Assessment of Surrogate Markers/Indices of Systemic Inflammation Among COVID-19 Patients with and Without Comorbid Conditions

Stephenson Lawson; Collins Amadi

doi:doi:10.11648/j.ajlm.20220701.13

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Assessment of Surrogate Markers/Indices of Systemic Inflammation Among COVID-19 Patients with and Without Comorbid Conditions

Stephenson Lawson, Collins Amadi

Published in American Journal of Laboratory Medicine (Volume 7, Issue 1)

Received: 6 January 2022 Accepted: 22 January 2022 Published: 9 February 2022

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Abstract

Background: As widely reported, comorbid conditions are a significant risk for severe COVID-19 infection which is characterized by heightened adverse consequences. Since cytokine-induced inflammatory processes define COVID-19 severity, this study was aimed to evaluate the burden of COVID-19-induced inflammatory episodes, assessed using surrogate markers/indices of inflammation, among COVID-19 patients with and without comorbid conditions in Nigeria. Methods: This was a retrospective analysis of data obtained from treatment-naive real-time polymerase chain reaction (RT-PCR) confirmed COVID-19 patients at the Eleme COVID-19 treatment center in Port Harcourt within the southern region of Nigeria. All relevant data was acquired from case notes, medical review charts, nurses’ charts, and laboratory records by trained research assistants using data acquisition templates. All the data acquired were analyzed and compared between the COVID-19 patients with and without comorbid conditions using standard descriptive and comparative statistical tools. Results: Among those studied (n=604), 31.8% (n=192) had at least one pre-existing comorbid condition while 68.2% (n=412) had no comorbid conditions before COVID-19 diagnosis/subsequent presentation. The comorbid positive subgroup were mostly males and had higher mean age, BMI, body temperature, SBP, DBP, and higher proportions of elderly patients, high-risk occupational status (health workers) and social behavior (cigarette smoking), obesity, severe disease, and worse disease outcome, but lower oxygen saturation compared to the comorbid negative subjects at presentation. Additionally, the comorbid positive subjects also had higher mean levels of blood urea, creatinine, pro-calcitonin, CRP, ferritin, Glasgow prognostic scores, fibrinogen, D-Dimer, and the fibrinogen-albumin ratio, total white cell counts, isolated neutrophil counts, neutrophil-lymphocyte count ratio, and the platelet-lymphocyte count ratio but lower levels of potassium, albumin, isolated lymphocyte count and isolated platelet count compared to the comorbid negative subjects (p<0.05). The inflammatory markers/indices were significantly associated with obesity, age ≥65 years, hypertension, past/current cigarette smoking, diabetes, and cardiovascular disease. Conclusion: Comorbidities are significantly associated with amplified systemic inflammatory markers and indices among COVID-19 subjects. This may indicate the pathophysiologic link between various comorbidities and the COVID-19 severity among Nigerians. However, further studies are recommended to substantiate the findings of the current study.

Published in	American Journal of Laboratory Medicine (Volume 7, Issue 1)
DOI	10.11648/j.ajlm.20220701.13
Page(s)	16-22
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), 2022. Published by Science Publishing Group

