Levels Of D-Dimer, Ferritin, Neutrophil To Lymphocyte Ratio, And Monocyte To Lymphocyte Ratio For Hospitalized COVID-19 Patients In Baghdad-Iraq: A Case-Control Study

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Shahad Sabah Khalid , Zahraa Mohammed Ali , Laith G. Shareef , Mohanad Faris Raheem


Background: A novel form of coronavirus, "severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was described in Wuhan in 2019. The pandemic has become one of humanity's most significant health challenges, quickly increasing infected people. As a result, the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) in the United States have approved interim clinical guidelines for the management of patients with confirmed coronavirus disease (COVID-19). However, there is limited evidence of the clinical manifestations for the prognosis of COVID-19.  

Methods: During the study period, a total of 90 subjects were enrolled, 45 of which were healthy as controls and 45 of which were hospitalized patients given a diagnosis of COVID-19 by real-time reverse transcription-polymer chain reaction (RT-PCR). A total of five ml of venous blood specimen was reserved for every individual to start measuring D-dimer, Ferritin, neutrophil to lymphocyte ratio, and monocyte to lymphocyte ratio in their blood to determine if there is a correlation between these markers' levels and COVID-19 infection by using SPSS version 23.

Results: This study revealed a remarkable increase in the measured values of D-dimer, Ferritin, and neutrophil to lymphocyte ratio (NLR), while a decrease in monocyte to lymphocyte ratio (MLR) in patients' blood compared to the control group, with p-values < 0.001 for each of these markers.

Conclusions: D-dimer, ferritin, and NLR all increase, while MLR decrease in COVID-19 disease; in this study, D-dimer and NLR were shown to be excellent diagnostic biomarkers, ferritin very good, while MLR suitable diagnostic biomarkers for severe COVID-19 infection   

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