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Serum homocysteine level and severity of coronavirus disease-2019 (COVID-19)
Jelita Siregar1, Darmadi Darmadi2
11Department of Clinical Pathology, Faculty of Medicine, Universitas Sumatera Utara, Dr Mansyur 5, Medan, Indonesia.
Insights
Serum homocysteine levels can help identify severe COVID-19 cases. This study found homocysteine to be a reliable biomarker for stratifying coronavirus disease-2019 severity.
Area of Science:
- Clinical Medicine
- Biomarkers
- Infectious Diseases
Background:
- Coronavirus disease-2019 (COVID-19) remains a global health concern.
- Identifying severe cases and predicting outcomes is crucial.
- Novel biomarkers are needed to assess COVID-19 severity.
Purpose of the Study:
- To evaluate the role of serum homocysteine levels in stratifying COVID-19 severity.
- To compare homocysteine with other established biomarkers.
Main Methods:
- Cross-sectional study conducted in Medan, Indonesia (May-December 2021).
- Included 100 adult COVID-19 patients.
- Excluded patients with specific comorbidities and medications.
Main Results:
- Severe COVID-19 was observed in 20% of subjects.
- Significantly higher levels of homocysteine, hs-CRP, D dimer, and procalcitonin in severe cases.
- Homocysteine demonstrated 87.5% sensitivity and 78.9% specificity for severe COVID-19.
Conclusions:
- Serum homocysteine is a potential biomarker for determining COVID-19 severity.
- Homocysteine offers a valuable tool for clinical risk stratification.
Introduction:
Coronavirus disease-2019 (COVID-19) is still a global health problem nowadays. A particular COVID-19 patients develop severe symptoms. Some biomarkers can be used to determine disease severity and improve outcome. Homocysteine is one of the novel biomarkers. The objective of this study is to determine the role of serum homocysteine level in stratifying severity of COVID-19.
Methods:
A cross-sectional study was conducted in Medan, Indonesia from May to December 2021. Subjects were obtained using consecutive sampling method. Inclusion criteria was COVID-19 patients aged 18 years or older and willing to participate in the study. Patients with malignancy, chronic kidney disease, thyroid disease, coronary heart disease, and who consume several medications including cholestyramine, metformin, methotrexate, fibrate, and contraceptive pill, were excluded. Data regarding demographic, laboratory, and biomarker were gathered from each subject. Statistical analyses were conducted at 95% confidence interval.
Results:
A total of 100 patients were enrolled. Most subjects were males (59%) and from Batak ethnicity (64%). Twenty percent subjects had severe COVID-19. The levels of serum high-sensitivity C-reactive protein (hs-CRP), D dimer, homocysteine, and procalcitonin were significantly higher in severe COVID-19 subjects. D dimer had the highest sensitivity (91.7%) and specificity (94.7%) in stratifying severe COVID-19, followed by hs-CRP (91.7% and 85.5%, respectively), homocysteine (87.5% and 78.9%, respectively), and procalcitonin (58.3% and 74.0%, respectively).
Conclusion:
Homocysteine can be used as a biomarker to determine COVID-19 severity.
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