Marker In COVID-19 Patients Research Articles

Evaluation of plateletcrit level from platelet indices as a prognostic marker in COVID-19 patients.

COVID-19 disease bears similarities to a wide range of diseases, from simple flu infections to severe acute respiratory distress syndrome and is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). In this study, we aimed to elucidate the plateletcrit levels in patients with and without mortality who had been admitted to the intensive care unit because of pneumonia associated with SARS-CoV-2. In total, 434 patients were evaluated in this retrospective analysis. Their demographic data, comorbid diseases, Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores, platelet, lymphocyte, white blood cell (WBC) and neutrophil counts; mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), hemoglobin and C-reactive protein (CRP) levels and neutrophil-lymphocyte ratios (NLRs) were obtained from the hospital's electronic database on the days of the patients' intensive care unit admissions. Afterwards, their PLR, PNR, and MPV/PLT ratios were calculated. APACHE II score, length of hospital stay, WBC count, PCT, PLR, NLR, and CRP levels affected mortality. Increases in hospital stay duration, APACHE II score, platelet-lymphocyte ratio (PLR), and CRP, as well as decreases in PCT percentage, were associated with mortality. ROC curve analysis was performed to determine the success of PCT, PLR, and NLR in predicting mortality in COVID-19 patients and to determine cut-off values for mortality. It was determined that PCT, PLR, and NLR could correctly classify patients at rates of 58.9%, 59.2%, and 66.8% (moderate), respectively. The risk of mortality was higher in patients with PCT values of 0.188 or less, PLR values greater than 293.46, and NLR values greater than 9.49. In the COVID-19 patients evaluated in this study, plateletcrit indices could be utilized to predict mortality.

Gene expression of protein kinase AMP-activated catalytic subunit alpha 1 (PRKAA1), solute carrier family 2 member 1 (SLC2A1) and mechanistic target of rapamycin (MTOR) in metformin-treated type 2 diabetes patients with COVID-19: impact on inflammation markers.

The COVID-19 pandemic has resulted in a global health crisis that has severely impacted patients with type 2 diabetes (T2D). T2D patients have a higher risk of experiencing severe COVID-19 symptoms, hospitalization, and mortality compared to patients without diabetes. The dysregulated immune response in T2D patients can exacerbate the severity of COVID-19 symptoms. Insulin therapy, a common treatment for T2D patients, has been linked to increased mortality in COVID-19 patients with T2D. However, metformin, an anti-diabetic medication, has been shown to have anti-inflammatory properties that may mitigate the cytokine storm observed in severe COVID-19 cases. In this study, we investigated how the PRKAA1, SLC2A1, and MTOR genes contribute to inflammation markers in COVID-19 patients with T2D, who were receiving either insulin or metformin therapy. Our findings revealed that metformin treatment was associated with reduced expression of genes involved in Th1/Th17 cell differentiation. These results suggest that metformin could be a potential treatment option for T2D patients with COVID-19 due to its anti-inflammatory properties, which may improve patient outcomes.

Exploring Immune Cell Profiles and NLRP3 Gene Expression as Potential Diagnostic Markers in COVID-19 Patients: A Commentary

Exploring Immune Cell Profiles and NLRP3 Gene Expression as Potential Diagnostic Markers in COVID-19 Patients: A Commentary

Relationship of thrombospondin-1 and thrombospondin-2 with hematological, biochemical and inflammatory markers in COVID-19 patients

Abstract Objectives Roles of thrombospondin-1 (TSP-1) and thrombospondin-2 (TSP-2) in tissue repair and inflammation are well-documented, but the association of their serum expressions with the pathogenesis of COVID-19 remains unclear. We investigate the roles of TSP-1 and TSP-2 in COVID-19. Methods 106 SARS-CoV-2 infected patients and 23 healthy people were enrolled in our study. COVID-19 patients were divided into two groups as non-severe and severe. TSP-1 and TSP-2 concentrations were measured with an enzyme-linked Immunosorbent Assay, and blood markers were analyzed with routine laboratory techniques. Results COVID-19 patients had significantly higher TSP-1 and TSP-2 levels than healthy controls. TSP-1 and TSP-2 positively correlated with inflammatory markers, including ESR, CRP, PCT, ferritin, and biochemical parameters such as ALT, AST, BUN, CK, and LDH. In addition, TSP-1 and TSP-2 were negatively correlated with hematological markers such as LYM, EOS, and HGB. Receiver operating characteristic analyses revealed that COVID-19 may be predicted with TSP-1 levels over 189.94 ng/mL and TSP-2 levels higher than 0.70 ng/mL. Conclusions Our analysis suggests that TSP-1 and TSP-2 expressions at the systemic level may have clinical importance for COVID-19.

