Correlation between COVID-19 and biochemical laboratory markers: Serum ferritin, procalcitonin, troponine and some enzymes for Iraqi patients

Coronaviruses (COVID) are a genus of viruses that really are capable of infecting a wide variety of animals and causing moderate to severe respiratory pathogens. Two highly virulent viral diseases with zoonotic origins, SARS-CoV and MERS-CoV, respectively, that suddenly appeared in living beings and causes fatal lung infection, bring starting to emerge COVID-19 into the 20th century as a novel public health issue. Our study aimed at the detection of the relationship of some biochemical markers with COVID-19 infection in AL-Anbar governorate/Iraq. Patients who had COVID-19 confirmed at Al-Ramadi Teaching Hospital in Anbar, Iraq, study period from April to December 2021, The study covers 100 Iraqi patients (60 patients was COVID-19 and 40 normal subject samples with age range 20 to 70 years. All of the patients who had COVID-19 were positive for the virus that was confirmed by polymerase chain reaction test. The patients and healthy subjects were divided into four groups according to COVID-19 IgM values. The mild group (IgM 1.0-2.0, N= 25 patients), moderate group (2.0< IgM ≤ 4.0, N=18 patients) and severe groups (IgM >4.0, N= 17 patients) were comparison with controls (IgM <1.0, N= 40 patients) of matched age. The control group in these investigations was seemingly healthy samples taken from a local lab in Al-Anbar, as well as healthy people (no previous or current infection with COVID-19). The person's name, age, sex, symptoms, and drug history should all be written down in a file. The average age of the subjects in the study was 65 years old and patients more than 55 years were at higher risk of developing COVID-19. Among of them 17 patients (33.5 %) had extreme to severe stages that required ICU treatment and more than half of them died later. The number of male patients exposed to infection is approximately 70% higher than the number of female patients, who recorded 30%. On the other hand, when comparing between the studies groups, a significant association was reported between biochemical parameters study and severity of COVID-19. The results was finding that Ferritin; AUC: 0.969 with 86% sensitivity and 100% specificity, Procalcitonin; AUC: 0.926 with 100% sensitivity and 89.5% specificity, cardiac troponin I; AUC: 0.988 with 100% sensitivity and 94.7% specificity, Alanine transaminase; AUC: 0.957, with 87.9% sensitivity and 100% specificity, Aspartate transaminase; AUC: 0.764, with 81.8% sensitivity and 71.4% specificity, Alkaline phosphatase; AUC: 0.807, with 69.7% sensitivity and 100% specificity. Lactate dehydrogenase AUC: 0.974, with 97% sensitivity and 100% specificity. Urea AUC: 0.958, with 95% sensitivity and 87.5% specificity and Creatinine AUC: 0.88, with 95% sensitivity and 68.7% specificity. The results demonstrate that patients with diabetes, asthma, hypertension and cardiac disease were at higher risk of developing COVID-19. The patients with COVID-19 symptoms and sign such as fever and dry cough were at higher risk of developing COVID-19 (55% and 78% respectively). Infection with COVID-19 may increase within advanced age especially at 55 years and over in Iraqi patients. Comorbidities showed a significant between severe, mild, and moderate cases in patients with diabetes, hypertension, and cardiac disease. Also highly significant appeared in asthma cases while non-significant may be shown in smoking patients. With current values of procalcitonine > 0.5 ng/mL, and ferritin > 600 μg/L, cardiac troponin I >1600 ng/L indicates that COVID-19 is progressing to a critical stage, which should be continuously monitored and perhaps averted. Monitoring renal function tests, liver and cardiac enzymes, over the course of mild to severe illness is essential because of the possibility of further harm owing to consequences and treatment.