EVALUATION OF THROMBOCYTOPENIA, D-DIMER, INFLAMMATORY CRP, AND CBC MARKERS IN COVID-19 CASES, INCLUDING PATIENTS FROM IRAQ, USING A CASE-CONTROL METHODOLOGY
DOI:
https://doi.org/10.25271/sjuoz.2024.12.4.1333Keywords:
delta variant of COVID-19, D-dimer, C-reactive protein, and complete blood countAbstract
COVID-19 is a highly contagious viral illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It primarily affects the respiratory system but can also impact other significant organs. Its rapid spread has heightened interest in biomarkers for screening and early diagnosis. This study evaluated D-dimer, C-reactive protein (CRP), and complete blood count (CBC) levels in patients with COVID-19 compared to healthy individuals. A total of 50 healthy individuals and 50 COVID-19 patients, aged 20 to 65, were included in the study, excluding individuals with conditions such as leukemia, thalassemia, or pregnancy. Whole blood and plasma samples were collected for CBC and D-dimer assays and stored at 2-4°C. The COVID-19 patients had significantly higher levels of D-dimer, CRP, white blood cells (WBC), granulocytes, and granulocyte percentage as compared with the healthy individuals (p<0.01), lower levels of lymphocyte percentage, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) (p<0.01), as shown. The severe COVID-19 cases often show elevated D-dimer levels, indicating a higher risk of thrombosis. Increased CRP levels correlate with more severe conditions and help assess inflammation severity. A CBC provides insights into blood components, like RBC and WBC, and platelets. During COVID-19, CBC results may reveal lymphopenia, a low lymphocyte count linked to increased severity. For the most accurate and current information, consult healthcare professionals, reliable health organizations, or recent scientific studies on COVID-19.
References
Abdelhadi, A., & Kassem, A. (2021). Candida pneumonia with lung abscess as a complication of severe COVID-19 pneumonia. International medical case reports journal, 853-861. doi: https://doi.org/10.2147/IMCRJ.S342054.
Abdullah, Z. M., Goreal, A. A., & Abdo, J. M. (2023). Impact of SARS-CoV-2 RNA titer on the level of IgG antibodies in recovered patients with COVID-19 disease. The Journal of Infection in Developing Countries, 17(04), 432-438. https://doi.org/10.3855/jidc.17372
Ali, N. (2020). Elevated levels of C‐reactive protein may be an early marker to predict the risk for the severity of COVID‐19. Journal of medical virology, 92(11), 2409. doi: https://doi.org/10.1002/jmv.26097
Bros, J., Ibershoff, L., Zollmann, E., Zacher, J., Tomschi, F., Predel, H. G. & Grau, M. (2023). Changes in Hematological and Hemorheological Parameters Following Mild COVID-19: A 4-Month Follow-Up Study. Hematology reports, 15(4), 543-554. https://doi.org/10.3390/hematolrep15040057
Calder, P. C. (2020). Nutrition, immunity and COVID-19. BMJ nutrition, prevention & health, 3(1), 74. https://doi.org/10.1136%2Fbmjnph-2020-000085
Chen, G., Zhao, X., Chen, X., & Liu, C. (2023). Early decrease in blood lymphocyte count is associated with poor prognosis in COVID-19 patients: a retrospective cohort study. BMC Pulmonary Medicine, 23(1), 453. https://doi.org/10.1186/s12890-023-02767-z
Chen, W., Zheng, K. I., Liu, S., Yan, Z., Xu, C., & Qiao, Z. (2020). Plasma CRP level is positively associated with the severity of COVID-19. Annals of clinical microbiology and antimicrobials, 19, 1-7. https://doi.org/10.1186/s12941-020-00362-2
Elbe, S., & Buckland‐Merrett, G. (2017). Data, disease and diplomacy: GISAID's innovative contribution to global health. Global challenges, 1(1), 33-46. https://doi.org/10.1002/jcp.30367
Elkhalifa, A. M., Elderdery, A. Y., Al Bataj, I. A., Tamomh, A. G., Alyami, M. M., Almakrami, H. A., ... & Mok, P. L. (2022). [Retracted] Hematological Findings among COVID‐19 Patients Attending King Khalid Hospital at Najran, Kingdom of Saudi Arabia. BioMed Research International, 2022(1), 4620037. https://doi.org/10.1155%2F2022%2F4620037
