COVID 19 Severity Correlation between Inflammatory Markers and High Resolution Computerised Tomography

Main Article Content

Ashaq Parrey Abir Aijaz Mohd Ismail Mir Sadaqat Manzoor Koka Basharat Ahmad Hilal Bhat Yasmeen Amin

Abstract

Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. The outbreak of SARS-CoV-2 was considered to have originally started via a zoonotic transmission associated with the seafood market in Wuhan, China. Later it was recognized that human to human transmission played a major role in the subsequent outbreak. The Inflammatory responses caused by  viral replication of SARS-CoV-2 with cellular destruction can recruit macrophages and monocytes and lead to the release of cytokines and chemokines.These  inflammatory markers then attract immune cells and activate immune responses, leading to cytokine storms .Many such inflammatory markers have been attributed to determine the severity of SARS-CoV-2 disease   and mortality associated with it. The Inflammatory markers such as   serum ferritin, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and interleukin-6 (IL-6) have been reported to be significantly associated with the high risks of the development of severe COVID-19 disease.  


Aims and objectives


The aim of the study was to find out correlation between inflammatory markers and HRCT chest severity in hospitalised COVID-19 patients.


 Results and conclusion.


 The study supported the existing data that high load of inflammatory markers is associated with more severe COVID-19 lung disease and indirectly high mortality ,out of four inflammatory markers which included D Dimer ,IL6,Serum ferritin and LDH we found three markers  IL6,Serum ferritin and LDH has significant relation with CT severity

Article Details

How to Cite
PARREY, Ashaq et al. COVID 19 Severity Correlation between Inflammatory Markers and High Resolution Computerised Tomography. Medical Research Archives, [S.l.], v. 9, n. 12, dec. 2021. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2619>. Date accessed: 26 dec. 2024. doi: https://doi.org/10.18103/mra.v9i12.2619.
Section
Research Articles

