Inflammatory Profile in Omicron Variant-Associated Covid-19: Evaluating Biomarkers for Severity Prediction
Keywords:
COVID-19, CRP, D-Dimer, WBCs, biomarkers, severityAbstract
Background: The COVID-19 pandemic demands effective biomarkers for assessing disease
severity. C-reactive protein (CRP), D-Dimer, and White Blood Cell counts (WBCs) have
emerged as potential indicators of COVID-19 severity and prognosis.
Materials and Methods: This study, conducted at Qalla Hospital, enrolled 112 confirmed
COVID-19 patients and 35 healthy controls. Comprehensive clinical and laboratory evaluations
included CRP, D-Dimer, and WBC measurements. Diagnosis of COVID-19 followed established
clinical criteria and confirmed through SARS-CoV-2 testing. Rigorous assessments were
conducted to ensure precise participant classification.
Results: Significantly elevated CRP (p-value=0.0001), D-Dimer (p-value=0.0001), and WBCs
were observed in COVID-19 patients compared to healthy controls. Elevated CRP levels
indicating inflammation, increased D-Dimer levels associated with coagulation abnormalities,
and raised WBCs within CRP level (0.943) indicative of an immune response were prevalent in
COVID-19 patients. Gender distribution was balanced, while comorbidities such as diabetes
mellitus (25%), hypertension (34.8%), kidney disease (6.2%), and multiple concurrent diseases
(34%) were prevalent in the COVID-19 cohort.
Discussion: The substantial differences in CRP, D-Dimer, and WBCs underscore their
potential as valuable biomarkers for diagnosing and monitoring COVID-19 severity. These
biomarkers could serve as critical tools in evaluating disease progression, predicting
complications, and guiding tailored therapeutic interventions. Conclusion: CRP, D-Dimer, and
WBCs exhibited marked disparities between healthy individuals and COVID-19 patients,
indicating their potential as diagnostic and prognostic indicators. Continued investigation into
these biomarkers' utility may refine risk stratification and treatment strategies, ultimately
improving patient outcomes in COVID-19 management. Understanding the clinical implications
of CRP, D-Dimer, and WBC levels could profoundly impact disease management and patient
care strategies.
References
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li
H, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan,
China: a retrospective cohort study. Lancet [Internet]. Elsevier Ltd; 2020; 395: 1054–62. doi:
1016/S0140-6736(20)30566-3.
Jiang F, Deng L, Zhang L, Cai Y, Cheung CW, Xia Z. Review of the Clinical Characteristics of
Coronavirus Disease 2019 (COVID-19). J Gen Intern Med. Journal of General Internal Medicine; 2020;
: 1545–9. doi: 10.1007/s11606-020-05762-w.
Gavriatopoulou M, Ntanasis-Stathopoulos I, Korompoki E, Fotiou D, Migkou M, Tzanninis IG,
Psaltopoulou T, Kastritis E, Terpos E, Dimopoulos MA. Emerging treatment strategies for COVID-19
infection. Clin Exp Med [Internet]. Springer International Publishing; 2021; 21: 167–79. doi:
1007/s10238-020-00671-y.
Machhi J, Herskovitz J, Senan AM, Dutta D, Nath B, Oleynikov MD, Blomberg WR, Meigs DD,
Hasan M, Patel M, Kline P, Chang RCC, Chang L, et al. The Natural History, Pathobiology, and Clinical
Manifestations of SARS-CoV-2 Infections. J Neuroimmune Pharmacol. Journal of Neuroimmune
Pharmacology; 2020; 15: 359–86. doi: 10.1007/s11481-020-09944-5.
Ali HN, Ali KM, Rostam HM, Ali AM, Tawfeeq HM, Fatah MH, Figueredo GP. Clinical
laboratory parameters and comorbidities associated with severity of coronavirus disease 2019 (COVID19) in Kurdistan Region of Iraq. Pract Lab Med [Internet]. Elsevier B.V.; 2022; 31: e00294. doi:
1016/j.plabm.2022.e00294.