Flower, T. G., Buffalo, C. Z., Hooy, R. M., Allaire, M., Ren, X., & Hurley, J. H. (2021). Structure of SARS-CoV-2 ORF8, a rapidly evolving immune evasion protein. Proceedings of the National Academy of Sciences, 118(2), e2021785118. https://doi.org/10.1073/pnas.2021785118
Gameil, M. A., Marzouk, R. E., Elsebaie, A. H., & Rozaik, S. E. (2021). Long-term clinical and biochemical residue after COVID-19 recovery. Egyptian liver journal, 11, 1-8. https://doi.org/10.1186/s43066-021-00144-1
Henry, B. M., et al. (2020). Hematologic abnormalities in patients with COVID-19: A review. American Journal of Hematology, 95(7), 773 783. https://doi.org/10.1515/cclm-2020-0369
Huang, H., Zhu, Y., Niu, Z., Zhou, L., & Sun, Q. (2021). SARS-CoV-2 N501Y variants of concern and their potential transmission by mouse. Cell Death & Differentiation, 28(10), 2840-2842. https://doi.org/10.1038/s41418-021-00846-4
Khan, A., Alsofayan, Y., Alahmari, A., Alowais, J., Algwizani, A., Alserehi, H., & Jokhdar, H. (2021). COVID-19 in Saudi Arabia: the national health response. Eastern Mediterranean Health Journal, 27(11), 1114-1124. https://doi.org/10.26719/emhj.21.048
Khan, A., Zia, T., Suleman, M., Khan, T., Ali, S. S., Abbasi, A. A., ... & Wei, D. Q. (2021). Higher infectivity of the SARS‐CoV‐2 new variants is associated with K417N/T, E484K, and N501Y mutants: an insight from structural data. Journal of cellular physiology, 236(10), 7045-7057. https://doi.org/10.1002/jcp.30367
Li, J., Zhang, K., Zhang, Y., Gu, Z., & Huang, C. (2023). Neutrophils in COVID-19: recent insights and advances. Virology journal, 20(1), 169. https://doi.org/10.1186/s12985-023-02116-w
Li, Q., Cao, Y., Chen, L., Wu, D., Yu, J., Wang, H., & Hu, Y. (2020). Hematological features of persons with COVID-19. Leukemia, 34(8),2163-2172. https://doi.org/10.1038%2Fs41375-020-0910-1
Li, Q., Guan, X., Wu, P., Wang, X., Zhou, L., Tong, Y., & Feng, Z. (2020). Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. New England journal of medicine, 382(13), 1199-1207.
DOI: https://doi.org/10.1056/NEJMoa2001316.
Lippi, G., & Favaloro, E. J. (2020). D-dimer is associated with severity of coronavirus disease 2019: a pooled analysis. Thrombosis and haemostasis, 120(05), 876-878. DOI: https://doi.org/10.1055/s-0040-1709650
Lippi, G., Mullier, F., & Favaloro, E. J. (2023). D-dimer: old dogmas, new (COVID-19) tricks. Clinical Chemistry and Laboratory Medicine (CCLM), 61(5), 841-850. https://doi.org/10.1515/cclm-2022-0633
Lippi, G., Plebani, M., & Henry, B. M. (2020). Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: a meta-analysis. Clinica chimica acta, 506, 145-148. https://doi.org/1 https://doi.org/10.1016/j.cca.2020.03.022
Mao, J., Dai, R., Du, R. C., Zhu, Y., Shui, L. P., & Luo, X. H. (2021). Hematologic changes predict clinical outcome in recovered patients with COVID-19. Annals of hematology, 100(3), 675-689. https://doi.org/10.1007/s00277-021-04426-x
Merza, M. A., Al Mezori, A. A. H., Mohammed, H. M., & Abdulah, D. M. (2020). COVID-19 outbreak in Iraqi Kurdistan: The first report characterizing epidemiological, clinical, laboratory, and radiological findings of the disease. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14(4), 547-554. https://doi.org/10.1016/j.dsx.2020.04.047
Merza, M. A., Aswad, S. M., Sulaiman, H. M., Abdulah, D. M., Rasheed, W. S., & Taib, N. I. (2021). Clinical and epidemiological characteristics and outcomes of Coronavirus disease-19 patients in a large longitudinal study. International journal of health sciences, 15(4), 29. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8265303/
Otto, S. P., Day, T., Arino, J., Colijn, C., Dushoff, J., Li, M., & Ogden, N. H. (2021). The origins and potential future of SARS-CoV-2 variants of concern in the evolving COVID-19 pandemic. Current Biology, 31(14), R918-R929. https://doi.org/10.1016/j.cub.2021.06.049
Petrone, L., Petruccioli, E., Vanini, V., Cuzzi, G., Fard, S. N., Alonzi, T., & Goletti, D. (2021). A whole blood test to measure SARS-CoV-2-specific response in COVID-19 patients. Clinical microbiology and infection, 27(2), 286-e7.doi: https://doi.org/10.1016/j.cmi.2020.09.051.