Correlation of circulating endothelial markers in COVID-19 patients admitted to the intensive care unit with laboratory data

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still a global concern with high morbidity and mortality rates. The role of endothelial cells in the progress of COVID-19 is well established. Therefore, the current study aimed to measure the endothelial markers and their correlation with the hematological parameters in intensive care unit-admitted COVID-19 patients. This study involved 111 adult participants, including 55 ICU-admitted patients with COVID-19 and 56 healthy controls. Levels of E-selectin, ICAM-1, and VCAM-1 in the plasma of the study participants were measured and correlated with hematological parameters. The study demonstrates that COVID-19 patients admitted to the ICU have higher levels of E-selectin, ICAM-1, and VCAM-1 compared to healthy controls ( p < .05). These elevated levels can serve as reliable indicators of endothelial dysfunction and early markers for the detection and prediction of endothelial cell involvement in COVID-19 complications. The findings of this study suggest that increased levels of E-selectin, VCAM-1, and ICAM-1 in patients with COVID-19 are indicative of the participation of endothelial cells in the pathogenesis of COVID-19 complications. Consequently, these endothelial markers are proposed as potential early indicators for predicting the severity of COVID-19.

Common Prognostic Biomarkers and Outcomes in Patients with COVID-19 Infection in Saudi Arabia.

Background: COVID-19 is a respiratory disease that eventually became a pandemic, with 300 million people infected around the world. Alongside the improvement in COVID-19 management and vaccine development, identifying biomarkers for COVID-19 has recently been reported to help in early prediction and managing severe cases, which might improve outcomes. Our study aimed to find out if there is any correlation between clinical severity and elevated hematological and biochemical markers in COVID-19 patients and its effect on the outcome. Methods: We have collected retrospective data on socio-demographics, medical history, biomarkers, and disease outcomes from five hospitals and health institutions in the Kingdom of Saudi Arabia. Results: Pneumonia was the most common presentation of COVID-19 in our cohort. The presence of abnormal inflammatory biomarkers (D-dimer, CRP, troponin, LDH, ferritin, and t white blood cells) was significantly associated with unstable COVID-19 disease. In addition, patients with evidence of severe respiratory disease, particularly those who required mechanical ventilation, had higher biomarkers when compared to those with stable respiratory conditions (p < 0.001). Conclusion: Identifying biomarkers predicts outcomes for COVID-19 patients and may significantly help in their management.

ASSESSMENT OF D. DIMER VALUE IN COVID-19 INFECTED PATIENTS

A global catastrophe caused by the COVID-19 epidemic has had negative effects on both health and the economy. The coagulation system may be involved in the pathophysiology of COVID-19 since D-Dimer, a measure of hypercoagulability, is higher in COVID-19 individuals with severe illness. In order to determine whether there is a relationship between D-Dimer levels and disease severity, this study measured the levels of D-Dimer in COVID-19 patients with severe and non-severe disease. The average age of the 72 confirmed COVID-19 patients in the research was 52.85 10.65. Based on the severity, the individuals were split into two groups, and the levels of D-Dimer were measured in each group. In contrast to individuals with less severe symptoms, those with severe COVID-19 symptoms had considerably higher levels of D-Dimer, according to the study. Cough, fever, breathing difficulties, and gastrointestinal symptoms were also discovered in the study to be statistically significant in patients with severe symptoms. The most prevalent co-morbid conditions among the individuals were hypertension and diabetes. These results emphasise the significance of identifying patients at risk for poor outcomes, tracking their D-Dimer levels and suggesting that D-Dimer levels may be a helpful prognostic marker in COVID-19 patients.

Role of diagnostic and prognostic value of hemocytometry markers in Covid-19 patients.

Role of diagnostic and prognostic value of hemocytometry markers in Covid-19 patients.

