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Inflammatory markers and neopterin levels in relation to mild COVID-19
1Department of Internal Medicine, Faculty of Medicine, Hitit University, Çorum, Turkey. dralpaslan_78@hotmail.com.
Objective:
The immunopathology of acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection involves an excessive inflammatory response. Approximately 80% of patients with coronavirus disease 2019 (COVID-19) have a mild illness, 20% require hospitalization, and approximately 5% require intensive care. Neopterin is a macrophage activation marker produced by monocytes and macrophages following activation by interferon-gamma (IFN-γ). It is crucial to determine neopterin levels and evaluate them together with inflammatory, coagulation, and biochemical markers in moderate/mild SARS-CoV-2 infection.
Patients And Methods:
The present study compared plasma neopterin and inflammatory as well as biochemical markers of 50 patients with COVID-19 and 38 healthy volunteers without COVID-19.
Results:
The data of 38 participants did not show statistically significant differences in serum neopterin levels between the mild/moderate COVID-19 and control groups (p=0.259). White blood cell (WBC), neutrophil, lymphocyte, platelet (PLT), hemoglobin (HGB), procalcitonin (PCT), ferritin, prothrombin time (PT), activated partial thromboplastin time (aPTT), international normalized ratio (INR) and lymphocyte CRP ratio (LCR) values were significantly different between the study groups (p<0.001, p=0.001, p=0.001, p<0.001, p=0.014, p<0.001, p=0.001, p<0.001, p=0.004, p<0.001, p<0.001, respectively). According to the ROC analysis, the WBC, PT, Na, and LCR values exceeding the cutoff values may be predictive of COVID-19.
Conclusions:
Although there were no significant differences in serum neopterin levels between the groups, there were high values in patients with severe SARS-CoV-2 infection in previous studies and these values were maintained for a long time. The present study found that neopterin levels were not elevated in mild/moderate COVID-19 patients.
Insights
Serum neopterin levels were not elevated in patients with mild to moderate COVID-19. However, other inflammatory and coagulation markers showed significant differences, with some potentially predicting COVID-19.
Area of Science:
- Immunopathology
- Infectious Diseases
- Biochemistry
Background:
- Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection triggers an excessive inflammatory response.
- While most COVID-19 cases are mild, a significant percentage require hospitalization, highlighting the need for understanding disease markers.
- Neopterin, a marker of macrophage activation, is influenced by interferon-gamma (IFN-γ) and is studied in relation to inflammatory conditions.
Purpose of the Study:
- To investigate serum neopterin levels in patients with mild to moderate COVID-19.
- To compare neopterin and other inflammatory, coagulation, and biochemical markers between COVID-19 patients and healthy controls.
- To assess the potential of these markers in predicting COVID-19.
Main Methods:
- A comparative study involving 50 patients diagnosed with COVID-19 and 38 healthy volunteers.
- Plasma neopterin levels were measured and compared between the groups.
- Various inflammatory markers (e.g., white blood cell count, neutrophils, lymphocytes), coagulation parameters (e.g., prothrombin time, aPTT), and biochemical markers were analyzed.
Main Results:
- No statistically significant difference was observed in serum neopterin levels between mild/moderate COVID-19 patients and the control group (p=0.259).
- Significant differences were found in white blood cell count, neutrophils, lymphocytes, platelets, hemoglobin, procalcitonin, ferritin, prothrombin time, aPTT, INR, and LCR between the groups (p<0.05 for all).
- Receiver Operating Characteristic (ROC) analysis suggested that elevated white blood cell count, prothrombin time, sodium levels, and LCR may be predictive of COVID-19.
Conclusions:
- Serum neopterin levels are not elevated in patients with mild to moderate COVID-19.
- Previous studies indicated high neopterin levels in severe SARS-CoV-2 infection, which were sustained over time.
- The study identified several inflammatory and coagulation markers that differ significantly between COVID-19 patients and controls, with potential predictive value.
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