Keywords

COVID-19, Inflammatory Markers, Comorbid Conditions

References

[1]	Acter T, Uddin N, Das J, Akhter A, Choudhury TR, Kim S. Evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as coronavirus disease 2019 (COVID-19) pandemic: A global health emergency. Science of the Total Environment. 2020; 730: 138996.
[2]	Pal M, Berhanu G, Desalegn C, Kandi V. Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2): An Update. Cureus. 2020; 12 (3): e7423.
[3]	Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: A review. Clin Immunol. 2020; 215: 108427. DOI: 10.1016/j.clim.2020.108427.
[4]	Hu B, Huang S, Yin L. The cytokine storm and COVID-19. Journal of medical virology. 2021; 93 (1): 250-6.
[5]	Gustine JN, Jones D. Immunopathology of Hyperinflammation in COVID-19. Am J Pathol. 2021; 191 (1): 4-17.
[6]	Ji W, Huh K, Kang M, Hong J, Bae GH, Lee R, et al. Effect of underlying comorbidities on the infection and severity of COVID-19 in Korea: a nationwide case-control study. J Korean Med Sci. 2020; 35 (25). e237.
[7]	Fathi M, Vakili K, Sayehmiri F, Mohamadkhani A, Hajiesmaeili M, Rezaei-Tavirani M, et al. The prognostic value of comorbidity for the severity of COVID-19: A systematic review and meta-analysis study. PloS one. 2021; 16 (2): e0246190.
[8]	Gude-Sampedro F, Fernández-Merino C, Ferreiro L, Lado-Baleato Ó, Espasandín-Domínguez J, Hervada X, Cadarso CM, et al. Development and validation of a prognostic model based on comorbidities to predict COVID-19 severity: A population-based study. International journal of epidemiology. 2021; 50 (1): 64-74.
[9]	Alasia D, Owhonda G, Maduka O, Nwadiuto I, Arugu G, Tobin-West C, et al. Clinical and epidemiological characteristics of 646 hospitalized SARS-Cov-2 positive patients in Rivers State Nigeria: a prospective observational study. Pan Afri Med J. 2021; 38: 25. DOI: 10.11604/pamj.2021.38.25.26755.
[10]	De Lucena TM, da Silva Santos AF, de Lima BR, de Albuquerque Borborema ME, et al. Mechanism of inflammatory response in associated comorbidities in COVID-19. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020; 14 (4): 597-600.
[11]	Naing L, Winn T, Rusli BN. Practical issues in calculating the sample size for prevalence studies. Arch Orofac Sci. 2006; 1: 9–14.
[12]	Nigerian Centre for Disease Control (NCDC) National Interim Guidelines for Clinical Management of COVID-19. Accessed 25^th December 2021.
[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): 1061-68.
[14]	Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1995; 854: 1-452.
[15]	Afsin E, Cosgun M. COVID-19 and comorbidities: Predictors, clinical course, relationship with disease severity, and outcome. Exp Biomed Res. 2021; 4 (4): 302-13.
[16]	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.
[17]	Zhou Y, Yang Q, Chi J, Dong B, Lv W, Shen L, et al. Comorbidities and the risk of severe or fatal outcomes associated with coronavirus disease 2019: A systematic review and meta-analysis. Int J Infect Dis. 2020; 99: 47-56.
[18]	Hameed I, Masoodi SR, Mir SA, Nabi M, Ghazanfar K, Ganai BA. Type 2 diabetes mellitus: From a metabolic disorder to an inflammatory condition. World J Diabetes 2015; 6 (4): 598–612.
[19]	Rahmani-Kukia N, Abbasi A. Physiological and Immunological Causes of the Susceptibility of Chronic Inflammatory Patients to COVID-19 Infection: Focus on Diabetes. Front Endocrinol (Lausanne). 2021; 12: 576412. DOI: 10.3389/fendo.2021.576412.
[20]	Chiappetta S, Sharma AM, Bottino V, Stier C. COVID-19 and the role of chronic inflammation in patients with obesity. Int J Obes (Lond). 2020; 44 (8): 1790-2.
[21]	De Lucena TMC, da Silva Santos AF, de Lima BR, de Albuquerque Borborema ME, de Azevêdo Silva J. Mechanism of inflammatory response in associated comorbidities in COVID-19. Diabetes Metab Syndr. 2020; 14 (4): 597-600.
[22]	Maggi P, Ricci E, Messina V, Salzillo A, Simeone F, Iodice A, et al. Dangerous liaisons? The role of inflammation and comorbidities in HIV and SARS-CoV-2 infection. Expert Review of Clinical Immunology. 2021; 17 (3): 201-8.

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APA Style

Stephenson Lawson, Collins Amadi. (2022). Assessment of Surrogate Markers/Indices of Systemic Inflammation Among COVID-19 Patients with and Without Comorbid Conditions. American Journal of Laboratory Medicine, 7(1), 16-22. https://doi.org/10.11648/j.ajlm.20220701.13

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ACS Style

Stephenson Lawson; Collins Amadi. Assessment of Surrogate Markers/Indices of Systemic Inflammation Among COVID-19 Patients with and Without Comorbid Conditions. Am. J. Lab. Med. 2022, 7(1), 16-22. doi: 10.11648/j.ajlm.20220701.13

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AMA Style

Stephenson Lawson, Collins Amadi. Assessment of Surrogate Markers/Indices of Systemic Inflammation Among COVID-19 Patients with and Without Comorbid Conditions. Am J Lab Med. 2022;7(1):16-22. doi: 10.11648/j.ajlm.20220701.13

