[ Les marqueurs de l’inflammation dans le COVID-19: C-Reactive Protein, ferritine et LDH, sont-ils des prédicteurs fiables de sévérité ? ]
Volume 70, Issue 1, December 2023, Pages 10–20
Leila El Akkari1 and Fatima El Boukhrissi2
1 Department of Biochemistry-Toxicology, Moulay Ismail Military Hospital, Meknes, Morocco
2 Biochemistry Laboratory, Military Hospital Moulay Ismail, Meknes, Morocco
Original language: French
Copyright © 2023 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction: COVID-19 disease is an infectious disease characterized by a wide spectrum of clinical manifestations of varying severity. Biological markers play an important role in its management. The objective of this work is to study the association between the elevation of certain markers of inflammation: CRP, ferritin and LDH, and the severity of COVID-19. Materials and methods: This is a retrospective study carried out at the biochemistry laboratory of HMMI in Meknes, covering a series of 324 patients, hospitalized and declared positive for COVID-19. Patients are divided into 2 groups according to the severity of the disease; severe or moderate form, and all received a complete biological assessment including: CRP, ferritin and LDH. The aim of this study is to determine the role of these inflammatory markers in predicting the severity of COVID-19. Results: In a series of 324 cases, the average age is 33 years with a M/F sex ratio of 5. 40 patients developed the severe form of the disease, in whom the average age and the number of comorbidities, are both significantly higher than in the moderate forms group (age, p = 0.000; comorbidities, p < 0.05). Plasma concentrations of CRP, ferritin and LDH were respectively increased in 164 (25.3%), 128 (19.7%), and 136 (21%) patients, with a statistically significant difference between the 2 groups of patients. . However, statistical analysis shows that only CRP and ferritin levels are significant predictors of severe forms of COVID-19. A CRP level ≥ 31.80 mg/L predicts disease severity with a sensitivity of 80% and a specificity of 96.5%. For ferritin, the predictive rate of severity is ≥ 295ng/mL, with a sensitivity of 70% and a specificity of 88.7%. Discussion: Despite the limited size of our sample, the results of our study are consistent with those of the literature. They indicate that serum levels of CRP and ferritin are reliable and early predictors of the severity of COVID-19. Some studies have examined the prognostic role of other inflammatory markers, such as interleukin-6 and procalcitonin. However, it is difficult to carry out a large panel of tests in our context, given that they are not widely available. Conclusion: Our study showed that serum CRP and ferritin levels are better than LDH in predicting severe forms of COVID-19. They can be determined easily in almost all laboratories, which would help ensure adequate care and monitoring of patients upon admission.
Author Keywords: COVID-19, C-Reactive Protein, ferritin, LDH, predictors, severity.
Volume 70, Issue 1, December 2023, Pages 10–20
Leila El Akkari1 and Fatima El Boukhrissi2
1 Department of Biochemistry-Toxicology, Moulay Ismail Military Hospital, Meknes, Morocco
2 Biochemistry Laboratory, Military Hospital Moulay Ismail, Meknes, Morocco
Original language: French
Copyright © 2023 ISSR Journals. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Introduction: COVID-19 disease is an infectious disease characterized by a wide spectrum of clinical manifestations of varying severity. Biological markers play an important role in its management. The objective of this work is to study the association between the elevation of certain markers of inflammation: CRP, ferritin and LDH, and the severity of COVID-19. Materials and methods: This is a retrospective study carried out at the biochemistry laboratory of HMMI in Meknes, covering a series of 324 patients, hospitalized and declared positive for COVID-19. Patients are divided into 2 groups according to the severity of the disease; severe or moderate form, and all received a complete biological assessment including: CRP, ferritin and LDH. The aim of this study is to determine the role of these inflammatory markers in predicting the severity of COVID-19. Results: In a series of 324 cases, the average age is 33 years with a M/F sex ratio of 5. 40 patients developed the severe form of the disease, in whom the average age and the number of comorbidities, are both significantly higher than in the moderate forms group (age, p = 0.000; comorbidities, p < 0.05). Plasma concentrations of CRP, ferritin and LDH were respectively increased in 164 (25.3%), 128 (19.7%), and 136 (21%) patients, with a statistically significant difference between the 2 groups of patients. . However, statistical analysis shows that only CRP and ferritin levels are significant predictors of severe forms of COVID-19. A CRP level ≥ 31.80 mg/L predicts disease severity with a sensitivity of 80% and a specificity of 96.5%. For ferritin, the predictive rate of severity is ≥ 295ng/mL, with a sensitivity of 70% and a specificity of 88.7%. Discussion: Despite the limited size of our sample, the results of our study are consistent with those of the literature. They indicate that serum levels of CRP and ferritin are reliable and early predictors of the severity of COVID-19. Some studies have examined the prognostic role of other inflammatory markers, such as interleukin-6 and procalcitonin. However, it is difficult to carry out a large panel of tests in our context, given that they are not widely available. Conclusion: Our study showed that serum CRP and ferritin levels are better than LDH in predicting severe forms of COVID-19. They can be determined easily in almost all laboratories, which would help ensure adequate care and monitoring of patients upon admission.
