Marker In COVID-19 Patients Research Articles

Investigation of Biochemical and Inflammatory Markers in COVID-19 Patients Hospitalized in the Intensive Care Unit: An Observational Study in Northern Iran

Background: Since the first documentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), there has been a notable emphasis on it in a brief period, especially as the mortality rate and confirmed cases steadily rise. The rapid and accurate laboratory identification of an ongoing COVID-19 infection is essential for efficient pandemic control. For diagnostic purposes, various testing methods have been developed to detect the severity of COVID-19. These diagnostic methods play a crucial role in identifying and managing the spread of the virus within communities worldwide. Methods: This cross-sectional observational study was conducted from February to June 2020, spanning four months. Patient clinical records and laboratory biomarkers data were collected. Results: In this study, 263 patients were involved, with an average age of 59.38 ± 15.26 years, and 51.3% of them (135 patients) were male. The typical hospital stay was 9.25 ± 6.9 days. The patients were divided into three groups: Those who survived (49.4%), those receiving treatment (4.9%), and those who did not survive (45.6%), with all treated patients surviving. An important connection was observed between serum lactate dehydrogenase (LDH), creatine phosphokinase (CPK), urea, leukocytosis, lymphopenia, high polymorphonuclear neutrophil (PMN) counts, and poor patient outcomes (P-value < 0.05). Elevated aspartate transaminase (AST) levels also showed a close relationship with adverse outcomes (P-value = 0.05). Furthermore, most patients with hyponatremia, high fasting blood glucose, and elevated serum creatinine levels did not survive, despite lacking statistical significance. Conclusions: Serum biomarkers serve as prognostic indicators for the severity of COVID-19 patients. Leveraging these markers aids in promptly diagnosing patients at high mortality risk and facilitates more effective treatments in the disease's initial phases. These biomarkers can help healthcare providers identify patients at higher risk of complications and guide the implementation of targeted interventions to improve patient outcomes.

Effects of Non-invasive Vagus Nerve Stimulation on Inflammatory Markers in COVID-19 Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

The international healthcare community has encountered several difficulties because of the COVID-19 pandemic brought on by SARS-CoV-2. COVID-19 can lead to an abnormal immune response that features excessive inflammation, so targeting the vagus nerve through non-invasive vagus nerve stimulation (nVNS) may hold promise as an intervention. This meta-analysis aimed to examine the outcomes of using nVNS on different inflammatory biomarkers in COVID-19 patients. Up until May 2023, we performed a review of online databases. We included randomized controlled trials (RCTs) that discussed how nVNS affected patients with COVID-19's clinical outcomes. Using the Revman 5.4 software (Cochrane, London, United Kingdom), a meta-analysis was carried out to find the pooled mean difference (MD), with 95% confidence intervals (CIs), of nVNS effects on different inflammatory biomarkers, including interleukin-10 (IL-10), C-reactive protein (CRP), IL-6, and cortisol levels. The review included four RCTs involving 180 COVID-19 patients. Following nVNS treatment, there was a significant increase in IL-10 levels (MD = 1.53, 95% CI: 0.77, 2.29; p < 0.001). CRP levels (MD = -2.24, 95% CI: -4.52, 0.05; p = 0.06), IL-6 levels (MD = 4.07, 95% CI: -3.16, 11.32; p = 0.27), cortisol levels (MD = 1.45, 95% CI: -11.67, 14.57; p = 0.83), and D-dimer levels (MD = -0.47, 95% CI: -1.31, 0.38; p = 0.28) did not differ significantly. These findings suggest that nVNS may positively impact certain inflammatory markers in COVID-19 patients, suggesting that nVNS could be a beneficial adjunctive treatment.

Impact of Omega-3 Fatty Acid Supplementation in Parenteral Nutrition on Inflammatory Markers and Clinical Outcomes in Critically Ill COVID-19 Patients: A Randomized Controlled Trial.

