Impact of inflammatory markers, dread diseases and cycle threshold (Ct) Values in COVID-19 progression

Abstract

The link between the inflammatory marker and SARS-CoV-2 cycle threshold (Ct) with disease progression remains undefined, mainly in coronavirus disease-2019 (COVID-19). Therefore, this study aimed to identify several inflammatory markers (Ferritin, LDH, and D-dimer), and Ct values to predict outcomes in hospitalized COVID-19 Iraqi patients. A case study was performed on 426 patients to guess cutoff values of inflammatory markers that were detected by a real-time polymerase chain reaction (RT-PCR) and specific auto-analyzer instrument. Significantly increased levels of inflammatory markers in critical and severe patients compared with mild-moderate (p < 0.001). Compared with aging and disease severity, inflammatory markers and Ct values are significantly related to the aging and severity in critical and severe COVID-19 patients (p < 0.001). Finding the Ct value was negatively associated with Ferritin, LDH, and D-dimer (p < 0.001); moreover, inflammatory markers concentrations and Ct values were significantly higher during the first ten days. The Ct values correlate with some relevant clinical parameters of inflammation. Higher levels of D dimer, S. Ferritin and LDH were associated with older age and the severity of COVID-19. The area under the ROC curve indicates that serum ferritin was the highest and excellent predictor for disease severity. Keywords: Coronavirus disease 2019; Inflammation; D-dimer; Ferritin; Lactate dehydrogenase; Cycle threshold (Ct).