Gender-based differences of inflammatory, coagulation, and cardiac markers in COVID-19 patients in Erbil city

In December 2019, a new coronavirus disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appeared in Wuhan city and quickly became a global health issue. COVID-19 causes various symptoms ranging from no symptoms to potentially deadly pneumonia. The study aimed to understand the effects of SARS-CoV-2 infection on immune response and the differences in inflammatory, coagulation, and cardiac biomarkers between male and female patients. Between June 1st and November 1st, 2020, 95 cases of SARS-CoV-2 infected individuals were studied at Zanko Hospital. SARS-CoV-2 infection was confirmed using the real-time RT-PCR technique. All cases were analyzed for clinical, epidemiological, and laboratory data. On average, the patients were 50.64 (SEM= 2.359) years old, with 61 males and 34 females. The patients had elevated C-reactive protein (CRP), which was 43.96 (SEM= 6.154), while the erythrocyte sedimentation rate (ESR) was 50.50 (SEM= 5.498). The mean of D-Dimer, ferritin and lactate dehydrogenase (LDH) were 1.204 (SEM= 0.164), 534.7 (SEM= 61.48), and 366.6 (SEM= 36.81), respectively. There were no significant differences in the study's data mentioned above between male and female patients. In conclusion, inflammation is the most prominent symptom in COVID-19 patients, and males and females are nearly equally affected.

Coronary calcifications as a new prognostic marker in COVID-19 patients: role of CT.

COVID-19 pneumonia, caused by the virus Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), was declared a pandemic by the WHO on 11th March 2020. While Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) represents the diagnostic gold standard of infection, computed tomography (CT) has been shown to have an important role in supporting the diagnosis, quantifying the severity, and assessing the efficacy of treatment and its response. Coronary artery calcification (CAC) is a CT finding that estimates atherosclerosis and can be quantified using the coronary artery calcium score (CACS). The purpose of this study is to demonstrate the correlation between coronary artery calcification and mortality rate in COVID-19 patients. Three hundred seventeen (317) hospitalized patients with SARS-CoV-2 infection were ruled in this retrospective study. All patients underwent a non-ECG-gated chest CT to evaluate lung parenchymal involvement. In the same cohort, we observed the two main coronary arteries (common trunk, circumflex, anterior interventricular and right coronary heart) using a visual score, so patients were divided into four groups based on Ordinal CAC Score (OCS) levels. The multivariate analysis proved that the OCS value was statistically correlated with the mortality rate (p < 0.001). In fact, in the group of patients with an OCS value of 0, the mortality rate was 10.1% (10/99 patients), in the group with OCS between 1 and 4 was 18.9% (21/111), in the OCS group of patients ranged from 5 to 8 was 30.4% (24/79) and in the OCS group between 9 and 12 was 46.4% (13/28). We suggest that calcific atheromasia of the coronary arteries in patients with COVID-19 can be considered a prognostic marker of clinical outcome.

COVID-19 Infections and Inflammatory Markers in Patients Hospitalized During the First Year of the Pandemic.

The clinical presentations in patients with SARS-CoV-2 (COVID-19) infections range from asymptomatic upper respiratory infections to acute respiratory failure with bilateral pulmonary infiltrates requiring mechanical ventilation. Clinicians often measured inflammatory markers in hospitalized patients to characterize the severity of the infection. Multiple studies published in 2020 reported information on the frequency of elevated inflammatory markers in hospitalized patients in various categories of disease severity. The PubMed database was searched using the terms "Inflammatory markers in COVID-19 patients" and "Clinical features of patients infected with COVID-19." Thirty-three publications were analyzed in detail to determine which inflammatory markers were increased and the frequency of these increases in various clinical classifications, including patients requiring hospitalization, patients with pneumonia, patients with severe infection, patients requiring intensive care unit admission, and patients who died. C-reactive protein (CRP) was the most frequently elevated inflammatory marker in all categories. Ferritin, D-dimer, and erythrocyte sedimentation rate levels were also frequently elevated. In general, frequencies were higher in patients with more severe infections. For example, 24 out of 24 patients who died had an elevated CRP level. This review provides concrete information about the frequency of various inflammatory markers in patients with COVID-19 infection who required hospitalization. It also provides us some insight into the approach clinicians took in the early phase of this pandemic in their efforts to characterize these patients and perhaps understand the disease process better. However, these results might suggest that clinicians and laboratory directors should develop protocols to optimize laboratory testing.

Correlation of the severity of mucormycosis with levels of inflammatory markers in COVID-19 patients

Correlation of the severity of mucormycosis with levels of inflammatory markers in COVID-19 patients

IMPACT OF COVID-19 ON THYROID FUNCTION: EVIDENCE FROM IRAN.

