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Serum troponin, D-dimer, and CRP level in severe coronavirus (COVID-19) patients
Ayad M Ali1, Hassan M Rostam2,3, Mohammed H Fatah4
1Department of Chemistry, College of Sciences, University of Garmian, Kalar, Kurdistan Region, Iraq.
Insights
Elevated troponin, C-reactive protein (CRP), and D-dimer levels indicate higher COVID-19 mortality risk. These biomarkers, along with white blood cells (WBCs), were significantly higher in deceased patients and families experiencing multiple losses.
Area of Science:
- Biochemistry
- Immunology
- Infectious Diseases
Background:
- Abnormal levels of inflammation and coagulation biomarkers, including troponin, C-reactive protein (CRP), and D-dimer, are associated with coronavirus disease 2019 (COVID-19) progression.
- These biomarkers play a role in the disease's severity and outcomes.
Purpose of the Study:
- To investigate the correlation of troponin, CRP, D-dimer, white blood cell (WBC), and polymerase chain reaction-cycle threshold (PCR-Ct) values in COVID-19 survivors versus deceased patients.
- To assess differences in these parameters between survivors and non-survivors.
- To examine biomarker correlations within families who experienced multiple COVID-19 related deaths and compare them to a control group.
Main Methods:
- Retrospective analysis of biomarker levels (troponin, CRP, D-dimer, WBC) and PCR-Ct in COVID-19 patients.
- Comparison of biomarker levels between survivor and deceased groups.
- Correlation analysis within affected families and comparison with an unrelated control group.
Main Results:
- Significant differences in D-dimer, CRP, and troponin levels were observed between survivor and deceased groups during the first week of hospitalization.
- By the second week, all studied parameters (troponin I, D-dimer, CRP, WBCs) showed significant differences between the groups.
- WBC levels positively correlated with CRP in male survivors and with troponin in deceased male patients. In families with multiple deaths, troponin correlated positively with D-dimer, CRP, and WBCs during the second week.
Conclusions:
- Troponin, D-dimer, CRP, and WBC levels were significantly higher in non-survivors compared to survivors of COVID-19.
- Elevated troponin and WBC levels were notably associated with families experiencing multiple COVID-19 related deaths compared to controls.
Background:
Abnormal inflammation coagulation biomarker levels of troponin, C-reactive protein (CRP), and D-dimer levels in serum have been demonstrated to be associated and involved in the disease progression of coronavirus disease 2019 (COVID-19).
Methods:
First: the study aimed to investigate the correlation of troponin, CRP, d-dimer, white blood cell (WBC) and polymerase chain reaction-cycle threshold (PCR-Ct) within COVID-19 survivors (143 patients; 79 males, 64 females) and in deceased (30 patients; 12 males, 18 females) group. Also, assessing any differences between both groups in studied parameters. Second: a correlation study of studied parameters' level has been conducted within families (41 patients; 23 males [seven deaths] and 18 females [eight deaths]) that lost more than one member due to the severity of the disease. Also, differences between these family and control group (132 patients; 69 males and 63 females) group in studied parameters have been assessed.
Results:
In the first week of hospitalization, there were significant differences in D-dimer, CRP and troponin level between survived and deceased patient groups. In the second week of the admission, both groups had significant differences in the level of all studied parameters; troponin I, D-dimer, CRP, and WBCs. WBC levels positively correlated to CRP in male survivors (r = 0.75, p < 0.0001), and to troponin in deceased male patients (r = 0.74, p = 0.007). The second week of patient admission was critical in the group of families who lost more than one person, when troponin was correlated positively with D-dimer, CRP, and WBCs.
Conclusion:
Troponin, D-dimer, CRP, and WBCs level were significantly higher in COVID-19 patients who died than in COVID-19 survivors. High troponin and WBC levels, were considerably associated with families that lost more than one member, when compared with the unrelated COVID-19 patient control.
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