The heightened inflammatory response observed in COVID-19 patients suggests that omega-3 fatty acids (O3FA) may confer anti-inflammatory benefits. This randomized, double-blind, single-center clinical trial aimed to evaluate the effect of O3FA supplementation in parenteral nutrition (PN) on inflammatory markers in COVID-19 patients admitted to the intensive care unit (ICU). A total of 69 patients were randomized into three groups: one received standard lipid emulsion, and two received O3FA (Omegaven®) at doses of 0.1 g/kg/day and 0.2 g/kg/day, respectively, in addition to Smoflipid®. The primary outcomes measured were serum levels of C-reactive protein (CRP) and interleukin-6 (IL-6) on days 1, 5, and 10 of PN initiation. Secondary outcomes included additional inflammatory markers (TNF-α, IFN-γ, IL-1Ra, CXCL10), hepatic function, triglyceride levels, and clinical outcomes such as mortality and length of ICU and hospital stay. Results indicated a significant reduction in CRP, IL-6, and CXCL10 levels in the group receiving 0.1 g/kg/day O3FA compared to the control. Additionally, the higher O3FA dose was associated with a shorter ICU and hospital stay. These findings suggest that O3FA supplementation in PN may reduce inflammation and improve clinical outcomes in critically ill COVID-19 patients.

Food-derived antioxidants intake association with serum oxidative stress markers and lung infection symptoms in COVID-19 infectious angina patients

PurposeResearch indicated that dietary antioxidants could improve immune system performance. This study aims to investigate the association of COVID-19 symptoms, total antioxidant capacity and serum inflammatory markers, with dietary antioxidants intake among angina patients.Design/methodology/approachA food frequency questionnaire was used in a cross-sectional study among 135 angina patients with COVID-19, to assess dietary antioxidants consumption. Serum levels of tumor necrosis factor, interleukin 1ß, malondialdehyde, high-sensitivity C-reactive protein and total antioxidant capacity were measured by enzyme-linked immunosorbent assay methods.FindingsAmong study angina patients, 76.67% followed unhealthy food patterns and 23.33% followed anti-inflammatory dietary patterns before hospitalization. The angina patients with anti-inflammatory food pattern had less fever (p = 0.021), cough (p = 0.018), dyspnea (p = 0.024), diarrhea (p = 0.014) and pneumonia severity index (p = 0.014) compared to patients with unhealthy food pattern. The serum levels of tumor necrosis factor, interleukin 1ß, high-sensitivity C-reactive protein and malondialdehyde, had a significantly negative association with dietary antioxidants intake (p < 0.05).Originality/valueThere are significant association between antioxidant intake with serum inflammation markers in COVID-19 patients. There is a need for more clinical trial studies for approval of these results.

The effect of tocilizumab administration on inflammatory markers in COVID-19 patients

BackgroundThe COVID-19 outbreak was declared a worldwide emergency as a result of its rapid spread. The number of people infected with COVID-19 is increasing rapidly around the world, and pneumonia can develop in COVID-19 cases. The monoclonal antibody tocilizumab blocks the interleukin-6 receptor, which in turn reduces inflammation.Aimof the workThe study aims to determine how tocilizumab affects inflammatory markers, laboratory indices, and oxygen therapy.Subjects and methodsThis retrospective observational study aimed to assess the effect of tocilizumab on inflammatory markers, laboratory parameters, and short-term outcomes in COVID-19 cases. Data was collected from 55 patients with COVID-19 who tested positive for SARS-CoV-2 using PCR. These patients were admitted to Ain Shams University Specialized Hospital—Obour between June 1, 2021, and May 31, 2022.ResultsAfter tocilizumab administration, C-reactive protein levels decreased significantly, but there was no statistically significant change in hemoglobin, serum ferritin, or D-dimer levels. Following tocilizumab administration, the leukocyte counts, and platelet count increased significantly. There was a significant correlation between the presence of comorbidities in the studied patients (e.g., heart failure, post-renal transplantation, and hepatitis C virus) and the risk of mortality. The study's final result showed a significant decrease in platelet count in dead patients compared to discharged patients after receiving tocilizumab. Regarding oxygen therapy following tocilizumab administration, the use of face masks and non-rebreather facemasks was high in dead patients, while nasal prong usage was high in discharged patients. After receiving tocilizumab, there was an increase in the mean liters of oxygen required in dead patients compared to discharged patients.ConclusionAfter administration of tocilizumab in COVID-19 hospitalized patients who have progressing disease, there was highly and significantly decrease in CRP level with no statistically significant alteration in the levels of hemoglobin, serum ferritin, and D-dimer and an increase in TLC and platelets was observed. Following tocilizumab administration, there was a decrease in oxygen demands, an improvement in oxygen therapy and oxygen saturation. Tocilizumab is a recommended therapy option.

