Potentials of Varied Inflammatory Indices in the Prediction of COVID-19 Severity Among Nigerians

Stephenson Lawson; Collins Amadi

doi:doi:10.11648/j.ab.20221001.13

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Potentials of Varied Inflammatory Indices in the Prediction of COVID-19 Severity Among Nigerians

Stephenson Lawson, Collins Amadi

Published in Advances in Biochemistry (Volume 10, Issue 1)

Received: 5 January 2022 Accepted: 20 January 2022 Published: 28 January 2022

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Abstract

Background: The coronavirus disease of 2019 (COVID-19) is theorized to be associated with significant inflammatory episodes. This tends to define the severity and culminates in adverse consequences of the disease. Therefore, the current study evaluated the potentials of varied inflammatory markers/indices that define the COVID-19 severity. Methods: This was a retrospective analysis of pre-treatment data obtained from patients with positive real-time polymerase chain reaction (RT-PCR)-confirmed COVID-19 disease in one of the treatment centers in Port Harcourt, South-south Nigeria. Data were obtained from case notes, medical review charts, nurses’ charts, and laboratory records by trained research assistants in the treatment center using pretested data acquisition templates. Abstracted data were compared between the severe positive and severe negative subgroups and the potentials of varied inflammatory indices were evaluated among the severe positive subgroup using standard protocols. Results: A total of 600 eligible cases were studied. Among the eligible cases, 543 (90.5%) had severe negative disease, while 57 (9.5%) had severe positive disease. The severe positive COVID-19 patients had higher mean blood levels of urea, creatinine, pro-calcitonin, C-reactive protein (CRP), ferritin, higher Glasgow prognostic scores (GPS), fibrinogen, D-dimer, fibrinogen-albumin ratio, total white cell count, neutrophil counts, composite neutrophil/lymphocyte ratio (NLR), composite platelet to lymphocyte ratio but lower potassium, albumin, hemoglobin levels, and isolated lymphocyte and platelet counts compared to the severe positive COVID-19 subjects (p<0.05). The C-reactive protein, GPS, D-dimer, and the composite NLR ratio indices significantly predicted COVID-19 severity on the crude regression model which was maintained in the adjusted model. However, serum CRP concentrations (AUC: 0.95; 95% CI: 0.82-1.00; p<0.001) maintained a more robust predictive potential compared to the GPS (AUC: 0.94; 95% CI: 0.84-1.00; p<0.001), D-dimer levels (AUC: 0.89; 95% CI: 0.79-0.94; p=0.004), and the composite NLR (AUC: 0.87; 95% CI: 0.77-0.92). Conclusion: The current study corroborates the role of inflammation in the COVID-19 disease severity. The clinical utility of these inflammation-induced markers/indices especially the CRP, GPS, D-dimer, and the NLR should be prioritized among Nigerians during the management of the disease.

Published in	Advances in Biochemistry (Volume 10, Issue 1)
DOI	10.11648/j.ab.20221001.13
Page(s)	18-24
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

