding was non-significantly more frequent. The length of ICU stay was significantly longer among non-survivors, and shorter among survivors. The variations between the two groups were significant among subgroups >= 40 or 60. Conclusions In critically ill patients with COVID-19, aspirin has the potential role as an adjuvant therapeutic, lowering the risk of mechanical ventilation, thromboembolic events, ARDS, and ICU mortality. Patients older than 40 years were a significant category that might benefit from aspirin.

Assessment of Serum Hypoxia-Inducible Factor-1 and Chemerin Levels as Potential Markers of Severity in COVID-19 Patients

Background: Coronavirus infection (COVID-19) the year 2019 is linked to systemic inflammation Adipokine activity has a wide spectrum of effects on infection pathogenesis. Many elements associated with this condition, such as inflammation, platelet activation, and endothelial dysfunction, may make patients more susceptible to venous or arterial thrombosis. Hypoxia is also a direct result of the lung damage found in COVID-19. Chemerin is a dipokine that has inflammatory and metabolic functions. Hypoxia-Inducible Factor-1 (HIF-1) is a protein that regulates oxygen homeostasis in the body. Objective: Our study focused on two indicators (Chemerin, and Hypoxia-inducible factor-1) in COVID-19 in the hopes of demonstrating biomarkers linked to illness severity. Materials and methods: This is a casecontrol study in which (COVID-19) patients were recruited from the Intensive Care Unit ICU department of the AL-Amal Hospital in AL-Najaf City, Iraq, before receiving any treatment, and compared to seemingly healthy volunteers as the control group. Mild/moderate, severe, and critically sick individuals were separated into three categories. The enzyme-linked immunosorbent assay (ELISA) kit was used to evaluate blood chemerin and HIF-1 levels in all patient and control groups. COVID-19 participants' clinical symptoms, laboratory test findings, and outcomes were studied retrospectively. Results: COVID-19 patients had significantly higher levels of HIF-1 and chemerin than healthy volunteers (2.1 0.48 and 244.3 153.97;P 0.001 vs. 1.36 0.49 and 195.03 153.97;P=0.015, respectively). Critically illnes patients had considerably greater serum chemerin and HIF-1 levels than healthy individuals (P 0.0001). However, there was no changes in HIF-1 levels between the mild/moderate patients and the healthy group. Chemerin and HIF-1 levels were positively correlated with ferritin, d-dimer, and NLR levels. Conclusion: Levels of Chemerin and HIF-1 in COVID-19 patients are early indicators of the severity disease and have been linked to the risk of mortality in patients. © 2022, ResearchTrentz Academy Publishing Education Services. All rights reserved.