SARS-CoV-2 Infection Positively Correlates with Hyperglycemia and Inflammatory Markers in COVID-19 Patients: A Clinical Research Study.

Diabetes mellitus (DM) is a common comorbidity in COVID-19 subjects. Hyperglycemia at hospital admission identified as a major risk factor and is responsible for poor prognosis. Hematological and inflammatory parameters have been recognized as predictive markers of severity in COVID-19. In this clinical study, we aimed to assess the impact of hyperglycemia at hospital admission on hematological and several inflammatory parameters in COVID-19 patients. A total of 550 COVID-19 subjects were primarily categorized into two major groups (normoglycemic and hyperglycemic) based on random blood sugar levels. On the first day of hospitalization, subjects' oxygen saturation, random blood sugar, hematological variables, and inflammatory parameters were recorded. The hyperglycemic group exhibited higher levels of serum ferritin, total leukocyte count (TLC), lactate dehydrogenase (LDH), neutrophil count, and neutrophil-to-lymphocyte ratio (NLR). In contrast, oxygen saturation and lymphocyte count were lower compared to the normoglycemic group. Significantly elevated levels of hematological variables (TLC, neutrophil count, NLR) and inflammatory parameters (serum ferritin) were observed in the hyperglycemic group. Among inflammatory parameters, only serum ferritin levels showed statistical significance. This study supports the clinical association between hyperglycemia and an increased severity of COVID-19. Consequently, the identification of these parameters is a crucial and valuable prognostic indicator for assessing disease severity in hyperglycemic subjects.

Estimation of some Inflammatory Markers in Covid-19 Patients in Erbil / City

Estimation of some Inflammatory Markers in Covid-19 Patients in Erbil / City

Correlation study of CBC derivatives and biochemical prognostic marker in covid-19 patients

: SARS-CoV2 infection induces inflammatory responses and acute lung injury in human beings. Infection causes certain haematological and biochemical changes in patients. This study aimed analyze the correlation between CBC derivatives and biochemical prognostic marker in COVID-19.: Total 80 individuals selected, 50 COVID-19 positive patients and 30 subjects negative for COVID-19 RT-PCR test. Blood collected was sent to NLR, RDW, assayed in Beckman Coulter DxH 800. Serum CRP estimated by Immuno-turbidimetric method, ferritin by CLIA. Plasma collected estimate for D-DIMER by CLIA. Unpaired T test &amp; Pearson correlation (IBM SPSS 22.0) were used. : Elevated levels of NLR (p value &amp;#60;0.001), RDW (p value &amp;#60;0.001), FERRITIN (p value &amp;#60;0.001), D-D-DIMER (p value &amp;#60;0.001), CRP (p value &amp;#60;0.001) some research parameters like LHD and RSF show significant decrease. In current study the NLR positively correlate to CRP (r value=0.5, p value &amp;#60;0.001), NLR positively correlate to D-DIMER (r value=0.3, p value&amp;#60;0.05), RDW positively correlated to CRP (r value=, 0.3, p value &amp;#60;0.05), RDW negatively correlated to ferritin (r value=-0.439, p value &amp;#60;0.001)LHD negatively correlated ferritin (r value=-0.316, p value=&amp;#60;0.05), MAF negatively correlated to D-dimer (r value=-0.244 &amp;#60;0.05), MSCV positively correlated with CRP (r value=0.336, p value= &amp;#60;0.05).: The cytokine storm produced during covid-19 infection which inturn develop neutrophilia and lymphopenia, CRP production and also cause elevation of procoagulants &amp;D-dimer. RDW and CRP are positively correlated they are elevated during inflammatory conditions.RDW and FERRITIN show negative correlation. Retrospective study have some limitation so future studies will reveal more information.