COVID-19, COVID-19 Severity, COVID-19 Inflammatory Markers/Indices

References

[1]	Ramphul K, Ramphul Y, Park Y, Lohana P, Dhillon BK, Sombans S. A comprehensive review and update on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Coronavirus disease 2019 (COVID-19): what do we know now in 2021?. Arch Med Sci Atheroscler Dis. 2021; 6: e5-e13.
[2]	Devezas T, Miranda LCM. On the global time evolution of the COVID-19 pandemic: Logistic modeling. Technol Forecast Soc Change. 2022; 175: 121387. DOI: 10.1016/j.techfore.2021.121387.
[3]	Adesunkanmi AO, Ubom AE, Olasehinde O, Wuraola FO, Ijarotimi OA, Okon NE, Ikimalo JI, Fasubaa OB, Adesunkanmi AR. Impact of the COVID-19 pandemic on surgical residency training: perspective from a low-middle income country. World J Surg. 2021; 45 (1): 10-7.
[4]	Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: A review. Clinical immunology. 2020; 215: 108427.
[5]	Osuchowski MF, Winkler MS, Skirecki T, et al. The COVID-19 puzzle: deciphering pathophysiology and phenotypes of a new disease entity. Lancet Respir Med. 2021; 9 (6): 622-642. DOI: 10.1016/S2213-2600(21)00218-6.
[6]	Alam JM, Asghar SS, Ali H, Mahmood SR, Ansari MA. Profiling of inflammatory biomarkers in mild to critically ill severe acute respiratory syndrome corona virus-19 (SARS COVID-19) patients from Karachi, Pakistan. Pakistan J Pharma Sci. 2021; 34 (1): 429-33.
[7]	Iqbal S, Kumar S, Mustafa I, Arora M, Sah SP, Sharma S. Association of biochemical indices and severity of COVID-19. Int J Health Clin Res. 2021; 4 (11). 246-8.
[8]	Farid E, Sridharan K, Alsegai OA, Khawaja SA, Mansoor EJ, Teraifi NA, Qahtani MA, Salman JA. Utility of inflammatory biomarkers in patients with COVID-19 infections: Bahrain experience. Biomark Med. 2021; 15 (8): 541-9.
[9]	Liu J, Liu Y, Xiang P, Pu L, Xiong H, Li C, et al. Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage. J Transl Med. 2020 May 20; 18 (1): 206. DOI: 10.1186/s12967-020-02374-0.
[10]	Qun S, Wang Y, Chen J, Huang X, Guo H, Lu Z, et al. Neutrophil-to-Lymphocyte Ratios Are Closely Associated With the Severity and Course of Non-mild COVID-19. Front Immunol. 2020; 11: 2160. DOI: 10.3389/fimmu.2020.02160.
[11]	Ikeagwulonu RC, Obeta MU, Ugwu IN. Systematic review of laboratory parameters predicting severity and fatality of COVID-19 hospitalised patients. New Zealand Journal of Medical Laboratory Science. 2020; 74 (3): 165-80.
[12]	Ifeanyi OE, Mercy OH, Prayer NN, Chijindu OH. Cytokines, coagulation profile and haematological changes in COVID-19 patients as indicators of their health status: A review. European Journal of Biomedical. 2020; 7 (7): 724-9.
[13]	Kuluöztürk M, Deveci F, Turgut T, Öner Ö. The Glasgow Prognostic Score and fibrinogen to albumin ratio as prognostic factors in hospitalized patients with COVID-19. Expert Rev Respir Med. 2021; 15 (8): 1061-1068. DOI: 10.1080/17476348.2021.1923483.
[14]	Naing L, Winn T, Rusli BN. Practical issues in calculating the sample size for prevalence studies. Arch Orofac Sci. 2006; 1: 9–14.
[15]	Nigerian Centre for Disease Control (NCDC) National Interim Guidelines for Clinical Management of COVID-19. Accessed 25^th December 2021.
[16]	Akinwumi JA, Edem FV, Arinola GO. Cellular Inflammatory Indices in Hospitalized Nigerian COVID-19 Patients. J Health Sci Res 2021; 6 (2): 19-26.
[17]	Rahman MA, Shanjana Y, Tushar MI, Mahmud T, Rahman GM, Milan ZH, et al. Hematological abnormalities and comorbidities are associated with COVID-19 severity among hospitalized patients: Experience from Bangladesh. PLOS ONE. 2021; 16 (7): e0255379.
[18]	Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. COVID-19: consider cytokine storm syndromes and immunosuppression. The lancet. 2020; 395 (10229): 1033-4.
[19]	Zeng F, Huang Y, Guo Y, Yin M, Chen X, Xiao L, Deng G. Association of inflammatory markers with the severity of COVID-19: a meta-analysis. International Journal of Infectious Diseases. 2020; 96: 467-74.
[20]	Ponti G, Maccaferri M, Ruini C, Tomasi A, Ozben T. Biomarkers associated with COVID-19 disease progression. Crit Rev Clin Lab Sci. 2020; 57 (6): 389-399.
[21]	Li X, Liu C, Mao Z, Xiao M, Wang L, Qi S, Zhou F. Predictive values of neutrophil-to-lymphocyte ratio on disease severity and mortality in COVID-19 patients: a systematic review and meta-analysis. Crit Care. 2020; 24 (1): 1-0.
[22]	Kuluöztürk M, Deveci F, Turgut T, Öner Ö. The Glasgow Prognostic Score and fibrinogen to albumin ratio as prognostic factors in hospitalized patients with COVID-19. Expert Rev Respir Med. 2021: 1-8.