Qin, C., Zhou, L., Hu, Z., Zhang, S., Yang, S., Tao, Y., ... & Tian, D. S. (2020). Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clinical infectious diseases, 71(15), 762-768. https://doi.org/10.1093/cid/ciaa248.
Rostami, M., & Mansouritorghabeh, H. (2020). D-dimer level in COVID-19 infection: a systematic review. Expert review of hematology, 13(11), 1265-1275. https://doi.org/10.1080/17474086.2020.1831383
Sharma, A., Tiwari, S., Deb, M. K., & Marty, J. L. (2020). Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2): a global pandemic and treatment strategies. International journal of antimicrobial agents, 56(2), 106054. https://doi.org/10.1016/j.ijantimicag.2020.106054
Sohrabi, C., Alsafi, Z., O'neill, N., Khan, M., Kerwan, A., Al-Jabir, A., & Agha, R. (2020). World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). International journal of surgery, 76, 71-76. https://doi.org/10.1016/j.ijsu.2020.02.034
Taher, S. M., Abdo, J. M., & Merza, M. A. (2023). Whole Genome Sequence Analysis of SARS-COV-2 Isolated from COVID-19 Patients in Duhok Province, Iraq. https://doi.org/10.20944/preprints202304.0961.v1
Tang, N., Li, D., Wang, X., & Sun, Z. (2020). Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. Journal of thrombosis and haemostasis, 18(4), 844-847. https://doi.org/10.1111/jth.14768
Upadhyay, J., Tiwari, N., & Ansari, M. N. (2020). Role of inflammatory markers in corona virus disease (COVID-19) patients: a review. Experimental Biology and Medicine, 245(15), 1368-1375. https://doi.org/10.1177/1535370220939477
World Health Organization (2022) WHO health emergency dashboard who (covid-19) homepage. Available: https://www.who.int/emergencies/diseases/novel-coronavirus-2019 Accessed: 20 June 2022.
Xie, J., Tong, Z., Guan, X., Du, B., & Qiu, H. (2020). Clinical characteristics of patients who died of coronavirus disease 2019 in China. JAMA network open, 3(4), e205619-e205619. doi: https://doi.org/10.1001/jamanetworkopen.2020.5619
Xu, X., Chen, P., Wang, J., Feng, J., Zhou, H., Li, X., ... & Hao, P. (2020). Evolution of the novel coronavirus from the ongoing Wuhan outbreak and modeling of its spike protein for risk of human transmission. Science China Life Sciences, 63, 457-460. https://doi.org/10.1007/s11427-020-1637-5 Zhou, P., Yang, X. L., Wang, X. G., Hu, B., Zhang, L., Zhang, W., & Shi, Z. L. (2020). A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature, 579(7798), 270-273. https://doi.org/10.1038/s41586-020-2012-7
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Nishtiman Younis Mosa , Dilan Jassim Khalil, Sameera A. Othman, Jasem M. Abdo, Adil A. Othman
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License [CC BY-NC-SA 4.0] that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work, with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online.