Does COVID-19 affect thyroid more than non-COVID-19 infections? A retrospective study

Abstract Objectives To evaluate the thyroid hormone levels and infection markers in COVID-19 patients and compare them to those in non-COVID-19 patients with infection in a large retrospective dataset. Methods In this study, thyroid-stimulating hormone (TSH), thyroid hormones (free T3 and free T4), and several infection markers were reviewed. The study group was divided into three groups that had no thyroid-related disorders: control patients (Group 0; n=7,981), COVID-19 patients (Group 1; n=222), and non-COVID-19 patients with infection (Group 2; n=477). The data were assessed for correlation and group comparisons. Results There was a reduction in median (25th–75th percentile) fT3 levels in COVID-19 patients 4.17 pmol/L (3.46–4.85) compared to non-COVID-19 patients with infection 4.65 pmol/L (4.12–5.15), p&lt;0.0001. We detected a negative correlation between fT3 and neutrophil-to-lymphocyte ratio (NLR) in Group 1 (r=−0.534) and Group 2 (r=−0.346) (p&lt;0.0001), indicating a relatively stronger link between fT3 and NLR in COVID-19 patients than non-COVID-19 patients with infection. Additionally, the fT3 levels remained significantly different between study groups when the model was adjusted for age, gender, and infection markers. Conclusions COVID-19 and non-COVID-19 infections are associated with low fT3 levels, which likely represent the suppression of the hypothalamic-pituitary-thyroid axis from non-thyroidal illness syndrome.

D-dimer level and inflammatory markers in COVID-19 patients with and without diabetes mellitus - A comparative study during the first wave of the pandemic

Introduction and Aim: High prevalence of diabetes mellitus makes it crucial to understand the distinctive inflammatory features of COVID-19 infection. Hyperglycemia and diabetes mellitus are independent prognosticators for mortality and morbidity in SARS-CoV-2 infection. This study compares D-dimer and inflammatory markers in COVID-19 patients with and without T2DM during the first wave of the pandemic. Materials and Methods: A retrospective study was conducted at a tertiary care hospital. D-dimer, IL-6, Ferritin, CRP and LDH levels in COVID-19 patients with and without T2DM were compared. D-dimer values were correlated with the IL-6, Ferritin, CRP, LDH and checked for statistical evidence. HbA1c levels were assessed for association of the severity of COVID-19 infection. Results: Serum levels of inflammatory biomarkers of 205 COVID-19 patients were compared in which 106 had T2DM and 99 were non- diabetic. Ferritin and LDH showed statistically significant elevation in diabetic COVID-19 patients. D-dimer showed positive correlation with all the inflammatory markers both in diabetic and non-diabetic COVID-19 patients. HbA1c showed statistically significant positive correlation only with Ferritin in COVID-19 patients with T2DM. Conclusion: Ferritin was significantly associated with severity of diabetes as indicated by correlation to HbA1c. D-dimer, Ferritin, IL-6 and LDH levels were significant in COVID 19 patients having diabetes and those without.