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@article{10.11648/j.ajlm.20220701.13,
  author = {Stephenson Lawson and Collins Amadi},
  title = {Assessment of Surrogate Markers/Indices of Systemic Inflammation Among COVID-19 Patients with and Without Comorbid Conditions},
  journal = {American Journal of Laboratory Medicine},
  volume = {7},
  number = {1},
  pages = {16-22},
  doi = {10.11648/j.ajlm.20220701.13},
  url = {https://doi.org/10.11648/j.ajlm.20220701.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajlm.20220701.13},
  abstract = {Background: As widely reported, comorbid conditions are a significant risk for severe COVID-19 infection which is characterized by heightened adverse consequences. Since cytokine-induced inflammatory processes define COVID-19 severity, this study was aimed to evaluate the burden of COVID-19-induced inflammatory episodes, assessed using surrogate markers/indices of inflammation, among COVID-19 patients with and without comorbid conditions in Nigeria. Methods: This was a retrospective analysis of data obtained from treatment-naive real-time polymerase chain reaction (RT-PCR) confirmed COVID-19 patients at the Eleme COVID-19 treatment center in Port Harcourt within the southern region of Nigeria. All relevant data was acquired from case notes, medical review charts, nurses’ charts, and laboratory records by trained research assistants using data acquisition templates. All the data acquired were analyzed and compared between the COVID-19 patients with and without comorbid conditions using standard descriptive and comparative statistical tools. Results: Among those studied (n=604), 31.8% (n=192) had at least one pre-existing comorbid condition while 68.2% (n=412) had no comorbid conditions before COVID-19 diagnosis/subsequent presentation. The comorbid positive subgroup were mostly males and had higher mean age, BMI, body temperature, SBP, DBP, and higher proportions of elderly patients, high-risk occupational status (health workers) and social behavior (cigarette smoking), obesity, severe disease, and worse disease outcome, but lower oxygen saturation compared to the comorbid negative subjects at presentation. Additionally, the comorbid positive subjects also had higher mean levels of blood urea, creatinine, pro-calcitonin, CRP, ferritin, Glasgow prognostic scores, fibrinogen, D-Dimer, and the fibrinogen-albumin ratio, total white cell counts, isolated neutrophil counts, neutrophil-lymphocyte count ratio, and the platelet-lymphocyte count ratio but lower levels of potassium, albumin, isolated lymphocyte count and isolated platelet count compared to the comorbid negative subjects (p<0.05). The inflammatory markers/indices were significantly associated with obesity, age ≥65 years, hypertension, past/current cigarette smoking, diabetes, and cardiovascular disease. Conclusion: Comorbidities are significantly associated with amplified systemic inflammatory markers and indices among COVID-19 subjects. This may indicate the pathophysiologic link between various comorbidities and the COVID-19 severity among Nigerians. However, further studies are recommended to substantiate the findings of the current study.},
 year = {2022}
}

