Study design and patients:
The present study was conducted at Qalla Hospital, focusing on patients diagnosed with COVID-19 and a control group of healthy individuals. A total of 147 cases were enrolled, comprising 112 confirmed COVID-19 patients and 35 control cases. Among the COVID-19 patients, there were 53 males (47.3%) and 59 females (52.7%), whereas the control group consisted of 16 males (45.7%) and 19 females (54.3%). The enrollment of participants aimed to achieve representation across genders in both COVID-19 and control cohorts. The demographic characteristics of the COVID-19 patient cohort revealed comorbidities prevalent among the enrolled individuals. The distribution of comorbidities in COVID-19 patients was as follows: diabetes mellitus was observed in 28 cases (25%), hypertension in 39 cases (34.8%), kidney disease in 7 cases (6.2%), and multiple concurrent diseases in 38 cases (34%).
All COVID-19 cases were diagnosed based on established clinical criteria and confirmed through laboratory testing for SARS-CoV-2 infection. The control group, comprising healthy individuals, underwent assessments to ensure the absence of COVID-19 symptoms and a negative SARS-CoV-2 test result. Data collection involved detailed medical history reviews, physical examinations, laboratory investigations, and analysis of various biomarkers and clinical parameters to assess disease severity, prognosis, and associated comorbidities among COVID-19 patients.
Table1 Clinical and Demographic characteristics of Covid-19 patients and control casesTop of Form
Parameters
|
Control cases % (n=35)
|
Patients % (n=112)
|
Age
|
35 (24-48)
|
44(33-57)
|
Gender:
|
Male
|
16 (45.7%)
|
53 (47.3%)
|
Female
|
19 (54.3%)
|
59 (52.7%)
|
Comorbidities
|
Diabetes
|
0
|
28 (25%)
|
Hypertension
|
0
|
39 (34.8)
|
Kidney
|
0
|
7 (6.2%)
|
Multiple
|
0
|
38 (34%)
|
Biological Biomarkers:
Biological marker tests conducted in this study aimed to evaluate specific indicators associated with COVID-19 severity and prognosis. The investigation included comprehensive analyses utilizing various laboratory analyzers for the assessment of key biomarkers.
The study utilized a range of analyzers for the quantification of specific biological markers. The Cobas C111 analyzer (Roche Diagnostics) was employed for the investigation of C-reactive protein (CRP) levels in serum. CRP quantification aids in assessing the degree of inflammation, with normal values for adults considered to be <5.0 mg/L. This quantitative immunological determination of CRP provided essential insights into the inflammatory status among study participants[20].
Furthermore, the Cobas E411 analyzer (Roche Diagnostics) was utilized for the measurement of ferritin, a marker often associated with inflammation and iron storage regulation. The ferritin investigation aimed to provide additional information regarding inflammatory processes and potential iron metabolism abnormalities related to COVID-19 infection.
The study also assessed D-dimer levels, a fibrin degradation product indicative of blood clot formation, using the fluorescence immunoassay iChroma™ II (Boditech Med Inc.). The D-dimer Rapid Quantitative Test identified elevated levels of D-dimer (>500 ng/ml) that might be associated with increased coagulation activity, aiding in the assessment of thrombotic risk among COVID-19 patients.
Additionally, cardiac troponin I, a marker for myocardial injury, was analyzed using the Cobas E411 analyzer. Troponin I tests were conducted through a fully automated immunoassay analysis using ElectroChemiLuminescence technology. The normal range for troponin I levels in the study was defined between 0 and 0.4 ng/ml, providing crucial insights into potential cardiac complications among the participants.
The Medonic M‐Series haematology analyzer (Medonic M32; Boule Medical AB) was primarily employed for conducting complete blood count (CBC) tests, offering comprehensive insights into various blood cell parameters.
The selection of these biological markers and the utilization of specialized analyzers aimed to provide a comprehensive understanding of the inflammatory, coagulation, and cardiac profiles among the study participants.
Statistical Analysis:
Statistical analysis involved the utilization of Analysis of Variance (ANOVA) to examine variations in CRP levels and D-Dimer. Additionally, simple linear regression was utilized to assess the relationship between CRP and WBCs.
Ethical Approval:
The research conducted in this study adhered to ethical guidelines and received approval from the General Directorate of Health (Approval Code: 0011-22). Prior to commencing the study, all protocols and procedures were reviewed and approved to ensure compliance with ethical standards and participant welfare.