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APA Style

Stephenson Lawson, Collins Amadi. (2022). Potentials of Varied Inflammatory Indices in the Prediction of COVID-19 Severity Among Nigerians. Advances in Biochemistry, 10(1), 18-24. https://doi.org/10.11648/j.ab.20221001.13

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ACS Style

Stephenson Lawson; Collins Amadi. Potentials of Varied Inflammatory Indices in the Prediction of COVID-19 Severity Among Nigerians. Adv. Biochem. 2022, 10(1), 18-24. doi: 10.11648/j.ab.20221001.13

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AMA Style

Stephenson Lawson, Collins Amadi. Potentials of Varied Inflammatory Indices in the Prediction of COVID-19 Severity Among Nigerians. Adv Biochem. 2022;10(1):18-24. doi: 10.11648/j.ab.20221001.13

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@article{10.11648/j.ab.20221001.13,
  author = {Stephenson Lawson and Collins Amadi},
  title = {Potentials of Varied Inflammatory Indices in the Prediction of COVID-19 Severity Among Nigerians},
  journal = {Advances in Biochemistry},
  volume = {10},
  number = {1},
  pages = {18-24},
  doi = {10.11648/j.ab.20221001.13},
  url = {https://doi.org/10.11648/j.ab.20221001.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ab.20221001.13},
  abstract = {Background: The coronavirus disease of 2019 (COVID-19) is theorized to be associated with significant inflammatory episodes. This tends to define the severity and culminates in adverse consequences of the disease. Therefore, the current study evaluated the potentials of varied inflammatory markers/indices that define the COVID-19 severity. Methods: This was a retrospective analysis of pre-treatment data obtained from patients with positive real-time polymerase chain reaction (RT-PCR)-confirmed COVID-19 disease in one of the treatment centers in Port Harcourt, South-south Nigeria. Data were obtained from case notes, medical review charts, nurses’ charts, and laboratory records by trained research assistants in the treatment center using pretested data acquisition templates. Abstracted data were compared between the severe positive and severe negative subgroups and the potentials of varied inflammatory indices were evaluated among the severe positive subgroup using standard protocols. Results: A total of 600 eligible cases were studied. Among the eligible cases, 543 (90.5%) had severe negative disease, while 57 (9.5%) had severe positive disease. The severe positive COVID-19 patients had higher mean blood levels of urea, creatinine, pro-calcitonin, C-reactive protein (CRP), ferritin, higher Glasgow prognostic scores (GPS), fibrinogen, D-dimer, fibrinogen-albumin ratio, total white cell count, neutrophil counts, composite neutrophil/lymphocyte ratio (NLR), composite platelet to lymphocyte ratio but lower potassium, albumin, hemoglobin levels, and isolated lymphocyte and platelet counts compared to the severe positive COVID-19 subjects (pConclusion: The current study corroborates the role of inflammation in the COVID-19 disease severity. The clinical utility of these inflammation-induced markers/indices especially the CRP, GPS, D-dimer, and the NLR should be prioritized among Nigerians during the management of the disease.},
 year = {2022}
}

