Covid-19 Inflammation and Coagulation Markers

Patients with SARS-CoV-2 infection can experience a range of clinical manifestations, from no symptoms to critical illness. Covid-19 patients face a high risk of death for the severe complication such as hypoxemic respiratory failure, acute respiratory distress syndrome (ARDS), septic shock, elevation in multiple inflammatory cytokines, thromboembolic disease, and/or exacerbation of underlying comorbidities. In addition to pulmonary disease, patients with COVID-19 may also experience cardiac, hepatic, renal, and central nervous system disease [1].

Novel biomarkers such as IL-6, Ferritin, PCT, hs-CRP and D-dimer are reliable biomarkers related to COVID-19 progression and used to divide patients into severity of illness categories, ensuring optimal resource allocation and patients management [2].

Specification

* Product specifications and parameters are subject to the Instruction for Use.

Clinical Significance

D-Dimer:

Quantitative determination of D-Dimer in human plasma

D-Dimer is a degradation product of crosslinked fibrin and the elevated concentration of D-Dimer indicates increased coagulation and fibrinolytic activities. D-dimer testing is of clinical use when there is a suspicion of deep venous thrombosis (DVT) or pulmonary embolism (PE). Coagulation disorders are relatively frequently encountered among COVID-19 patients, especially among those with severe disease [3].

IL-6

Quantitative determination of Interleukin-6 (IL-6) in human serum and plasma (EDTA)

IL-6 is a pleiotropic cytokine with central roles in immune regulation, inflammation, hematopoiesis, and oncogenesis. Elevated levels of IL-6 are significantly associated with sepsis, septic shock and cytokine storm which are severe complications of SARS-CoV-2 infection. High levels of IL-6 showed a statistically significant correlation with severe illness of COVID-19 patients [4].

Ferritin

Quantitative determination of Ferritin in human serum

Ferritin is a ubiquitous intracellular protein that stores iron and releases it in a controlled fashion. A high level of Ferritin, measure of stored iron, was found to be associated with severe disease in COVID-19 patients and was linked to high fatality rates [5]. It is mainly used as routine inflammatory examination for COVID-19 patients.

hs-CRP

Quantitative determination of hs-CRP (high-sensitivity C-Reactive Protein) in human serum and plasma (EDTA, heparin or sodium citrate)

CRP is an annular (ring-shaped), pentameric protein found in blood plasma, whose levels rise in response to inflammation. CRP was elevated in 60.7% of COVID-19 patients.

PCT

Quantitative determination of PCT (Procalcitonin) in human serum and plasma (heparin, EDTA)

Procalcitonin (PCT) is a precursor of the hormone calcitonin, which is involved with calcium homeostasis, and is produced by the C-cells of the thyroid gland. The level of procalcitonin rises in a response to a proinflammatory stimulus, especially of severe infections. Increased procalcitonin values were associated with a nearly 5-fold higher risk of severe infection. [6]

References

[1] WHO. Clinical management of severe acute respiratory infection when COVID-19 is suspected external icon. 13 March 2020.

[2] CDC. Overview of Testing for SARS-CoV-2 (COVID-19). Mar. 17, 2021.

[3] Qu J, Wu C, Li X, Zhang G, Jiang Z, Li X, et al. Profile of immunoglobulin G and IgM antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clin Infect Dis. 2020 Nov 19;71(16):2255-8.

[4] Wolfel R, Corman VM, Guggemos W, Seilmaier M, Zange S, Muller MA, et al. Virological assessment of hospitalized patients with COVID-2019. Nature. 2020 May;581(7809):465-9.

[5] Zhou, F. et al. "Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study." Lancet (London, England) 395 (2020): 1054 - 1062.

[6] Lippi, G. et al. "Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis." Clinica Chimica Acta; International Journal of Clinical Chemistry 506 (2020): 145 - 148.

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