References

1. Wu, J. T., Leung, K. & Leung, G. M. Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study. Lancet 395, 689–697 (2020).
2. Hui, D. S. et al. The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health - the latest 2019 novel coronavirus outbreak in Wuhan, China. Intl. J. Infect. Dis. 91, 264–266 (2020).
3. World Health Organization. Coronavirus disease 2019 (COVID-19). Situation report – 51. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200311-sitrep-51-covid-19.pdf?sfvrsn=1ba62e57_10 (2020).
4. Liu J., Yu H., Zhang S. The indispensable role of chest CT in the detection of coronavirus disease 2019 (COVID-19) European Journal of Nuclear Medicine and Molecular Imaging. 2020,
5. Emedicine.medscape.com. Coronavirus Disease 2019 (COVID-19) Clinical Presentation: History, Physical Examination, Complications. https://emedicine.medscape.com/article/2500114-clinical. [Google Scholar]
6. Thomas-Rüddel D., Winning J., Dickmann P., et al. “Coronavirus disease 2019” (COVID-19): update für anästhesisten und intensivmediziner märz 2020. Der Anaesthesist. 2020;69(4):p. 225. doi: 10.1007/s00101-020-00758-x. [PubMed] [CrossRef] [Google Scholar]
7. Leonardi A., Scipione R., Alfieri G., et al. Role of computed tomography in predicting critical disease in patients with covid-19 pneumonia: a retrospective study using a semiautomatic quantitative method. European Journal of Radiology. 2020;130:p. 109202. doi: 10.1016/j.ejrad.2020.109202.
8. Meng L., Qiu H., Wan L., et al. Intubation and ventilation amid the COVID-19 outbreak. Anesthesiology. 2020;132(6):p. 1317. doi: 10.1097/ALN.0000000000003296.
9. Zhang H.-t., Zhang J.-s., Zhang H.-h., et al. Automated detection and quantification of COVID-19 pneumonia: CT imaging analysis by a deep learning-based software. European Journal of Nuclear Medicine and Molecular Imaging. 2020;47(11):p. 2525. doi: 10.1007/s00259-020-04953-1.
10. Huang C., Wang Y., Li X., Ren L., Zhao J., Hu Y., Zhang L., Fan G., Xu J., Gu X., Cheng Z., Yu T., Xia J., Wei Y., Wu W., Xie X., Yin W., Li H., Liu M., Xiao Y., Gao H., Guo L., Xie J., Wang G., Jiang R., Gao Z., Jin Q., Wang J., Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506.
11. Weiss P., Murdoch D.R. Clinical course and mortality risk of severe COVID-19. Lancet. 2020;395(10229):1014–1015. doi: 10.1016/S0140-6736(20)30633-4. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
12. Cummings M.J., Baldwin M.R., Abrams D. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet. 2020;395(10239):1763–1770. doi: 10.1016/S0140-6736(20)31189-2. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
13. Henderson L.A., Canna S.W., Schulert G.S. On the alert for cytokine storm: immunopathology in COVID-19. Arthritis Rheum. 2020 doi: 10.1002/art.41285. [Published online on May 10] [PMC free article] [PubMed] [CrossRef] [Google Scholar]
14. Moore J.B., June C.H. Cytokine release syndrome in severe COVID-19. Science. 2020;368(6490):473–474. doi: 10.1126/science.abb8925. [PubMed] [CrossRef] [Google Scholar]
15. Channappanavar R., Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Semin Immunopathol. 2017;39(5):529–539. doi: 10.1007/s00281-017-0629-x. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
16. Chen R., Sang L., Jiang M. Longitudinal hematologic and immunologic variations associated with the progression of COVID-19 patients in China. J Allergy Clin Immunol. 2020 doi: 10.1016/j.jaci.2020.05.003. [published online on May 11] [PMC free article] [PubMed] [CrossRef] [Google Scholar]
17. Qin C., Zhou L., Hu Z. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020;71(15):762–768. doi: 10.1093/cid/ciaa248. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
18. Lv Z., Cheng S., Le J. Clinical characteristics and co-infections of 354 hospitalized patients with COVID-19 in Wuhan, China: a retrospective cohort study. Microb Infect. 2020;22(4-5):195–199. doi: 10.1016/j.micinf.2020.05.007. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
19. Wang Y., Lu X., Li Y. Clinical course and outcomes of 344 intensive care patients with COVID-19. Am J Respir Crit Care Med. 2020 Jun 1;201(11):1430–1434. doi: 10.1164/rccm.202003-0736LE. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
20. Chollet-Martin S., Jourdain B., Gibert C., Elbim C., Chastre J., Gougerot-Pocidalo M.A. Interactions between neutrophils and cytokines in blood and alveolar spaces during ARDS. Am J Respir Crit Care Med. 1996;154(3 Pt 1):594–601. doi: 10.1164/ajrccm.154.3.8810592. [PubMed] [CrossRef] [Google Scholar]
21. Gupta K.K., Khan M.A., Singh S.K. Constitutive inflammatory cytokine storm: a major threat to human Health. J Interferon Cytokine Res. 2020;40(1):19–23. doi: 10.1089/jir.2019.0085. [PubMed] [CrossRef] [Google Scholar]
22. Tanaka T., Narazaki M., Kishimoto T. IL-6 in inflammation, immunity, and disease. Cold Spring Harb Perspect Biol. 2014;6(10):a016295. doi: 10.1101/cshperspect.a016295. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
23. Zhou Y., Fu B., Zheng X., Wnag D., Zhao C., Qi Y., Sun R., Tian Z., Xu X., Wei H. Pathogenic T cells and inflammatory monocytes incite inflammatory storm in severe COVID-19 patients. Journal. 2020
24. Qin C., Zhou L., Hu Z., Zhang S., Yang S., Tao Y., Xie C., Ma K., Shang K., Wang W., Tian D.S. Dysregulation of immune response in patients with COVID-19 in Wuhan, China. Journal. 2020 doi: 10.1093/cid/ciaa248.
25. Wadman, M. C.-F., J, Kaiser, J & Matacic, C. How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes. Science https://www.sciencemag.org/news/2020/04/how-does-coronavirus-kill-clinicians-trace-ferocious-rampage-through-body-brain-toes (2020).
26. Oxley, T. J. et al. Large-vessel stroke as a presenting feature of Covid-19 in the young. N. Engl. J. Med. 382, e60 (2020).