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TY  - JOUR
T1  - Potentials of Varied Inflammatory Indices in the Prediction of COVID-19 Severity Among Nigerians
AU  - Stephenson Lawson
AU  - Collins Amadi
Y1  - 2022/01/28
PY  - 2022
N1  - https://doi.org/10.11648/j.ab.20221001.13
DO  - 10.11648/j.ab.20221001.13
T2  - Advances in Biochemistry
JF  - Advances in Biochemistry
JO  - Advances in Biochemistry
SP  - 18
EP  - 24
PB  - Science Publishing Group
SN  - 2329-0862
UR  - https://doi.org/10.11648/j.ab.20221001.13
AB  - Background: The coronavirus disease of 2019 (COVID-19) is theorized to be associated with significant inflammatory episodes. This tends to define the severity and culminates in adverse consequences of the disease. Therefore, the current study evaluated the potentials of varied inflammatory markers/indices that define the COVID-19 severity. Methods: This was a retrospective analysis of pre-treatment data obtained from patients with positive real-time polymerase chain reaction (RT-PCR)-confirmed COVID-19 disease in one of the treatment centers in Port Harcourt, South-south Nigeria. Data were obtained from case notes, medical review charts, nurses’ charts, and laboratory records by trained research assistants in the treatment center using pretested data acquisition templates. Abstracted data were compared between the severe positive and severe negative subgroups and the potentials of varied inflammatory indices were evaluated among the severe positive subgroup using standard protocols. Results: A total of 600 eligible cases were studied. Among the eligible cases, 543 (90.5%) had severe negative disease, while 57 (9.5%) had severe positive disease. The severe positive COVID-19 patients had higher mean blood levels of urea, creatinine, pro-calcitonin, C-reactive protein (CRP), ferritin, higher Glasgow prognostic scores (GPS), fibrinogen, D-dimer, fibrinogen-albumin ratio, total white cell count, neutrophil counts, composite neutrophil/lymphocyte ratio (NLR), composite platelet to lymphocyte ratio but lower potassium, albumin, hemoglobin levels, and isolated lymphocyte and platelet counts compared to the severe positive COVID-19 subjects (pConclusion: The current study corroborates the role of inflammation in the COVID-19 disease severity. The clinical utility of these inflammation-induced markers/indices especially the CRP, GPS, D-dimer, and the NLR should be prioritized among Nigerians during the management of the disease.
VL  - 10
IS  - 1
ER  -

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Author Information

Stephenson Lawson

Department of Medical Microbiology and Parasitology, Rivers State University/Rivers State University Teaching Hospital, Port Harcourt, Nigeria
Collins Amadi

Department of Chemical Pathology, Rivers State University/Rivers State University Teaching Hospital, Port Harcourt, Nigeria

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APA Style

Stephenson Lawson, Collins Amadi. (2022). Potentials of Varied Inflammatory Indices in the Prediction of COVID-19 Severity Among Nigerians. Advances in Biochemistry, 10(1), 18-24. https://doi.org/10.11648/j.ab.20221001.13

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ACS Style

Stephenson Lawson; Collins Amadi. Potentials of Varied Inflammatory Indices in the Prediction of COVID-19 Severity Among Nigerians. Adv. Biochem. 2022, 10(1), 18-24. doi: 10.11648/j.ab.20221001.13

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AMA Style

Stephenson Lawson, Collins Amadi. Potentials of Varied Inflammatory Indices in the Prediction of COVID-19 Severity Among Nigerians. Adv Biochem. 2022;10(1):18-24. doi: 10.11648/j.ab.20221001.13

