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Hematological, Inflammatory, Coagulation, and Oxidative/Antioxidant Biomarkers as Predictors for Severity and
Shukur Wasman Smail1, Esmaeil Babaei2,3, Kawa Amin4
1Department of Biology, College of Science, Salahaddin University, Erbil, Iraq.
Insights
Predicting COVID-19 mortality is possible using routine lab tests and oxidative stress biomarkers. Key predictors include D-dimer, malondialdehyde, and neutrophil/lymphocyte ratio, indicating disease severity.
Area of Science:
- Biochemistry
- Immunology
- Clinical Medicine
Background:
- Oxidative stress and inflammation are central to COVID-19 pathophysiology.
- Understanding predictors of COVID-19 severity and mortality is crucial for patient management.
Purpose of the Study:
- To investigate routine laboratory and oxidative stress/antioxidative biomarkers as predictors of COVID-19 mortality.
- To identify specific biomarkers associated with disease severity and prognosis.
Main Methods:
- Prospective cohort study of 120 COVID-19 patients and 60 healthy controls.
- Categorization of patients into mild, severe, and critical groups based on clinical criteria.
- Measurement of routine laboratory biomarkers, oxidative stress markers (MDA, NO, SOD, TAC), and antioxidant levels (Vitamin C, GPx, Catalase).
Main Results:
- Neutrophil/lymphocyte ratio (NLR), CRP, ferritin, and D-dimer were elevated in severe and critical cases.
- Increased malondialdehyde (MDA) and nitric oxide (NO) with decreased superoxide dismutase (SOD) and total antioxidant capacity (TAC) observed.
- D-dimer, MDA, and NLR were identified as predictors of mortality; NO and ferritin predicted ICU hospitalization.
Conclusions:
- Immune dysregulation and oxidative imbalance are linked in COVID-19.
- NLR, NO, ferritin, and D-dimer are potential predictors of COVID-19 severity and mortality.
- Age over 50 is associated with a poorer prognosis in the Kurdish population.
Purpose:
Oxidative stress (OS) and inflammation are pivotal points in the pathophysiology of coronavirus disease-2019 (COVID-19). This study aims to use routine laboratory and oxidative stress/antioxidative biomarkers as predictors for the mortality of the disease.
Patients And Methods:
This prospective cohort study, made up of 120 COVID-19 patients from emergency units in Erbil, Duhok, Kirkuk, and Sulaymaniyah cities in Iraq, from May the 1st to May the 30th, 2021, and 60 healthy controls (HCs) (n = 60). The patients were re-categorized into mild (n = 54), severe (n = 40), and critical (n = 26) groups based on the clinical criteria. Following admission to the hospital, blood was directly collected for measuring routine laboratory biomarkers.
Results:
Neutrophils and neutrophil/lymphocyte ratio (NLR) were higher in the critical group, while lymphocytes were lower in the severe and critical groups compared to the mild group. The CRP, ferritin, and D-dimer values were more elevated in severe and critical cases than in mild COVID-19 cases. The levels of malondialdehyde (MDA), nitric oxide (NO), and copper were elevated, while the superoxide dismutase (SOD) activity level and total antioxidant capacity (TAC) level were lower. However, vitamin C, glutathione peroxidase (GPx), and catalase activity levels were not changed in the COVID-19 groups compared to the HCs. NO and ferritin were predictors of ICU hospitalization; D-dimer, MDA, and NLR were predictors of mortality. NO, and NLR were predictors of SpO2 depression. Moreover, NO, and copper have both good diagnostic values, their cutoffs were 39.01 and 11.93, respectively.
Conclusion:
There is an association between immune dysregulation and oxidative imbalance. The biomarkers, that could be considered as predictors for the severity and mortality of COVID-19, are the NLR, NO, ferritin, and D-dimer. The age equal to and older than 50 has a poor prognosis in the Kurdish population.
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