Soluble Endoglin and Syndecan-1 levels predicts the clinical outcome in COVID-19 patients

Endothelial instability is reported to be involved in the pathogenesis of COVID-19. The mechanism that regulates the endothelial dysfunction and disease virulence is not known. Studies on proteins that are released into circulation by activated endothelial cells may provide some means to understand the disease manifestation. The study investigated the circulating levels of two molecules Endoglin (Eng) and Syndecan-1 (SDC-1) that are presumed to be involved in the maintenance of endothelial integrity and their association with hypercoagulation marker in COVID-19 patients. The serum levels of Eng, SDC-1, D-mer were evaluated using ELISA at the time of admission (DOA) and day 7 post-admission among COVID-19 patients (N = 39 with 17 moderate and 22 severe cases). Compared to the time of admission, there was an increase in sEng and sSDC1 levels in all COVID-19 cases on day 7 post admission. The serum levels of sEng and sSDC-1 was significantly (P ≤ 0.001 & P ≤ 0.01 respectively) elevated in severe cases including the four deceased group compared to moderate cases on day 7 post admission. Further, the study molecules showed a strong positive association (P ≤ 0.001) with the hypercoagulation marker D-mer. The results show an early shedding of the endothelial proteins sEng and sSDC-1 into circulation as a host response to the viral infection during the febrile phase of infection. Increased levels of sEng and sSDC-1 along with D-mer could be beneficial in predicting COVID-19 disease severity.

Role of RBC Indices as Prognostic Markers in COVID-19 Patients

Role of RBC Indices as Prognostic Markers in COVID-19 Patients

Characteristics and biomarkers associated with mortality in COVID-19 patients presenting to the emergency department.

This study aimed to investigate the diverse clinical manifestations and simple early biomarkers predicting mortality of COVID-19 patients admitted to the emergency department (ED). A total of 710 patients with COVID-19 were enrolled from 6,896 patients presenting to the ED between January 2022 and March 2022. During the study period, a total of 478 patients tested positive for COVID-19, among whom 222 (46.4%) presented with extrapulmonary manifestations of COVID-19; 49 (10.3%) patients displayed gastrointestinal manifestations, followed by neurological (n=41; 8.6%) and cardiac manifestations (n=31; 6.5%). In total, 54 (11.3%) patients died. A Cox proportional hazards model revealed that old age, acute kidney injury at presentation, increased total leukocyte counts, low platelet counts, decreased albumin levels, and increased LDH levels were the independent predictors of mortality. The albumin levels exhibited the highest area under the curve in receiver operating characteristic analysis, with a value of 0.860 (95% confidence interval, 0.796-0.875). The study showed the diverse clinical presentations and simple-to-measure prognostic markers in COVID-19 patients presenting to the ED. Serum albumin levels can serve as a novel and simple early biomarker to identify COVID-19 patients at high risk of death.

The Effects of Colchicine Treatment on Cardiac and Inflammatory Markers in COVID-19 Patients Followed Up in Intensive Care Unit

The Effects of Colchicine Treatment on Cardiac and Inflammatory Markers in COVID-19 Patients Followed Up in Intensive Care Unit

Biochemical Markers in Covid-19 Patients in Tripoli, Libya; A Retrospective Study

Covid 19 can cause fatal pneumonia and serious complications. In the course of the disease the levels of different biochemical parameters increased and these parameters provide important information about the prognosis of the disease. The aim of this study was to investigate these biomarkers and to evaluate the relationship between biochemical parameters and length of stay in Covid 19 patients. A retrospective study was conducted from October 2020 to December 2021. A total of 156 Covid 19 patients hospitalized in Meitiga Military hospital were included. The demographic characteristics, length of stay, and biochemical parameters of the patients were scanned from the hospital's database and patient files and recorded. Patients were grouped according to the length of stay; 1st group: after 3 to 5 days, 2nd group: from 8 to 12 days, and 3rd group: after 13 days and more. Most of admitted cases were males, the majority of the participants were in age above 65 years old. CRP, FER, LDH, and D-dimer were gradually increased to the maximum mean; 131.4±67, 1052.3±710.1, 586±128.9, and 1196.2±409.1, respectively after 8 to 12 days and return to normal range after 13 days. To conclude, there is a positive correlation between the levels of these biomarkers and the prolongation of hospitalization in COVID-19 patients and these parameters can be associated with the severity disease.

