Role of Biomarkers Diagnostic Tools in Patients with COVID-19: Stratification Made Easy

Ahmed Abdallah Salman,1 Heba Mohamed Abdallah,2 Sami Eldahdouh,3 Sally Waheed Elkhadry,4 Samah Mohamed Awad,5 Ghada M K Gaballah,6 Eman Kamal Awaad,7 Mohammed Gaber Saad,8 Ahmed E Taha,9 Nahla K Gaballa7 1Internal Medicine Department, Faculty of medicine, Cairo University, Cairo, Egypt; 2Department of Clinical Pathology, National Liver Institute, Menoufia University, Shebin Elkom, Egypt; 3Department of Chest Diseases, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt; 4Department of Epidemiology and Community Medicine, National Liver Institute, Menoufia University, Shebin Elkom, Egypt; 5Clinical Microbiology and Immunology Department, National Liver Institute, Menoufia University, Shebin Elkom, Egypt; 6Medical Biochemistry Department, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt; 7Department of Anesthesiology and Intensive Care, National Liver Institute, Menoufia University, Shebin Elkom, Egypt; 8Department of Anesthesiology and Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; 9Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo, EgyptCorrespondence: Ahmed Abdallah Salman, Email [email protected] and Aims: In coronavirus disease 2019 (COVID-19) patients, several serum biomarkers have been identified. Upon intensive care unit (ICU) admission, these laboratory markers become more crucial to distinguish between patients with severe cases of COVID-19. It might assist doctors in predicting the course of illnesses and treating patients appropriately. This work was to investigate the role of biomarkers in patients with COVID-19 classification admitted to the hospital and identified by reverse transcription polymerase chain reaction (RT-PCR).Methods: Peripheral blood sample was taken from COVID-19 cases isolated on admission to determine C-reactive protein (CRP), D-dimer, Fibrinogen, neutrophil–lymphocyte ratio (NLR), leukocytes CRP ratio (LeCR), lymphocyte–CRP ratio (LCR), interleukin-6 (IL6), leukocytes interleukin 6 ratio (LeIL6), systemic inflammatory index (SII), platelet-to-lymphocyte ratio (PLR), and tissue plasminogen activator inhibitor one (tPAI-1). Follow-up for IL6, Ferritin, D-dimer, and tPAI-1 were determined on the 3rd and 7th days.Results: Comparisons of severity revealed that hypertension, chronic obstructive pulmonary disease (COPD), and Ischemia were major risk factors in COVID-19 patients. There was a statistically significant difference between the test groups for fibrinogen (p < 0.000), IL6 (p < 0.009), LeCR (p < 0.006), and LCR (p < 0.011).Conclusion: Based on laboratory test findings at the time of ICU admission, we can distinguish severe cases of COVID-19.Keywords: COVID-19, intensive care unit, risk factors, RT- PCR, serum biomarkers