Recent worldwide outbreak of novel coronavirus disease (CoVID-19) has affected massive human population including Pakistan, and has caused a huge number of mortalities in few months. CoVID-19 is an infectious disease caused by a virus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) which is single stranded RNA enveloped beta coronavirus and affects lower respiratory tract. It transmits from human to human through respiratory droplets. It uses its S-protein to recognize ACE2 (Angiotensin Converting Enzyme-2) receptors in lung epithelial cells where it attaches and causes infection. The incubation period is 2-14 days. In pre-symptomatic phase, body’s immune system starts antibodies production. Significant antibodies are IgM and IgG that produces within 03-06 days and 8-12 days respectively. This review provides the available information about immunological aspects in terms of diagnosis and screening of CoVID-19 and potential therapeutic targets for combating SARS-CoV-2 infection. Immunologic techniques to detect these antibodies are ELISA (Enzyme-linked Immunosorbent Assay), CMIA (Chemiluminescent Micro particle Immunoassay) and ICT (Immunochromatographic Test). Among these, ELISA and CMIA are found to be highly specific and sensitive in convalescent phase of infection. While the fundamental confirmatory test for SARS-CoV-2 infection is RT-PCR (Reverse Transcription Polymerase Chain Reaction) which detects the viral RNA in respiratory samples preferably nasopharyngeal swab. Serological assays are essential to find out rate of infection, and most importantly antibody titers in recovered patients to be used for therapeutic purpose. After some successful studies Convalescent Plasma is considered as a good therapeutic option in the absence of specific antiviral therapy.
Objective: To evaluate demographics, biochemical markers and clinical features of patients suffering from coronavirus disease-2019. Method: The cross-sectional study was conducted retrospectively at the Capital Hospital, Islamabad, and the Fauji Foundation Hospital, Rawalpindi, Pakistan, from October 08, 2021 to March 01, 2022 and comprised patients of either gender with coronavirus disease-2019 diagnosed on the basis of reverse transcriptase polymerase chain reaction. Patients’ demographic, clinical and laboratory findings were obtained using patient charge sheets. Coronavirus disease-2019 was categorised as non-severe, severe and critical, according to the World Health Organisation criteria. Data was analysed using SPSS 26. Results: Of the 431 patients, 91(21.1%) were men and 340(78.9%) were women. The overall mean age was 60.75±14.45 years. Of the total, 148(34.3%) had non-severe, 190(44.1%) severe and 93(21.6%) had critical condition at the time of admission. Hypertension 307(71.2%) and diabetes mellitus 249(57.8%) were the most common comorbidities, while fever 353(81.9%), shortness of breath 339(78.7%) and cough 302(70.1%) were the most common symptoms reported. Higher age was significantly associated with coronavirus disease-2019 severity (p<0.001). Among comorbidities, chronic kidney disease (p<0.001) and cancer (p=0.046), and, among signs and symptoms, shortness of breath (p=0.002) and chest pain (p=0.021), were significantly associated with coronavirus disease-2019 severity. Serum total bilirubin, alanine aminotransferase, urea and creatinine levels had significant association with disease severity (p<0.001). Total leukocyte count, neutrophil-to-lymphocyte ratio, prothrombin time, and plasma D-Dimer levels had significant association with disease severity (p<0.001). Serum ferritin, lactate dehydrogenase and interleukin-6 levels were also significantly associated with disease severity (p<0.05). Conclusion: Assessment of biochemical markers was an excellent way to monitor disease progression in coronavirus disease-2019 patients. Key Words: COVID-19, Diabetes, Severity, Hypertension, Clinical features.
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