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TY  - JOUR
T1  - Assessment of Surrogate Markers/Indices of Systemic Inflammation Among COVID-19 Patients with and Without Comorbid Conditions
AU  - Stephenson Lawson
AU  - Collins Amadi
Y1  - 2022/02/09
PY  - 2022
N1  - https://doi.org/10.11648/j.ajlm.20220701.13
DO  - 10.11648/j.ajlm.20220701.13
T2  - American Journal of Laboratory Medicine
JF  - American Journal of Laboratory Medicine
JO  - American Journal of Laboratory Medicine
SP  - 16
EP  - 22
PB  - Science Publishing Group
SN  - 2575-386X
UR  - https://doi.org/10.11648/j.ajlm.20220701.13
AB  - Background: As widely reported, comorbid conditions are a significant risk for severe COVID-19 infection which is characterized by heightened adverse consequences. Since cytokine-induced inflammatory processes define COVID-19 severity, this study was aimed to evaluate the burden of COVID-19-induced inflammatory episodes, assessed using surrogate markers/indices of inflammation, among COVID-19 patients with and without comorbid conditions in Nigeria. Methods: This was a retrospective analysis of data obtained from treatment-naive real-time polymerase chain reaction (RT-PCR) confirmed COVID-19 patients at the Eleme COVID-19 treatment center in Port Harcourt within the southern region of Nigeria. All relevant data was acquired from case notes, medical review charts, nurses’ charts, and laboratory records by trained research assistants using data acquisition templates. All the data acquired were analyzed and compared between the COVID-19 patients with and without comorbid conditions using standard descriptive and comparative statistical tools. Results: Among those studied (n=604), 31.8% (n=192) had at least one pre-existing comorbid condition while 68.2% (n=412) had no comorbid conditions before COVID-19 diagnosis/subsequent presentation. The comorbid positive subgroup were mostly males and had higher mean age, BMI, body temperature, SBP, DBP, and higher proportions of elderly patients, high-risk occupational status (health workers) and social behavior (cigarette smoking), obesity, severe disease, and worse disease outcome, but lower oxygen saturation compared to the comorbid negative subjects at presentation. Additionally, the comorbid positive subjects also had higher mean levels of blood urea, creatinine, pro-calcitonin, CRP, ferritin, Glasgow prognostic scores, fibrinogen, D-Dimer, and the fibrinogen-albumin ratio, total white cell counts, isolated neutrophil counts, neutrophil-lymphocyte count ratio, and the platelet-lymphocyte count ratio but lower levels of potassium, albumin, isolated lymphocyte count and isolated platelet count compared to the comorbid negative subjects (p<0.05). The inflammatory markers/indices were significantly associated with obesity, age ≥65 years, hypertension, past/current cigarette smoking, diabetes, and cardiovascular disease. Conclusion: Comorbidities are significantly associated with amplified systemic inflammatory markers and indices among COVID-19 subjects. This may indicate the pathophysiologic link between various comorbidities and the COVID-19 severity among Nigerians. However, further studies are recommended to substantiate the findings of the current study.
VL  - 7
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, Port Harcourt, Nigeria

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APA Style

Stephenson Lawson, Collins Amadi. (2022). Assessment of Surrogate Markers/Indices of Systemic Inflammation Among COVID-19 Patients with and Without Comorbid Conditions. American Journal of Laboratory Medicine, 7(1), 16-22. https://doi.org/10.11648/j.ajlm.20220701.13

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ACS Style

Stephenson Lawson; Collins Amadi. Assessment of Surrogate Markers/Indices of Systemic Inflammation Among COVID-19 Patients with and Without Comorbid Conditions. Am. J. Lab. Med. 2022, 7(1), 16-22. doi: 10.11648/j.ajlm.20220701.13

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AMA Style

Stephenson Lawson, Collins Amadi. Assessment of Surrogate Markers/Indices of Systemic Inflammation Among COVID-19 Patients with and Without Comorbid Conditions. Am J Lab Med. 2022;7(1):16-22. doi: 10.11648/j.ajlm.20220701.13