Author Keywords: COVID-19, C-Reactive Protein, ferritin, LDH, predictors, severity.
Abstract: (french)
Introduction: La maladie du COVID-19 est une maladie infectieuse qui se caractérise par un large spectre de manifestations cliniques de sévérité variable. Les marqueurs biologiques jouent un rôle important dans sa prise en charge. L’objectif de ce travail est d’étudier l’association entre l’élévation de certains marqueurs de l’inflammation: la CRP, la ferritine et la LDH, et la sévérité du COVID-19. Matériels et méthodes: Il s’agit d’une étude rétrospective réalisée au laboratoire de biochimie de l’HMMI de Meknès, portant sur une série de 324 patients, hospitalisés et déclarés positifs au COVID-19. Les patients sont répartis en 2 groupes selon la gravité de la maladie; forme sévère ou modérée, et ont tous bénéficié d’un bilan biologique complet comportant: la CRP, la ferritine et la LDH. Le but de cette étude est de déterminer le rôle de ces marqueurs de l’inflammation dans la prédiction de la sévérité du COVID-19. Résultats: Sur une série de 324 cas, l’âge moyen est de 33 ans avec un sexe ratio H/F de 5. 40 patients ont développé la forme sévère de la maladie, chez qui l’âge moyen et le nombre de comorbidités, sont tous les deux significativement plus élevés que dans le groupe des formes modérées (âge, p = 0,000; comorbidités, p < 0,05). Les concentrations plasmatiques de la CRP, ferritine et LDH sont respectivement augmentées chez 164 (25,3%), 128 (19,7%), et 136 (21%) des patients, avec une différence statistiquement significative entre les 2 groupes de malades. Cependant, L’analyse statistique montre que seuls les taux de la CRP et de la ferritine sont des prédicteurs significatifs des formes sévères du COVID-19. Un taux de CRP ≥ 31,80 mg/L prédit la gravité de la maladie avec une sensibilité de 80% et une spécificité de 96,5%. Pour la ferritine, le taux prédictif de sévérité est ≥ 295ng/mL, avec une sensibilité de 70% et une spécificité de 88,7%. Discussion: Malgré la taille limitée de notre échantillon, les résultats de notre étude concordent avec ceux de la littérature. Ils indiquent que les taux sériques de CRP et de ferritine, sont des prédicteurs fiables et précoces, en ce qui concerne la sévérité du COVID-19. Certaines études ont examiné le rôle pronostique d’autres marqueurs inflammatoires, comme l’interleukine-6 et la procalcitonine. Cependant, il est difficile de réaliser dans notre contexte un grand panel de tests, vu qu’ils ne sont pas largement disponibles. Conclusion: Notre étude a montré que les taux sériques de CRP et de ferritine sont meilleurs que ceux de la LDH dans la prédiction des formes sévères du COVID-19. Ils peuvent être déterminés facilement dans presque tous les laboratoires, ce qui aiderait à assurer une prise en charge et un suivi adéquat aux patients dès leur admission.
Author Keywords: COVID-19, C-Reactive Protein, ferritine, LDH, prédicteurs, sévérité.
How to Cite this Article
Leila El Akkari and Fatima El Boukhrissi, “Are markers of inflammation in COVID-19: C-Reactive Protein, ferritin and LDH reliable predictors of severity ?,” International Journal of Innovation and Scientific Research, vol. 70, no. 1, pp. 10–20, December 2023.