We assessed the association between the severity of COVID-19 and the thyroid function, and the relationship of thyroid hormones with inflammatory markers in COVID-19 patients. This observational study contained 95 COVID-19 patients. The covariates of interest included the thyroid-stimulating hormone (TSH) and the total form of thyroid hormones thyroxine and triiodothyronine. Furthermore, the inflammatory markers including C-reactive protein, erythrocyte sedimentation rate, lactate dehydrogenase (LDH), and lymphocyte were measured. To analyze the data, the t-test, the nonparametric test for comparing the medians, and the Spearman correlation were used. The median (interquartile range) of ages was equal to 53 (41-66) years old, including 54 men (56.8%). As the severity of COVID-19 progressed from moderate to severe, increasing, though non-significant, trends of thyroid dysfunction were observed, the most remarkable for TSH. The only significant association between thyroid hormones and inflammatory markers was a Spearman correlation of -0.28 between TSH and LDH. Moreover, a direct association was found between the severity of COVID-19 and the LDH levels (p-value<0.001). A direct relation between the severity of COVID-19 and the LDH level and a reverse association between the LDH level and the thyroid hormone, TSH was obtained.

The Clinical Significance of Cardiac Markers in COVID-19 Patients: A Review Article

SARS-CoV-2 is a highly contagious viral illness that started the COVID-19 pandemic in March 2020. Accumulating evidence suggests that the cardiovascular system is primarily affected by SARS-CoV-2. Cardiovascular complications such as myocarditis, acute coronary syndrome, heart failure, arrhythmias, and venous thromboembolism have been reported. The role of cardiac biomarkers in diagnosing and monitoring COVID-19 patients is becoming of particular interest, as it may provide insights into the underlying mechanisms of cardiovascular injury and inform clinical decision-making. Troponins, specifically troponin I, have been widely studied and was proven to be elevated in COVID-19 patients with myocardial injury, indicating a negative prognostic indicator and association with poorer outcomes. Elevated levels of Natriuretic peptides, such as B-type natriuretic peptide (BNP), have been noted in severe COVID-19 cases and are associated with higher mortality rates. However, it is essential to consider that elevated natriuretic peptide levels in COVID-19 patients may also be influenced by factors other than heart failure. CK-MB, a subtype of creatine kinase, has been found to have significantly higher concentrations in COVID-19 patients with high disease severity or non-survivor status, suggesting its potential as a biomarker for risk stratification in this population. Myoglobin and lactate dehydrogenase (LDH) are additional cardiac markers that can indicate heart muscle damage, but their specificity in COVID-19 patients may be limited. The widely used cardiac markers provide valuable diagnostic and prognostic information about cardiac injury and function in COVID-19 patients. Still, their performance characteristics and interpretation should be considered in the context of the individual patient and conjunction with other clinical assessments.

CORRELATION BETWEEN HEPCIDIN AND PROCALCITONIN AND THEIR DIAGNOSTIC ROLE IN PATIENTS WITH COVID-19.

The aim: The purpose of this study is to find out the association between procalcitonin and hepcidin in patients with COVID-19, in addition to their role as diagnostic markers. Materials and methods: A total of 75 patients infected with coronavirus were included in the current study, their age is ranging between 20 to 78 years. Those patients was hospitalized in Al-Sadr Teaching Hospital in Najaf, in Iraq. This study also included 50 healthy subjects which are volunteers and considered as a (control group). Biomarker (procalcitonin and hepcidin) measurements were achieved by electrochemiluminescent immunoassay (ECLIA) in the Elecsys immunoassay system. Results: The present study showed a significant increase the serum cencentration of hepcidin and procalcitonin in patients with COVID-19 as compared tohealthy subjects. There was a highly significant increasing(p < 0.01) in hepcidin and PCT level in patients with severe infection comparing to other catgaries.The current study also revealed that the sensitivity values of the markers were: 0.88%, 0.85 for procalcitonin and hepcidin respectively, which indicate high diagnostic power. Conclusions: Serum levels of hepcidin and procalcitonin are increased as inflammatory markers in COVID-19 patients with relatively high sensitivity. It seems that these imflammatory markers obviously elevate in the severe cases COVID-19dusease.

245. Can Inflammatory Markers be used as an Early predictor for Mechanical ventilation in COVID-19 patients with Stages IIIb-V Chronic Kidney Disease?