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@article{10.11648/j.ab.20221001.13,
  author = {Stephenson Lawson and Collins Amadi},
  title = {Potentials of Varied Inflammatory Indices in the Prediction of COVID-19 Severity Among Nigerians},
  journal = {Advances in Biochemistry},
  volume = {10},
  number = {1},
  pages = {18-24},
  doi = {10.11648/j.ab.20221001.13},
  url = {https://doi.org/10.11648/j.ab.20221001.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ab.20221001.13},
  abstract = {Background: The coronavirus disease of 2019 (COVID-19) is theorized to be associated with significant inflammatory episodes. This tends to define the severity and culminates in adverse consequences of the disease. Therefore, the current study evaluated the potentials of varied inflammatory markers/indices that define the COVID-19 severity. Methods: This was a retrospective analysis of pre-treatment data obtained from patients with positive real-time polymerase chain reaction (RT-PCR)-confirmed COVID-19 disease in one of the treatment centers in Port Harcourt, South-south Nigeria. Data were obtained from case notes, medical review charts, nurses’ charts, and laboratory records by trained research assistants in the treatment center using pretested data acquisition templates. Abstracted data were compared between the severe positive and severe negative subgroups and the potentials of varied inflammatory indices were evaluated among the severe positive subgroup using standard protocols. Results: A total of 600 eligible cases were studied. Among the eligible cases, 543 (90.5%) had severe negative disease, while 57 (9.5%) had severe positive disease. The severe positive COVID-19 patients had higher mean blood levels of urea, creatinine, pro-calcitonin, C-reactive protein (CRP), ferritin, higher Glasgow prognostic scores (GPS), fibrinogen, D-dimer, fibrinogen-albumin ratio, total white cell count, neutrophil counts, composite neutrophil/lymphocyte ratio (NLR), composite platelet to lymphocyte ratio but lower potassium, albumin, hemoglobin levels, and isolated lymphocyte and platelet counts compared to the severe positive COVID-19 subjects (pConclusion: The current study corroborates the role of inflammation in the COVID-19 disease severity. The clinical utility of these inflammation-induced markers/indices especially the CRP, GPS, D-dimer, and the NLR should be prioritized among Nigerians during the management of the disease.},
 year = {2022}
}

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TY  - JOUR
T1  - Potentials of Varied Inflammatory Indices in the Prediction of COVID-19 Severity Among Nigerians
AU  - Stephenson Lawson
AU  - Collins Amadi
Y1  - 2022/01/28
PY  - 2022
N1  - https://doi.org/10.11648/j.ab.20221001.13
DO  - 10.11648/j.ab.20221001.13
T2  - Advances in Biochemistry
JF  - Advances in Biochemistry
JO  - Advances in Biochemistry
SP  - 18
EP  - 24
PB  - Science Publishing Group
SN  - 2329-0862
UR  - https://doi.org/10.11648/j.ab.20221001.13
AB  - Background: The coronavirus disease of 2019 (COVID-19) is theorized to be associated with significant inflammatory episodes. This tends to define the severity and culminates in adverse consequences of the disease. Therefore, the current study evaluated the potentials of varied inflammatory markers/indices that define the COVID-19 severity. Methods: This was a retrospective analysis of pre-treatment data obtained from patients with positive real-time polymerase chain reaction (RT-PCR)-confirmed COVID-19 disease in one of the treatment centers in Port Harcourt, South-south Nigeria. Data were obtained from case notes, medical review charts, nurses’ charts, and laboratory records by trained research assistants in the treatment center using pretested data acquisition templates. Abstracted data were compared between the severe positive and severe negative subgroups and the potentials of varied inflammatory indices were evaluated among the severe positive subgroup using standard protocols. Results: A total of 600 eligible cases were studied. Among the eligible cases, 543 (90.5%) had severe negative disease, while 57 (9.5%) had severe positive disease. The severe positive COVID-19 patients had higher mean blood levels of urea, creatinine, pro-calcitonin, C-reactive protein (CRP), ferritin, higher Glasgow prognostic scores (GPS), fibrinogen, D-dimer, fibrinogen-albumin ratio, total white cell count, neutrophil counts, composite neutrophil/lymphocyte ratio (NLR), composite platelet to lymphocyte ratio but lower potassium, albumin, hemoglobin levels, and isolated lymphocyte and platelet counts compared to the severe positive COVID-19 subjects (pConclusion: The current study corroborates the role of inflammation in the COVID-19 disease severity. The clinical utility of these inflammation-induced markers/indices especially the CRP, GPS, D-dimer, and the NLR should be prioritized among Nigerians during the management of the disease.
VL  - 10
IS  - 1
ER  -

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