Crit Rev Clin Lab Sci undefined

Biomarkers associated with COVID-19 disease progression

^{Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Transplant, Oncological and Regenerative Medicine, Division of Clinical Pathology, University of Modena and Reggio Emilia, Modena, Italy;}

^{Dermatology Unit, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy;}

^{Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany;}

^{Department of Clinical Biochemistry, Medical Faculty, Akdeniz University, Antalya, Turkey}

CONTACT Tomris Ozben rt.ude.zinedka@nebzo, Department of Clinical Biochemistry, Medical Faculty, Akdeniz University, Antalya, Turkey

Received 2020 May 5; Revised 2020 May 12; Accepted 2020 May 14.

This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic is a scientific, medical, and social challenge. The complexity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is centered on the unpredictable clinical course of the disease that can rapidly develop, causing severe and deadly complications. The identification of effective laboratory biomarkers able to classify patients based on their risk is imperative in being able to guarantee prompt treatment. The analysis of recently published studies highlights the role of systemic vasculitis and cytokine mediated coagulation disorders as the principal actors of multi organ failure in patients with severe COVID-19 complications. The following biomarkers have been identified: hematological (lymphocyte count, neutrophil count, neutrophil–lymphocyte ratio (NLR)), inflammatory (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT)), immunological (interleukin (IL)-6 and biochemical (D-dimer, troponin, creatine kinase (CK), aspartate aminotransferase (AST)), especially those related to coagulation cascades in disseminated intravascular coagulation (DIC) and acute respiratory distress syndrome (ARDS). New laboratory biomarkers could be identified through the accurate analysis of multicentric case series; in particular, homocysteine and angiotensin II could play a significant role.

Keywords: COVID-19, biomarkers of disease progression, hematological biomarkers, inflammatory biomarkers, immunological biomarkers, biochemical biomarkers, neutrophil–lymphocyte ratio (NLR)

Abstract

Glossary

Abbreviations

ACE	angiotensin-converting enzyme
ALT	alanine aminotransferase
Ang	angiotensin
aPTT	activated partial thromboplastin time
ARDS	acute respiratory distress syndrome
AST	aspartate aminotransferase
AT2R	AT2 receptor
BK	bradykinin
CI	confidence interval
CK	creatine kinase
CKD	chronic kidney disease
COVID-19	coronavirus disease 2019
CRP	C-reactive protein
CT	computer tomography
CTL	cytotoxic T lymphocyte
DIC	disseminated intravascular coagulation
ESR	erythrocyte sedimentation rate
FDP	fibrin degradation product
G-CSF	granulocyte-colony stimulating factor
Hcy	homocysteine
HPLC	high-performance liquid chromatography
HR	hazard risk
ICU	intensive care unit
IL	interleukin
INF	interferon
IP	interferon-γ inducible protein
LDH	lactate dehydrogenase
MasR	Mas receptor
MCP	monocyte chemoattractant protein
MIP	macrophage inflammatory protein
MOF	multiple organ failure
NCP	novel coronavirus pneumonia
NK	natural killer
NLR	neutrophil–lymphocyte ratio
NO	nitric oxide
OR	odds ratio
ORF	open reading frame
PCT	procalcitonin
PLR	platelet-to-lymphocyte ratio
PT	prothrombin time
RAS	renin–angiotensin system
ROCK	RhoA/Rho kinase
S	spike
SARS-CoV-2	severe acute respiratory syndrome coronavirus 2
TNF	tumor necrosis factor
WBC	white blood cell

Glossary

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