Abstract Background The clinical use of inflammatory markers soared during the COVID-19 pandemic. Though studies have shown C-reactive protein (CRP) to predict mechanical ventilation (MV) in patients with COVID-19, its utility is unknown in patients with chronic kidney disease (CKD), who have elevated baseline CRP levels due to chronic inflammation and reduced renal clearance of inflammatory cytokines. Our aim was to assess the association of inflammatory markers like CRP, ferritin, LDH, D dimer, and MV rate in patients with stages IIIb-V CKD and COVID-19. Methods We conducted a cross-sectional study on inpatients in a community hospital from 12/1/19 to 1/1/22 with COVID-19 and stages IIIb-V CKD without a previous renal transplant. Primary endpoints were invasive MV (IMV) rates, noninvasive MV (NIMV) rates, and no MV. Statistical analyses used unpaired t-test for continuous variables and chi-square analysis for categorical variables. Cutoffs for variables were CRP 100 mg/L, ferritin 530ng/ml, D-dimer 0.5mg/L and LDH 590 U/L. Univariate analysis and Area under curve (AUC-ROC) between the covariates and outcomes were computed. Results 290 patients were screened, and 118 patients met inclusion criteria. CRP, D dimer, and ferritin were significantly different among the three groups. On univariate analysis for IMV, CRP had an OR 5.44; ferritin, OR 2.8; LDH, OR 7.7; D-dimer, OR 3.9, WBC count, OR 4.2 (p&amp;lt; 0.05). Admission CRP level was 0.747 for the IMV group (AUC-ROC, sensitivity 80.8%, specificity 50%) and 0.663 for the NIMV group (AUC-ROC, sensitivity 69.2%, specificity 53%) Conclusion Our results illustrate a positive correlation between CRP, ferritin, and D-dimer levels and MV and NIMV rates. The ROC demonstrates a good sensitivity for CRP levels in detecting MV thereby emphasizing the utility of these biomarkers as good predictive markers in COVID-19 patients with CKD. With increasing use of inflammatory markers to prognosticate disease severity in COVID, the applicability of these markers in different populations should be investigated. A similar pattern of elevated inflammatory markers predicting the rate of MV was found in patients with stages IIIb-V CKD. This may be because of the greater magnitude of increased inflammation due to COVID-19 itself compared with increased inflammation due to CKD alone. Disclosures All Authors: No reported disclosures.

Effect of vitamin D3 supplementation on cellular immunity and inflammatory markers in COVID-19 patients admitted to the ICU

Vitamin D as an immunomodulator has not been studied in patients with severe COVID-19. This study aimed to estimate the efficacy of vitamin D3 supplementation on cellular immunity and inflammatory markers in patients with COVID-19 admitted to the intensive care unit (ICU). A single-center, double-blind, randomized, placebo-controlled pilot trial was conducted (N = 110). Patients were randomly assigned to receive a weekly oral dose of 60,000 IU of vitamin D3 followed by daily maintenance doses of 5000 IU (n = 55) or placebo (n = 55). Primary outcomes were lymphocyte counts, natural killer (NK) and natural killer T (NKT) cell counts, neutrophil-to-lymphocyte ratio (NLR), and serum levels of inflammatory markers on 7th day of treatment. On day 7, patients in the vitamin D3 group displayed significantly higher NK and NKT cell counts and NLR than those in the placebo group did. The mortality rate (37% vs 50%, P = 0.16), need for mechanical ventilation (63% vs 69%, P = 0.58), incidence of nosocomial infection (60% vs 41%, P = 0.05) did not significantly differ between groups. Vitamin D3 supplementation, compared with placebo, significantly increased lymphocyte counts, but did not translate into reduced mortality in ICU.Trial Registration: ClinicalTrials.gov Identifier: NCT05092698.

Latent class analysis: an innovative approach for identification of clinical and laboratory markers of disease severity among COVID-19 patients admitted to the intensive care unit

