Articles

Evaluation of Hepatic, Renal and Cardiac Diagnostic Markers in Patients With Severe COVID-19

Abstract

SARS-CoV-2 that causes Coronavirus disease 2019 (COVID-19) was first known in Wuhan, China, in December 2019. The aim of this study was to evaluate the level of common hepatic, renal, and cardiac diagnostic markers in hospitals in patients with severe COVID 19. In this study, 259 patients with symptoms of severe COVID-19 and a positive RT-PCR assay of nasopharyngeal samples were enrolled. Inclusion criteria are positive for COVID-19 patients at the diagnosis of an infectious disease physician. Diagnostic markers of liver, kidney, and heart were evaluated by age and gender. In this study, 48.3% of patients severe with COVID-19 were male, and 51.7% were female. The mean of markers such as LDH, Direct Bilirubin, SGOT, SGPT, D-dimer was higher than normal, which was observed in men more than women. The mean of CK-MB also was higher than normal, which was observed in women more than men. The highest mean of markers was seen in the older ages. The mean of BUN was observed in the age range of 55-64 years and above 65 years above normal. But the mean of CPK, creatinine, potassium and alkaline phosphatase were normal. The results of the present study showed an increase in the level of some of the most important diagnostic markers of hepatic, renal, and cardiac in patients with COVID 19. This increase was greater in some markers, including SGOT, SGPT, Direct bilirubin, LDH, D-dimer, in men than in women, and more in older patients.

1. World Health Organization. Clinical management of COVID-19: interim guidance, 27 May 2020. Geneva: World Health Organization; 2020. (Accessed at WHO/2019-nCoV/clinical/2020.5.)
2. World Health Organization. Transmission of SARS-CoV-2: implications for infection prevention precautions: Scientific brief, 09 July 2020. Geneva: World Health Organization; 2020. (Accessed at WHO/2019-nCoV/Sci_Brief/Transmission_modes/2020.3.)
3. Singhal T. A Review of Coronavirus Disease-2019 (COVID-19). Indian J Pediatr 2020;87:281-6.
4. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.
5. Flythe JE, Assimon MM, Tugman MJ, Chang EH, Gupta S, Shah J, et al. Characteristics and Outcomes of Individuals With Pre-existing Kidney Disease and COVID-19 Admitted to Intensive Care Units in the United States. Am J Kidney Dis 2021;77:190-203.e1.
6. Shao M, Li X, Liu F, Tian T, Luo J, Yang Y. Acute kidney injury is associated with severe infection and fatality in patients with COVID-19: A systematic review and meta-analysis of 40 studies and 24,527 patients. Pharmacol Res 2020;161:105107.
7. Sharma A, Jaiswal P, Kerakhan Y, Saravanan L, Murtaza Z, Zergham A, et al. Liver disease and outcomes among COVID-19 hospitalized patients - A systematic review and meta-analysis. Ann Hepatol 2021;21:100273.
8. Levett JY, Raparelli V, Mardigyan V, Eisenberg MJ. Cardiovascular Pathophysiology, Epidemiology, and Treatment Considerations of Coronavirus Disease 2019 (COVID-19): A Review. CJC Open 2020;3:28-40.
9. Shoar S, Hosseini F, Naderan M, Mehta JL. Meta-analysis of Cardiovascular Events and Related Biomarkers Comparing Survivors Versus Non-survivors in Patients With COVID-19. Am J Cardiol. 2020;135:50-61.
10. Pourbagheri-Sigaroodi A, Bashash D, Fateh F, Abolghasemi H. Laboratory findings in COVID-19 diagnosis and prognosis. Clin Chim Acta 2020;510:475-82.
11. Medetalibeyoglu A, Catma Y, Senkal N, Ormeci A, Cavus B, Kose M, et al. The effect of liver test abnormalities on the prognosis of COVID-19. Ann Hepatol 2020;19:614-21.
12. Ye L, Chen B, Wang Y, Yang Y, Zeng J, Deng G, et al. Prognostic value of liver biochemical parameters for COVID-19 mortality. Ann Hepatol 2021;21:100279.
13. Wang Y, Shi L, Wang Y, Yang H. An updated meta-analysis of AST and ALT levels and the mortality of COVID-19 patients. Am J Emerg Med 2021;40:208-9.
14. Bashash D, Abolghasemi H, Salari S, Olfatifar M, Eshghi P, Akbari ME. Elevation of D-Dimer, But Not PT and aPTT, Reflects the Progression of COVID-19 Toward an Unfavorable Outcome: A Meta-Analysis. Iran J Blood Cancer 2020;12:47-53.
15. Lippi G, Favaloro EJ. D-dimer is Associated with Severity of Coronavirus Disease 2019: A Pooled Analysis. Thromb Haemost 2020;120:876-8.
16. Li P, Chen L, Liu Z, Pan J, Zhou D, Wang H, et al. Clinical Features and Short-term Outcomes of Elderly Patients With COVID-19. Int J Infect Dis 2020;97:245-50.
17. Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J, et al. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Sci China Life Sci 2020;63:364-74.
18. Yuan J, Zou R, Zeng L, Kou S, Lan J, Li X, et al. The correlation between viral clearance and biochemical outcomes of 94 COVID-19 infected discharged patients. Inflamm Res 2020;69:599-606.
19. Henry BM, Aggarwal G, Wong J, Benoit S, Vikse J, Plebani M, et al. Lactate dehydrogenase levels predict coronavirus disease 2019 (COVID-19) severity and mortality: A pooled analysis. Am J Emerg Med 2020;38:1722-6.
20. Yang J, Liao X, Yin W, Wang B, Yue J, Bai L, et al. Elevated cardiac biomarkers may be effective prognostic predictors for patients with COVID-19: A multicenter,observational study. Am J Emerg Med 2021;39:34-41.
21. Liu YM, Xie J, Chen MM, Zhang X, Cheng X, Li H, et al. Kidney function indicators predict adverse outcomes of COVID-19. Med (N Y) 2021;2:38-48.e2.
22. Cheng A, Hu L, Wang Y, Huang L, Zhao L, Zhang C, et al. Diagnostic performance of initial blood urea nitrogen combined with D-dimer levels for predicting in-hospital mortality in COVID-19 patients. Int J Antimicrob Agents 2020;56:106110.
23. Zhu Y, Du Z, Zhu Y, Li W, Miao H, Li Z. Evaluation of organ function in patients with severe COVID-19 infections. Med Clin (Barc) 2020;155:191-6.
24. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507-13.
Files
IssueVol 59, No 11 (2021) QRcode
SectionArticles
DOI https://doi.org/10.18502/acta.v59i11.7778
Keywords
Diagnostic markers Coronavirus disease 2019 (COVID-19) Abadan
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Mobarak S, Mohammadi A, Zahedi A, Jelvay S, Maghsoudi F, Assareh Zadegan Dezfuli MH, Balizadeh Karami AR, Radmanesh E. Evaluation of Hepatic, Renal and Cardiac Diagnostic Markers in Patients With Severe COVID-19. Acta Med Iran. 2021;59(11):656-661.