Background: Covid – 19 caused by SARS-CoV2 was declared a global pandemic by World Health Organization. Due to rapid disease progression causing severe and fatal complications, Effective biomarkers like D – Dimer, serum ferritin, CRP, IL-6, LDH would be helpful in screening, categorization of patients, their clinical management, and prevention of serious complications, especially in areas where radiological facilities arenot available immediately. Aims and Objectives: The study was aimed to investigate association between levels of inflammatory biomarkers with Covid – 19 disease severity and correlate it with HRCT chest finding to identify patients at risk of fatal complications. Materials and Methods: It was a retrospective monocentric observational study undertaken at a tertiary-care, COVID-19 dedicated centre. 200 Patients>18 year of age who were admitted from August 1, 2020 up to October 31,2020 with laboratory confirmed diagnosis of Covid – 19 were included in the study. Data was collected on demography, disease severity, laboratory measurements, radiology imaging retrospectively from electronic and laboratory records of patients. The disease severity was classified into mild to severe based on CT Severity scoring. HRCT Chest and inflammatory biomarkers were sent in every patient at the time of admission and the outcome was recorded. Results: There were 133 male patients, 67 female patients in our study. Average age of patients having severe lung involvement is 54.1 years, whereas Average age of patients having non-severe lung involvement is 52 years but showed No significant association with severity of lung involvement. Severity of lung involvement according to HRCT chest findings was greater in patients with raised values of both D – Dimer and ferritin (RR:3.67, P value:<0.0001), compared to combination of raised value of D – Dimer with LDH (RR: 2.56, P value: 0.0383) or D – Dimer with CRP(RR:2.22, P value:0.0157) or isolated D– Dimer (RR:2.87, P value: 0.0727). Individually raised levels of serum ferritin, LDH and CRP were also found to be significantly associated with radiological severity among covid-19 patients. Neither raised IL-6 levels (p=0.368, RR: 0.76) nor did combined raised value of D – Dimer with IL-6 showed significant association with HRCT severity in our study (RR: 1.69, P value: 0.1193). Pearson correlation coefficients were also calculated and serum LDH showed strongest correlation with increasing lung involvement in HRCT chest, followed by serum ferritin. Conclusion: Based on the significant association, combination of D – Dimer with ferritin as well as isolated levels of inflammatory markers can help in assessing the severity of Covid – 19 disease based on its correlation with radiological severity, thereby it will help in immediate categorization of patients into different risk groups following diagnosis, to ensure optimal resource allocation.

Background: COVID-19 is currently the most common cause of morbidity and mortality worldwide. Diabetes is also one of the most common causes of morbidity and associated complications. Identification of prognostic markers like glycated hemoglobin can help early categorization of patients and their better management. Aims and Objectives: To determine if Glycated Hemoglobin (HbA1c) levels are associated with radiological severity of COVID -19 disease, thereby predict prognosis in COVID -19 patients. Its association with D dimer andIL-6 was also evaluated to assess hypercoagulability and systemic inflammation in these patients. Materials and Methods: A monocentric retrospective observational study was conducted during admission period from August 1, 2020- October 31, 2020. HbA1c levels of 188 patients who tested positive for COVID-19 in a dedicated COVID-19 tertiary care center (L.N. Medical college and J.K. Hospital, Bhopal) were determined. They were divided into 2 groups: A (HbA1c level ≤6.5 %), B (HbA1c level >6.5 %). Severity of disease in terms of lung involvement in HRCT Chest was recorded. Their SpO2 and oxygen requirement at admission was also recorded. Among laboratory investigations, D dimer, IL6 Levels were obtained. Results: Out of 188 COVID-19 positive patients included in our study, there were 132 men, 56 women. Median age of patients was 66 years. Mean HbA1c level was 7.2%. Of these, 87 had normal HBA1C and 101 had raised HBA1C >6.5%. Oxygen was required in 58 patients with raised HbA1c (RR of 2.782, p value<0.0001), of which 42 patients had severe lung involvement (RR of 2.498, p value=0.0003). 20 (22.9%) patients with normal HbA1c required oxygen on admission, out of which 11 (12.6%) patients had severe lung involvement. Those who had higher HbA1c levels, had higher chances of severe lung involvement (>50%) in radiological evaluation (RR 2.783, p-value 0.0003, Positive Likelihood ratio: 2.78, 95% CI: 1.60 to 4.83, 85% specificity).Significant increase in D dimer was seen in 77 (76.2%) patients with raised HbA1c compared to 40 patients (45.9%) with normal HbA1c(RR-1.6582, p-value 0.0001). No significant relation between HbA1c levels with IL-6 was found. Conclusion: Patients with raised HBA1C contracting COVID-19 have more severe inflammation and greater lung involvement, higher chances of oxygen requirement and are associated with higher risk of hypercoagulability. HbA1C will not only help identify hyperglycemia but also help assess severity of disease (both clinically and radiologically), systemic inflammation, hypercoagulability, thereby helps in predicting prognosis, managing patients and hasten recovery.