ObjectiveThe aim of this study was to identify clinical and laboratory phenotype distribution patterns and their usefulness as prognostic markers in COVID-19 patients admitted to the intensive care unit (ICU) at Tygerberg Hospital, Cape Town. Methods and resultsA latent class analysis (LCA) model was applied in a prospective, observational cohort study. Data from 343 COVID-19 patients were analysed. Two distinct phenotypes (1 and 2) were identified, comprising 68.46% and 31.54% of patients, respectively. The phenotype 2 patients were characterized by increased coagulopathy markers (D-dimer, median value 1.73 ng/L vs 0.94 ng/L; p < 0.001), end-organ dysfunction (creatinine, median value 79 µmol/L vs 69.5 µmol/L; p < 0.003), under-perfusion markers (lactate, median value 1.60 mmol/L vs 1.20 mmol/L; p < 0.001), abnormal cardiac function markers (median N‐terminal pro‐brain natriuretic peptide (NT-proBNP) 314 pg/ml vs 63.5 pg/ml; p < 0.001 and median high‐sensitivity cardiac troponin (Hs-TropT) 39 ng/L vs 12 ng/L; p < 0.001), and acute inflammatory syndrome (median neutrophil-to-lymphocyte ratio 15.08 vs 8.68; p < 0.001 and median monocyte value 0.68 × 109/L vs 0.45 × 109/L; p < 0.001). ConclusionThe identification of COVID-19 phenotypes and sub-phenotypes in ICU patients could help as a prognostic marker in the day-to-day management of COVID-19 patients admitted to the ICU.

Relation between macrophage inflammatory protein-1 and intercellular adhesion molecule-1 and computed tomography findings in critically-ill saudi covid-19 patients

BackgroundSeveral, clinical and biochemical factors were suggested as risk factors for more severe forms of Covid-19. Macrophage inflammatory protein-1 alpha (MIP-1α, CCL3) is a chemokine mainly involved in cell adhesion and migration. Intracellular adhesion molecule 1 (ICAM-1) is an inducible cell adhesion molecule involved in multiple immune processes. The present study aimed to assess the relationship between baseline serum MIP-1α and ICAM-1 level in critically-ill Covid-19 patients and the severity of computed tomography (CT) findings. MethodsThe study included 100 consecutive critically-ill patients with Covid-19 infection. Diagnosis of infection was established on the basis of RT-PCR tests. Serum MIP-1α and ICAM-1 levels were assessed using commercially available ELISA kits. All patients were subjected to a high-resolution computed tomography assessment. ResultsAccording to the computed tomography severity score, patients were classified into those with moderate/severe (n=49) and mild (n = 51) pulmonary involvement. Severe involvement was associated with significantly higher MIP-1α and ICAM-1 level. Correlation analysis identified significant positive correlations between MIP-1α and age, D-dimer, IL6, in contrast, there was an inverse correlation with INF-alpha. Additionally, ICAM-1 showed significant positive correlations with age, D‐Dimer,- TNF—α, IL6,while an inverse correlation with INF-alpha was observed. ConclusionsMIP-1α and ICAM-1 level are related to CT radiological severity in Covid-19 patients. Moreover, these markers are well-correlated with other inflammatory markers suggesting that they can be used as reliable prognostic markers in Covid-19 patients.

Efficacy of a standardized herbal formulation from Glycyrrhiza glabra L. as an adjuvant treatment in hospitalized patients with COVID-19: A Randomized Controlled trial

IntroductionAs no specific pharmacological intervention has been known for COVID-19, medicinal plants may be a suitable candidate for management of this disease. The aim of this study was to investigate the efficacy of a herbal syrup from licorice as an adjuvant treatment in hospitalized patients with COVID-19. Materials and methods213 hospitalized patients diagnosed with COVID-19 were assigned to receive either standardized licorice syrup as an adjuvant treatment plus standard care [Syrup Group (SYRUP), N = 91], or standard care alone [Standard Group (STANDARD), N = 104], for 7 days. The primary endpoint was duration of hospitalization in survivors. The secondary endpoints included 25% increase in oxygen saturation, C-reactive protein (CRP) difference and lymphocyte difference from baseline, number of death and number of patients transferred to ICU. ResultsMean duration of admission was 5.24 days in SYRUP and 7.14 days in STANDARD (p < 0.001). Oxygen saturation increased in 86 of 91 patients (94.5%) in the licorice group, compared to 83 of 104 patients (79.8%) in the control group (p = 0.002). There was no significant difference between the two groups in the number of patients died during hospitalization (p = 0.837). Five patients in SYRUP and 16 patients in STANDARD were transferred to ICU (p < 0.026). Mean reduction in CRP (p < 0.001) and mean increase in the number of lymphocytes (p = 0.008) in SYRUP were significantly higher than STANDARD. DiscussionLicorice syrup as an adjuvant treatment demonstrated promising results on duration of hospital admission, O2 saturation as well as inflammatory markers in COVID-19 patients; however, further clinical studies with larger sample size are suggested to achieve more conclusive results.