INFLAMMATORY MARKER PROFILING IN COVID-19: UNRAVELING COMORBIDITY AND GENDER INFLUENCES

Background: The 2020 WHO-declared COVID-19 pandemic has left a profound global imprint. Notably, inflammatory markers have gained prominence in predicting disease severity, especially concerning the characteristic cytokine storm in severe cases. Alongside, comorbidities and gender have emerged as influential factors in disease outcomes. Thus, unraveling the intricate relationships between inflammatory markers, comorbidities, and gender is pivotal for optimal patient care. This study examines inflammatory marker roles in COVID-19, focusing on comorbidity presence and gender impacts. Methods: Conducted retrospectively at Bengalurus Abhaya Hospital from March 2020 to September 2021, this observational study examined C-reactive protein (CRP), lactate dehydrogenase (LDH), D-Dimer, creatine phosphokinase (CPK), Interleukin-6 (IL-6) and serum ferritin as inflammatory markers in COVID-19 patients. Patient cohorts with and without comorbidities, as well as male and female patients, underwent comparisons. Descriptive statistics, Kruskal-Wallis tests, and t-tests were used for data analysis. Results &amp; Discussion: Among patients with and without comorbidities, no statistically significant differences in inflammatory markers were identified. This finding suggests a complex, indirect relationship between comorbidities and distinct inflammatory responses, as measured by these markers. In contrast, gender-based analysis demonstrated significant variations in CRP, IL-6, CPK, and Ferritin levels among male and female COVID-19 patients. Hormonal, genetic, and immunological variations potentially underlie these disparities, impacting disease severity. This study underscores the intricate interplay between inflammatory markers, comorbidities, and gender within the COVID-19 context. Conclusion: In conclusion, this study advances the comprehension of inflammatory markers in COVID-19 patients. While comorbidities did not exhibit marker-specific links, significant gender-based differences in CRP, IL-6, CPK, and Ferritin levels emerged. This underscores the need for gender-specific investigations in disease progression. Continued research is pivotal to unveil underlying mechanisms and to tailor treatment strategies based on these gender-specific disparities.

Comparison of inflammatory markers in COVID-19 patients- a study based on disease severity groups

Objective: To compare different inflammatory markers in various coronavirus disease 2019 severity groups. Method: The cross-sectional, retrospective, comparative study was conducted at the Central Park Teaching Hospital, Lahore, Pakistan, and comprised data from April to June 2021 of coronavirus disease 2019 inpatients. The data was divided into mild, moderate and severe/critical category using the World Health Organisation interim guidelines. Data was analysed using SPSS 22. Results: Of the 50 patients, 29(58%) were males and 21(42%) were females. The overall mean age was 54.12±21.23 years. The mean age was 62±17.1years in critical group compared to 50±19.7 years in mild and 52±15.9 years in moderate groups. There were 8(16%) patients in the mild group, 16(32%) moderate and 26(52%) in the critical severity group. Mortality was the outcome in 19(38%) cases, and 14(73.7%) of them were in the critical group (p=0.03). C reactive protein, interleukin-6, serum ferritin and D-dimer levels were significantly different among the groups (p&lt;0.05). Conclusion: Older people were found to have experienced coronavirus disease 2019 in more severe forms. The inflammatory markers were significantly high in patients with severe disease and were associated with high mortality. Key Words: COVID-19, SARS CoV-2, SARS coronavirus, C-reactive protein, Ferritin, Interleukin-6, Acute-phase protein, Severity of illness.

Determination of Serum Calprotectin, Heparin-Binding Protein, and Some Inflammatory Factors in Patients with COVID-19

