A GLIMPSE OF THE INFLAMMATORY BIOMARKERS OF COVID-19

Neelakshi Pal and Kuntal Gupta*

ABSTRACT

Coronavirus disease 2019 is a clinical syndrome caused by the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). Patients can be asymptomatic or present respiratory and gastrointestinal symptoms, and those with multiple-organ failure which can lead to death. A life-threatening hyperinflammatory syndrome occurs after primary SARS-CoV-2 infection. Inflammation markers can appear elevated in infected individuals with SARS-CoV-2. Several research studies throughout the world suggested that the magnitude of the elevation of IL-6, CRP, PCT, HLA, Ferritin, D dimer, IL-6 and many others may relate to the severity of the resulting COVID-19. Monitoring levels of inflammatory markers may help identify progression to severity of the disease. Total lymphocyte count and levels of CD3+ and CD4+ T cells were decreased in severe and critical cases. The patients with acute respiratory distress syndrome expressed an elevated level of neutrophiles. Interleukin-6 was high in mild and severe patients. The D-dimer level was high in diabetic patients and patients who developed ARDS. Procalcitonin levels were elevated to varying degrees in severe and critical patients. Evidence shows that severe COVID-19 cases exhibit features of systemic inflammatory reactions, including hyperferritinemia. The severe patients had higher levels of serum ferritin than the nonsevere patients. The levels of serum ferritin positively correlate with levels of CRP. Azurophilic granules and similar molecules are elevated in the blood as they are liberated into the circulation. The elevated calprotectin level indicates the probability of the gastrointestinal involvement as a result of the COVID-19 disease.

Keywords: COVID-19, Inflammation, IL-6, IFN, HLA, TNF, D-dimer, PCT, Ferritin.