Abstract

Dysregulated inflammation and hypercoagulability underlie the development of severe illness in COVID-19. Biomarkers related to inflammasome activation, including interleukin (IL)-1β and NLRP3, and inflammatory lung cytokine as IL-8. As well as coagulation markers like D-dimer. The aim of this study was to identify associations between the dysregulated immune response biomarkers and the severity of the disease that will help in prognostic and potential therapeutic utility. Twenty five mild/moderate and 25 severe COVID-19 patients were included in this study as well as 25 healthy controls. Survival analysis was done after follow up for one month. Inflammasome (IL-1β, NLRP3), lung cytokine (IL-8), and vitamin D levels were analyzed by real time PCR and ELISA. The mRNA expression levels of IL-1β , NLRP3 and serum level of IL-8 were elevated in cases than controls. COVID-19 patients exhibited lower levels of vitamin D. The severe group showed significant higher levels of D dimer and ferritin. Correlation analyses indicated associations between IL-1β , NLRP3, IL-8, D-dimer and ferritin. ROC curve analyses demonstrated the potential of IL-1β , NLRP3 and IL-8 in distinguishing between mild/moderate and sever cases. Survival analyses indicated a link between high levels of IL-1β , NLRP3 and IL-8 with decreased survival.. The inflammasome appears pivotal in orchestrating detrimental hyperinflammation in severe COVID-19. IL-1β holds particular potential as a prognostic indicator of poor outcomes. In the future, the possible using of these biomarkers inhibitors may improve survival , decrease severity and improve management of the cases.

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