Gandhi RT, Lynch JB, del Rio C. Mild or Moderate Covid-19. N Engl J Med. 2020; 383: 1757–
doi: 10.1056/nejmcp2009249.
Matsunaga N, Hayakawa K, Terada M, Ohtsu H, Asai Y, Tsuzuki S, Suzuki S, Toyoda A, Suzuki
K, Endo M, Fujii N, Suzuki M, Saito S, et al. Clinical Epidemiology of Hospitalized Patients with
Coronavirus Disease 2019 (COVID-19) in Japan: Report of the COVID-19 Registry Japan. Clin Infect
Dis. 2021; 73: E3677–89. doi: 10.1093/cid/ciaa1470.
Ahmed M, Saeed H, Ali AM, Ali KM, Rostam HM. The Impact of Smoking on COVID-19
Severity : A Multi-Analysis Study. 2023; 6: 229–39.
Ali AM, Tofiq AM, Rostam HM, Ali KM, Tawfeeq HM. Disease severity and efficacy of
homologous vaccination among patients infected with SARS-CoV-2 Delta or Omicron VOCs, compared
to unvaccinated using main biomarkers. J Med Virol. 2022; 94: 5867–76. doi: 10.1002/jmv.28098.
Zheng Z, Peng F, Xu B, Zhao J, Liu H, Peng J, Li Q, Jiang C, Zhou Y, Liu S, Ye C, Zhang P,
Xing Y, et al. Risk factors of critical & mortal COVID-19 cases: A systematic literature review and metaanalysis. J Infect. Elsevier Ltd; 2020; 81: e16–25. doi: 10.1016/j.jinf.2020.04.021.
Ali AM, Abdlwahid RF, Ali KM, Mahmood KI, Rashid PMA, Rostam HM. The influence of
SARS-CoV-2 on male reproduction and men’s health. Eur J Clin Invest. 2023; : 1–11. doi:
1111/eci.14097.
Ali AM, Tofiq AM, Rostam HM, Ali KM TH. Corrigendum on “Disease severity and efficacy of
homologous vaccination among patients infected with SARS-CoV-2 Delta or Omicron VOCs, compared
to unvaccinated using main biomarkers.” . J Med Virol. : :5867-5876. doi: doi: 10.1002/jmv.28824.
Ponti G, Maccaferri M, Ruini C, Tomasi A, Ozben T. Biomarkers associated with
COVID-19 disease progression. Crit Rev Clin Lab Sci [Internet]. Taylor & Francis; 2020; 0: 389–99. doi:
1080/10408363.2020.1770685.
Shrestha MR, Basnet A, Tamang B, Khadka S, Maharjan R, Maharjan R, Chand AB,
Thapa S, Rai SK. Analysis of altered level of blood-based biomarkers in prognosis of COVID-19
patients. PLoS One [Internet]. 2023; 18: 1–11. doi: 10.1371/journal.pone.0287117.
Ali AM, Ali KM, Fatah MH, Tawfeeq HM, Rostam HM. SARS-CoV-2 reinfection in
patients negative for immunoglobulin G following recovery from COVID-19. New Microbes New Infect
[Internet]. Elsevier Ltd; 2021; 43: 100926. doi: 10.1016/j.nmni.2021.100926.
Ali KM, Rashid PMA, Ali AM, Tofiq AM, Salih GF, Dana OI, Rostam HM. Clinical outcomes
and phylogenetic analysis in reflection with three predominant clades of SARS-CoV-2 variants. Eur J
Clin Invest. 2023; : 1–15. doi: 10.1111/eci.14004.
Chemaitelly H, Nagelkerke N, Ayoub HH, Coyle P, Tang P, Yassine HM, Al-Khatib HA, Smatti
MK, Hasan MR, Al-Kanaani Z, Al-Kuwari E, Jeremijenko A, Kaleeckal AH, et al. Duration of immune
protection of SARS-CoV-2 natural infection against reinfection. J Travel Med. 2022; 29: 1–11. doi:
1093/jtm/taac109.
