Potential Role of Certain Biomarkers Such as Vitamin B12, ROS, Albumin, as Early Predictors for Prognosis of COVID-19 Outcomes

Abstract

COVID-19 disease is still a major global concern because of its morbidity and its mortality in severe disease. Certain biomarkers including Reactive Oxygen Species (ROS), vitamins, and trace elements are known to play a crucial role in the pathophysiology of the disease. The aim of our study was to evaluate how certain biomarkers, such as ROS, biochemical indicators, trace elements in serum blood of 139 COVID-19 hospitalized patients, and 60 non-COVID cases according to age and sex variations, can serve as the predictors for prognosis of COVID-19 outcome. An attempt of correlating these biomarkers with the severity of the disease as well as with each other is represented. All subjects were hospitalized from April 2021 until June 2021. A statistically significant increase of B12 levels (p = 0.0029) and ROS levels (p < 0.0001) as well as a decrease in albumin and Total Protein (T.P.) levels (p < 0.001) was observed especially in the early stage of the disease before CRP and ferritin elevation. Additionally, a statistically significant increase in ferritin (p = 0.007), B12 (p = 0.035, sALT p = 0.069, Glucose p = 0.012 and urea p = 0.096 and a decrease in Ca p = 0.005, T.P p = 0.052 albumin p = 0.046 between stage B (CRP values 6–30 mg/L) and C (CRP values 30–100 mg/L) was evident. Thus, this study concludes that clinicians could successfully employ biomarkers such as vitamin B12, ROS and albumin as possible prognosis tools for an early diagnosis. In addition, the total biochemical profile can assist in the understanding of the severity of COVID-19 disease, and could potentially lead to a better diet or early pharmaceutical treatment to prevent some of the more acute symptoms.

Thromboembolic Disease and Cardiac Thrombotic Complication in COVID-19: A Systematic Review

“…It induces the synthesis of fibrinogen, the precursor of clots, PAI-1 (an important inhibitor of our endogenous fibrinolytic mediators), and C-reactive protein (a biomarker of inflammation closely linked to COVID-19). During infection, the endothelium becomes activated, resulting in the loss of barrier function, expression of adhesion molecules, such as soluble ICAM-1 (intercellular adhesion molecule 1) and soluble VCAM-1 (vascular cell adhesion molecule 1), release of VWF (which allows platelet binding), the expression of TF (which activates the coagulation system) [ 1 , 23 , 34 , 35 , 36 , 37 , 73 ].…”

“…However, patients of older age and with comorbidities, such as cardiovascular disease, have a higher risk of developing more severe forms of the disease [ 35 ], regarding the most common laboratory changes lymphopenia and increase in lactate dehydrogenase occurring in patients with COVID-19 [ 73 ]. Again, the elevation of pro-inflammatory markers, such as C-reactive protein, D-dimer, ferritin, and interleukin-6 (IL-6), occur as prominent variations [ 1 , 15 , 36 , 37 ]. In particular, the levels of IL-6 can be related to the more complicated forms of the disease and presence of a procoagulant profile [ 1 , 15 ].…”

“…A Chinese retrospective study worked in this direction by revealing a percentage, i.e., 25% (20 out of 81) of patients admitted to the ICU, in whom an accident of VTE occurred. Of note, none of the patients had been managed with the use of VTE prophylaxis drugs [ 37 ]. Klok et al, in a multicenter study that included 184 patients with severe COVID-19, revealed a percentage of 31% (95% confidence interval: 20% to 41%) of patients who developed an accident of VTE.…”

Laboratory parameters related to disease severity and physical performance after reconvalescence of acute COVID-19 infection

“…According to a recent transcriptome analysis, vitamin B12 blocks several inflammation-related pathways that are activated in patients with moderate or severe COVID-19 infection 38 . However, there are also studies, which report an inverse relationship 39 or no link between COVID-19 severity and vitamin B12 concentrations 40 .…”