Abstract
As the COVID-19 (Coronavirus disease 19) pandemic spreads worldwide, the massive numbers of COVID-19 patients have created a considerable healthcare burden for every country. The clinical spectrum of SARS-CoV-2 infection is broad, ranging from asymptomatic to mild, moderate, severe, and critical. Most COVID-19 patients present with no or mild symptoms, but nearly one-fifth of all patients develop severe or life-threatening complications. In addition to localized respiratory manifestations, severe COVID-19 cases also show extra-pulmonary complications or induce multiorgan failure. Identifying, triaging, and treating patients at risk early is essential and urgent. This article reviews the potential prognostic value of various biomarkers at different clinical spectrum stages of COVID-19 infection and includes information on fundamental prognostic mechanisms as well as potential clinical implications. Biomarkers are measurable biochemical substances used to recognize and indicate disease severity or response to therapeutic interventions. The information they provide is objective and suitable for delivering healthcare providers with a means of stratifying disease state in COVID-19 patients. This, in turn, can be used to help select and guide intervention efforts as well as gauge the efficacy of therapeutic approaches. Here, we review a number of potential biomarkers that may be used to guide treatment, monitor treatment efficacy, and form individualized therapeutic guidance based on patient response. Implementation of the COVID-19 biomarkers discussed here may lead to significantly improved quality of care and patient outcomes for those infected with SARS-CoV-2 worldwide.
Highlights
COVID-19 (Coronavirus disease 19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, originated in Wuhan, China, in 2020 and quickly grew to pandemic levels, infecting approximately three hundred million people and claiming approximately five million lives worldwide [1]
Thromboembolic events, and direct viral invasion compromise the cardiovascular system in COVID-19 patients, as do particular medication side-effects and hospital-acquired infections [91,92]
Epidemiological evidence indicates that 12% to 20% of hospitalized patients with COVID-19 have cardiac injuries, as implied by raised cardiac troponin levels [91,94]
Summary
COVID-19 (Coronavirus disease 19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, originated in Wuhan, China, in 2020 and quickly grew to pandemic levels, infecting approximately three hundred million people and claiming approximately five million lives worldwide [1]. These markers have various potential benefits: (1) identification and recognition of at-risk patients; (2) stratification of COVID-19 severity; (3) assistance in the establishment of admission or intensive care criteria; (4) treatment guidance via response assessment; (5) prognosis evaluation; and (6) ICU or ordinary ward discharge criteria framing [9] These biomarkers can be sorted into different categories: (1) host immune response markers that are immunological and inflammatory in nature; (2) hematological abnormality markers; and (3) end-organ injury and systemic response markers including, but not limited to, coagulation factors, cardiac enzymes, and renal function markers [9,13]. Lymphopenia, Neutrophilia Decreased CD4+ CD8+ Decreased NK cell or B cell Neutrophil to Lymphocyte ratio Eosinopenia Thrombocytopenia
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