Background: Among the serum biomarkers of infectious diseases, calprotectin and heparin-binding protein (HBP) seem to be of clinical and diagnostic value in patients with COVID-19. Objectives: This study aimed to investigate the serum levels of calprotectin, HBP, and some other inflammatory markers in COVID-19 patients. Methods: In this case-control study, serum samples of 35 outpatients with COVID-19 and 35 healthy individuals were collected, and the levels of calprotectin, HBP, C-reactive protein (CRP), ferritin (FERR), as well as platelet (PLT) and neutrophil (NEU) counts and LDH activity, were determined. Results: At first, SARS-CoV2 viral RNA was detected in the pharyngeal swab specimens of COVID-19 patients. Calprotectin, FERR, and CRP levels, LDH activity, and PLT and NEU counts were found to be significantly higher in COVID-19 patients compared with controls (P &lt; 0.05), whereas no statistically significant difference was observed in HBP level (P &gt; 0.05). Serum calprotectin showed a significant correlation with CRP and FERR levels, LDH activity, and NEU count (P &lt; 0.001). Conclusions: Our findings showed that an increment in serum calprotectin level, together with increased CRP levels, might be a promising indicator of SARS-CoV2 infection.

Evaluation of cardiac diagnostic tests findings based on pro-BNP levels in COVID-19 pregnant patients.

Pro-b-type natriuretic peptide (Pro-BNP) is an inflammatory marker that indicates cardiac damage and inflammation. The elevation of this marker in COVID-19 patients can be used as a predictive factor in the prognosis of these patients. Our cross-sectional study investigated the evaluation of cardiac diagnostic test findings based on pro-BNP levels in pregnant COVID-19 patients in Sayyad Shirazi Hospital, Gorgan, Iran, in 2020-2022. A hundred and ten pregnant patients diagnosed with COVID-19 infection were evaluated for cardiac diagnostic tests (electrocardiogram (ECG) and echocardiography (Echo)) and pro-BNP levels. Data were analyzed using SPSS 25 software. Chi-square and Student's t-test will be used to test and compare the relationship between variables and compare them. A P-value less than 0.05 is considered statistically significant. The chi-square test was used to compare the ratio of qualitative variables among the groups if the presuppositions of chi-square distribution were established. Otherwise, Fisher's exact test was used. The mean age of participants were 31.06 ± 5.533 years and 49.1% of patients had pro-BNP levels above the cut-off value for predicting an adverse outcome of COVID-19. The mean ± standard deviation of pro-BNP levels in the low group was 46.125 ± 17.523 pg/mL and in the high group was 878.814 ± 1038.060 pg/mL. This study revealed that patients with higher pro-BNP plasma levels had a significant relation between, myocardial infarction (MI), pericardial effusion (PE), urgent Caesarean section (C/S), and mortality. In addition, no significant relation between gravid, trimester, vaccination, arrhythmia, heart block, and valves diseases with high pro-BNP levels was found. The current research showed that pro-BNP levels can be used as a diagnostic and valuable prognostic tool in pregnant women to diagnose cardiac complications by using ECG and Echo.

Influence of Vitamin D Level on Inflammatory and Prognostic Markers in COVID-19 - A Retrospective Study.

The ongoing pandemic of severe acute respiratory syndrome coronavirus 2019 (SARS-CoV-2) has caused an immense public health crisis worldwide. Emerging evidence has suggested that inflammatory response plays a critical role in the pathogenesis and prognosis of the disease. As vitamin D can modulate the immune system, this study has been designed to correlate vitamin D with inflammatory and prognostic markers in COVID-19 patients. The present study is a retrospective study examining the relationship between vitamin D levels and inflammatory markers in the COVID-19 disease. COVID-19 patients who were investigated for vitamin D, ferritin, D-dimer, C-reactive protein (CRP), and procalcitonin (PCT) level were only included. The patients were divided into hypovitaminosis D, and normal vitamin D. Correlation and logistic regression analyses were carried out to identify the strength and association of hypovitaminosis D with inflammatory markers in COVID-19 disease. The hypovitaminosis D group had significantly higher inflammatory markers compared to the normal vitamin D group. The correlation between hypovitaminosis D and procalcitonin was negative (r = -0.433), with a strong and significant association (p = 0.002). The correlation between hypovitaminosis D, CRP, and ferritin was weak and insignificant. The logistic regression between hypovitaminosis D and procalcitonin established a significant regression equation, leading to a significant linear model. This study concludes that patients with hypovitaminosis D should be treated with vitamin D therapy to reduce the severity of COVID-19 disease.