Fateh, Hawal Lateef, Negin Kamari, Ayad M. Ali, Jalal Moludi and SR. . “Association between
diet quality and BMI with side effects of Pfizer-BioNTech COVID-19 vaccine and SARS-CoV-2
immunoglobulin G titers.” Nutr Food Sci. 2023; 53: 738–51. doi: doi/10.1108/NFS-09-2022-
/full/html.
Europe E, Control EC for DP and. Risk of SARS-CoV-2 transmission from newly-infected
individuals with documented previous infection or vaccination. Tech Rep [Internet]. 2021; : 23. Available
Ali KM, Ali AM, Tawfeeq HM, Figueredo G, Rostam HM. Hypoalbuminemia in Patients
Following Their Recovery from Severe Coronavirus Disease 2019. J Med Virol [Internet]. 2021; : 0–2.
doi: 10.1002/jmv.27002.
Schneider M. The Role of Biomarkers in Hospitalized COVID-19 Patients With Systemic
Manifestations. Biomark Insights. 2022; 17. doi: 10.1177/11772719221108909.
Ali AM, Rostam HM, Fatah MH, Noori CM, Ali KM, Tawfeeq HM. Serum troponin, D-dimer,
and CRP level in severe coronavirus (COVID-19) patients. Immunity, Inflamm Dis. 2022; 10: 1–10. doi:
1002/iid3.582.
Yamamoto A, Wada H, Ichikawa Y, Mizuno H, Tomida M, Masuda J, Makino K, Kodama S,
Yoshida M, Fukui S, Moritani I, Inoue H, Shiraki K, et al. Evaluation of biomarkers of severity in
patients with COVID-19 infection. J Clin Med. 2021; 10: 4–11. doi: 10.3390/jcm10173775.
Debi H, Itu ZT, Amin MT, Hussain F, Hossain MS. Association of serum C-reactive protein
(CRP) and D-dimer concentration on the severity of COVID-19 cases with or without diabetes: a
systematic review and meta-analysis. Expert Rev Endocrinol Metab [Internet]. Taylor & Francis; 2022;
: 83–93. doi: 10.1080/17446651.2022.2002146.
Elibol E, Baran H. The relation between serum D-dimer, ferritin and vitamin D levels, and
dysgeusia symptoms, in patients with coronavirus disease 2019. J Laryngol Otol. 2021; 135: 45–9. doi:
1017/S0022215120002765.
Ali ET, Jabbar AS, Al Ali HS, Hamadi SS, Jabir MS, Albukhaty S. Extensive Study on
Hematological, Immunological, Inflammatory Markers, and Biochemical Profile to Identify the Risk
Factors in COVID-19 Patients. Int J Inflam. 2022; 2022. doi: 10.1155/2022/5735546.
Lee YK, Haam JH, Cho SH, Kim YS. Cross-Sectional and Time-Dependent Analyses on
Inflammatory Markers Following Natural Killer Cell Activity. Diagnostics. 2022; 12: 1–11. doi:
3390/diagnostics12020448.
Ali, A.M., Tofiq, A.M., Rostam, H.M., Ali, K.M. and Tawfeeq, H.M. Response to comments to
the editor on" Disease severity and efficacy of homologous vaccination among patients infected with
SARS-CoV-2 Delta or Omicron VOCs, compared to unvaccinated using main biomarkers". J Med Virol.
; 95: P.e28820.
Cohort-study AP, Smail SW, Babaei E, Amin K, Smail SW. Predictors for Severity and Mortality
in COVID-19 : Hematological , Inflammatory , Coagulation , and Oxidative / Antioxidant Biomarkers as
Predictors for Severity and Mortality in COVID-19 : A Prospective Cohort-Study. 2023; . doi:
2147/IJGM.S402206
Downloads
Published
Issue
Section
License
Copyright (c) 2024 University of Thi-Qar Journal Of Medicine
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