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@article{10.11648/j.ajlm.20220701.13,
  author = {Stephenson Lawson and Collins Amadi},
  title = {Assessment of Surrogate Markers/Indices of Systemic Inflammation Among COVID-19 Patients with and Without Comorbid Conditions},
  journal = {American Journal of Laboratory Medicine},
  volume = {7},
  number = {1},
  pages = {16-22},
  doi = {10.11648/j.ajlm.20220701.13},
  url = {https://doi.org/10.11648/j.ajlm.20220701.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajlm.20220701.13},
  abstract = {Background: As widely reported, comorbid conditions are a significant risk for severe COVID-19 infection which is characterized by heightened adverse consequences. Since cytokine-induced inflammatory processes define COVID-19 severity, this study was aimed to evaluate the burden of COVID-19-induced inflammatory episodes, assessed using surrogate markers/indices of inflammation, among COVID-19 patients with and without comorbid conditions in Nigeria. Methods: This was a retrospective analysis of data obtained from treatment-naive real-time polymerase chain reaction (RT-PCR) confirmed COVID-19 patients at the Eleme COVID-19 treatment center in Port Harcourt within the southern region of Nigeria. All relevant data was acquired from case notes, medical review charts, nurses’ charts, and laboratory records by trained research assistants using data acquisition templates. All the data acquired were analyzed and compared between the COVID-19 patients with and without comorbid conditions using standard descriptive and comparative statistical tools. Results: Among those studied (n=604), 31.8% (n=192) had at least one pre-existing comorbid condition while 68.2% (n=412) had no comorbid conditions before COVID-19 diagnosis/subsequent presentation. The comorbid positive subgroup were mostly males and had higher mean age, BMI, body temperature, SBP, DBP, and higher proportions of elderly patients, high-risk occupational status (health workers) and social behavior (cigarette smoking), obesity, severe disease, and worse disease outcome, but lower oxygen saturation compared to the comorbid negative subjects at presentation. Additionally, the comorbid positive subjects also had higher mean levels of blood urea, creatinine, pro-calcitonin, CRP, ferritin, Glasgow prognostic scores, fibrinogen, D-Dimer, and the fibrinogen-albumin ratio, total white cell counts, isolated neutrophil counts, neutrophil-lymphocyte count ratio, and the platelet-lymphocyte count ratio but lower levels of potassium, albumin, isolated lymphocyte count and isolated platelet count compared to the comorbid negative subjects (p<0.05). The inflammatory markers/indices were significantly associated with obesity, age ≥65 years, hypertension, past/current cigarette smoking, diabetes, and cardiovascular disease. Conclusion: Comorbidities are significantly associated with amplified systemic inflammatory markers and indices among COVID-19 subjects. This may indicate the pathophysiologic link between various comorbidities and the COVID-19 severity among Nigerians. However, further studies are recommended to substantiate the findings of the current study.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - Assessment of Surrogate Markers/Indices of Systemic Inflammation Among COVID-19 Patients with and Without Comorbid Conditions
AU  - Stephenson Lawson
AU  - Collins Amadi
Y1  - 2022/02/09
PY  - 2022
N1  - https://doi.org/10.11648/j.ajlm.20220701.13
DO  - 10.11648/j.ajlm.20220701.13
T2  - American Journal of Laboratory Medicine
JF  - American Journal of Laboratory Medicine
JO  - American Journal of Laboratory Medicine
SP  - 16
EP  - 22
PB  - Science Publishing Group
SN  - 2575-386X
UR  - https://doi.org/10.11648/j.ajlm.20220701.13
AB  - Background: As widely reported, comorbid conditions are a significant risk for severe COVID-19 infection which is characterized by heightened adverse consequences. Since cytokine-induced inflammatory processes define COVID-19 severity, this study was aimed to evaluate the burden of COVID-19-induced inflammatory episodes, assessed using surrogate markers/indices of inflammation, among COVID-19 patients with and without comorbid conditions in Nigeria. Methods: This was a retrospective analysis of data obtained from treatment-naive real-time polymerase chain reaction (RT-PCR) confirmed COVID-19 patients at the Eleme COVID-19 treatment center in Port Harcourt within the southern region of Nigeria. All relevant data was acquired from case notes, medical review charts, nurses’ charts, and laboratory records by trained research assistants using data acquisition templates. All the data acquired were analyzed and compared between the COVID-19 patients with and without comorbid conditions using standard descriptive and comparative statistical tools. Results: Among those studied (n=604), 31.8% (n=192) had at least one pre-existing comorbid condition while 68.2% (n=412) had no comorbid conditions before COVID-19 diagnosis/subsequent presentation. The comorbid positive subgroup were mostly males and had higher mean age, BMI, body temperature, SBP, DBP, and higher proportions of elderly patients, high-risk occupational status (health workers) and social behavior (cigarette smoking), obesity, severe disease, and worse disease outcome, but lower oxygen saturation compared to the comorbid negative subjects at presentation. Additionally, the comorbid positive subjects also had higher mean levels of blood urea, creatinine, pro-calcitonin, CRP, ferritin, Glasgow prognostic scores, fibrinogen, D-Dimer, and the fibrinogen-albumin ratio, total white cell counts, isolated neutrophil counts, neutrophil-lymphocyte count ratio, and the platelet-lymphocyte count ratio but lower levels of potassium, albumin, isolated lymphocyte count and isolated platelet count compared to the comorbid negative subjects (p<0.05). The inflammatory markers/indices were significantly associated with obesity, age ≥65 years, hypertension, past/current cigarette smoking, diabetes, and cardiovascular disease. Conclusion: Comorbidities are significantly associated with amplified systemic inflammatory markers and indices among COVID-19 subjects. This may indicate the pathophysiologic link between various comorbidities and the COVID-19 severity among Nigerians. However, further studies are recommended to substantiate the findings of the current study.
VL  - 7
IS  - 1
ER  -

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