Biomarkers associated with COVID-19 disease progression

Abstract

The coronavirus disease 2019 (COVID-19) pandemic is a scientific, medical, and social challenge. The complexity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is centered on the unpredictable clinical course of the disease that can rapidly develop, causing severe and deadly complications. The identification of effective laboratory biomarkers able to classify patients based on their risk is imperative in being able to guarantee prompt treatment. The analysis of recently published studies highlights the role of systemic vasculitis and cytokine mediated coagulation disorders as the principal actors of multi organ failure in patients with severe COVID-19 complications. The following biomarkers have been identified: hematological (lymphocyte count, neutrophil count, neutrophil-lymphocyte ratio (NLR)), inflammatory (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT)), immunological (interleukin (IL)-6 and biochemical (D-dimer, troponin, creatine kinase (CK), aspartate aminotransferase (AST)), especially those related to coagulation cascades in disseminated intravascular coagulation (DIC) and acute respiratory distress syndrome (ARDS). New laboratory biomarkers could be identified through the accurate analysis of multicentric case series; in particular, homocysteine and angiotensin II could play a significant role.

Do Laboratory Biomarkers Predict Survival in Severe COVID-19? A Cross-sectional Study

“…Published literature indicates that D-Dimer levels were signi cantly higher among those with severe disease. 1,5,7,10,21 This discrepancy may be due to the homogenous nature of our study population (severe COVID-19 patients admitted to ICU) while the majority of other studies had patients with mild, moderate and severe disease. It has been reported that patients with non-severe disease have a lower level of D-Dimer as compared to those with severe disease.…”

“…Multiple factors have been proposed for the complex and ill-de ned course of the illness. 5 In the most of the cases, the disease is fairly mild, while in the rest it results in severe disease leading to multiorgan failure and death. 6 Apart from gender, age, blood groups, and co-morbidities, a plethora of laboratory markers have been investigated to predict the course and outcome of the disease.…”

Hypoalbuminemia in Severe COVID-19 Post Recovery Patients

“…In addition, there was neither correlation between CRP and albumin (-0.3277) nor between ESR and albumin (-0.0504) ( Table 1). Studies have revealed no/slight increase of ESR and CRP 36,38,39 while other studies showed inconsiderable decrease of serum albumin in mildmoderate COVID-19 patients 38,40 . Most importantly no studies conducted on post recovery patients addressing those markers.…”

“…Ponti et al 36 found the severity of COVID-19 is positively correlated with ESR and CRP, while no study on both biomarkers after the recovery of COVID-19 patients has been recorded yet. Our data has revealed a positive correlation between ESR and CRP (R 2 =0.85) in severe COVID-19 post recovery patients.…”

Role of interleukin 6 as a predictive factor for a severe course of Covid-19: retrospective data analysis of patients from a Long-term Care Facility during Covid-19 Outbreak

“…Such patients need close monitoring and early transfer to the hospital. Various biomarkers, especially in ammatory markers like C-reactive protein (CRP), ferritin, brinogen, D-dimer and Interleukin 6 (IL-6) are associated with Covid-19 progression [10,11]. According to known evidence, IL-6 is superior to CRP and other markers of in ammation in predicting respiratory failure in Covid-19 [16,17].…”