27. Liu J., Yu H., Zhang S. The indispensable role of chest CT in the detection of coronavirus disease 2019 (COVID-19) European Journal of Nuclear Medicine and Molecul Imaging. 2020, https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC7118704/#CR2 , In press. [PMC free article] [PubMed] [Google Scholar]
28. Li K., Fang Y., Li W., et al. CT image visual quantitative evaluation and clinical classification of coronavirus disease (COVID-19) European Radiology. 2020;30(8):4407–4416. doi: 10.1007/s00330-020-06817-6. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
29. Huang L., Han R., Ai T., et al. Serial quantitative chest CT assessment of COVID-19: deep-learning approach. Radiology:
Cardiothoracic Imaging. 2020;2(2):p. e200075. doi: 10.1148/ryct.2020200075. https://pubs.rsna.org/doi/10.1148/ryct.2020200075. [CrossRef] [Google Scholar]
30. Lessmann N., Sánchez C. I., Beenen L., et al. Automated assessment of CO-rads and chest CT severity scores in patients with suspected COVID-19 using artificial intelligence. Radiology. 2020:p. 202439. doi: 10.1148/radiol.2020202439. https://pubs.rsna.org/doi/10.1148/radiol.2020202439. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
31. Deng Y, Liu W, Liu K, et al. Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 (COVID-19) in Wuhan, China: a retrospective study. Chin Med J (Engl) 2020;133:1261–7.
32. Chen G, et al. Clinical and immunologic features in severe and moderate Coronavirus Disease 2019. J Clin Invest. 2020b;130(5):2620–9
33. Gao Y, et al. Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19. J Med Virol. 2020;92(7):791–6.
34. Tao L, et al. The potential role of IL-6 in monitoring severe case of coronavirus disease 2019.
35. Gong J, et al. Correlation analysis between disease severity and inflammation-related parameters in patients with COVID-19 pneumonia.
36. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan China: a retrospective cohort study. Lancet 2020;395:1054–62.
37. Chen T, Wu D, Chen H, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ 2020;368:m1091.
38. Wang Y, Lu X, Chen H, et al. Clinical course and outcomes of 344 intensive care patients with COVID-19. Am J Respir Crit Care Med 2020;201:1430–4.Cited Here |View Full Text | PubMed | CrossRe
39. An W, Xia F, Chen M, et al. Analysis of clinical features of 11 death cases caused by COVID-19. J Pract Med 2020;1–6.
40. Wang L, He W, Yu X, et al. Coronavirus disease 2019 in elderly patients: characteristics and prognostic factors based on 4-week follow-up. J Infect 2020;80:639–45.
41. Tu WJ, Cao J, Yu L, et al. Clinicolaboratory study of 25 fatal cases of COVID-19 in Wuhan. Intensive Care Med 2020;46:1117–20.
42. He XW, Lai JS, Cheng J, et al. Impact of complicated myocardial injury on the clinical outcome of severe or critically ill COVID-19 patients. Chin J Cardiol 2020;1–9.
43. Black S., Kushner I., Samols D. C-reactive protein. J Biol Chem. 2004;279(47):48487–48490. doi: 10.1074/jbc.R400025200. [PubMed] [CrossRef] [Google Scholar]
44. Khalid I., Alraddadi B.M., Dairi Y. Acute management and long-term survival among subjects with severe Middle East respiratory syndrome coronavirus pneumonia and ARDS. Respir Care. 2016;61(3):340–348. doi: 10.4187/respcare.04325. [PubMed] [CrossRef] [Google Scholar]
45. Cheng Z.J., Shan J. Novel coronavirus: where we are and what we know. Infection. 2019;48(2):155–163. doi: 10.1007/s15010-020-01401-y. 2020. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
46. Xu X., Han M., Li T. Effective treatment of severe COVID-19 patients with tocilizumab. Proc Natl Acad Sci U S A. 2020;117(20):10970–10975. doi: 10.1073/pnas.2005615117
47. Chen C.Y., Lee C.H., Liu C.Y., Wang J.H., Wang L.M., Perng R.P. Clinical features and outcomes of severe acute respiratory syndrome and predictive factors for acute respiratory distress syndrome. J Chin Med Assoc. 2005;68(1):4–10. [PMC free article] [PubMed] [Google Scholar]
48. Chiang C.H., Shih J.F., Su W.J., Perng R.P. Eight-month prospective study of 14 patients with hospital-acquired severe acute respiratory syndrome. Mayo Clin Proc. 2004;79(11):1372–1379. [PMC free article] [PubMed] [Google Scholar]
49. Tao R.J., Luo X.L., Xu W. Viral infection in community acquired pneumonia patients with fever: a prospective observational study. J Thorac Dis. 2018;10(7):4387–4395. [PMC free article] [PubMed] [Google Scholar]
50. Chen G, et al. Clinical and immunologic features in severe and moderate Coronavirus Disease 2019. J Clin Invest. 2020b;130(5):2620–9.
51. Tao L, et al. The potential role of IL-6 in monitoring severe case of coronavirus disease 2019. https://doi.org/10.1101/2020.03.01.20029769. Posted on medRxiv 10 Mar 2020.
52.Gong J, et al. Correlation analysis between disease severity and inflammation-related parameters in patients with COVID-19 pneumonia. https://doi.org/10.1101/2020.02.25.20025643. Posted on medRxiv 27 Feb 2020.
53. Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, et al. Hematological findings and complications of COVID-19. Amer J Hematol. (2020) 95:834–47. doi: 10.1002/ajh25829
54. Kernan K.F., Carcillo J.A. Hyperferritinemia and inflammation. Int Immunol. 2017;29(9):401–409. doi: 10.1093/intimm/dxx031.
55. Manuel V and Christian CR. Ferritin levels and Covid -19. Pan American journal of Public Health. 2020; (44): e72. https://doi.org/10.26633/RPSP.2020.72
56. Mehta P., McAuley D.F., Brown M. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395(10229):1033–1034. doi: 10.1016/S0140-6736(20)30628-0. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
57. Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. Cui S, Chen S, Li X, Liu S, Wang F J Thromb Haemost. 2020 Jun; 18(6):1421-1424.
58. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: a retrospective cohort study.Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X, Guan L, Wei Y, Li H, Wu X, Xu J, Tu S, Zhang Y, Chen H, Cao B Lancet. 2020 Mar 28; 395(10229):1054-1062.