Background: COVID-19 has caused a considerable number of hospital admissions in China since December 2019. Many COVID-19 patients experience signs of acute respiratory distress syndrome, and some are even in danger of dying. Objective: to measure the serum levels of D-dimer, Neutrophil-Lymphocyte count ratio (NLR), and neopterin in patients hospitalized with severe COVID-19 in Baghdad, Iraq. And to determine the cut-off values (critical values) of these markers for the distinction between the severe patients diagnosed with COVID-19 and the controls. Materials and methods: In this case-control study, we collect blood from 89 subjects, 45 were severe patients hospitalized in many Baghdad medical centers who were diagnosed with COVID-19 infection, and 44 were apparently healthy subjects as a control. The time of collection is from September 15 th to December 31 th, 2021. The optimal cut-off points (critical values) and prognostic relevance of D-dimer, Neutrophil-Lymphocyte count ratio (NLR), and neopterin were investigated using (ROC) curves analysis. Results: In severe patients hospitalized with COVID-19 the levels of D-dimer, NLR, and neopterin were statistically significantly higher than in control participants (P< 0.005). The D-dimer, NLR, and neopterin tests have areas under the receiver operating characteristic (ROC) curves of 0.920, 0.90, and 0.74 respectively, and their critical values for the differentiation between the severe patients and control were 0.22 µg/ml, 2.56, and 3.02 nmol/L. Conclusions: D-dimer, NLR, and neopterin levels in sever COVID-19 patients were higher than control, with values of greater than 0.22µg/ml, 2.56 and 3.02nmol/L respectively was linked to a severe COVID-19infection with good sensitivity and selectivity.
Cite this article:
Marwa Younus Fadhil, Eman Saadi Saleh. Assessment of Serum Neopterin Levels in patients hospitalized with severe COVID-19. Research Journal of Pharmacy and Technology 2023; 16(4):1669-3. doi: 10.52711/0974-360X.2023.00273
Marwa Younus Fadhil, Eman Saadi Saleh. Assessment of Serum Neopterin Levels in patients hospitalized with severe COVID-19. Research Journal of Pharmacy and Technology 2023; 16(4):1669-3. doi: 10.52711/0974-360X.2023.00273 Available on: https://rjptonline.org/AbstractView.aspx?PID=2023-16-4-21
1. Devi KN, Rosy JS. ECMO therapy for COVID-19. Asian J. Nursing Education and Research. 2021; 11(2):299-301. doi: 10.5958/2349-2996.2021.00072.0
2. Patil VK, Shaikh AZ. Corona (Covid - 19). Asian J. Pharm. Res. 2020; 10(4):275-285. doi: 10.5958/2231-5691.2020.00048.9
3. Negi R, Saharan K, Pillai K. Knowledge regarding Immunity Boosting Measures for Self-care during COVID-19 crisis: Survey of Urban Community in Haryana. Asian Journal of Nursing Education and Research. 2021; 11(4):488-4. doi: 10.52711/2349-2996.2021.00117
4. Negi R, Arti. Novel Coronavirus (COVID 19) Knowledge and Perception: A Survey of Healthcare workers. Asian Journal of Nursing Education and Research. 2021; 11(4):503-9. doi: 10.52711/2349-2996.2021.00120
5. Debnath S, Chakravorty R, Devi D. COVID 19 and its management. Asian Journal of Pharmaceutical Research. 2021; 11(2):117-1. doi: 10.52711/2231-5691.2021.00022
6. Naresh BV. A Review of the 2019 Novel Coronavirus (COVID-19) Pandemic. Asian J. Pharm. Res. 2020; 10(3):233-238. doi: 10.5958/2231-5691.2020.00040.4
7. Vishnu KN, Uppala PK, Vangoori Y, Gudhanti SNKR. A Review on Covid 19 Pandemic and its Global Effects. Asian Journal of Pharmaceutical Research. 2021; 11(4):242-6. doi: 10.52711/2231-5691.2021.00042
8. Talele SG, Ahire ED, Surana KR, Sonawane VN, Talele GS. Corona Virus Disease (COVID-19): A past and Present Prospective. Asian Journal of Pharmaceutical Research. 2022; 12(1):45-3. doi: 10.52711/2231-5691.2022.00008.
9. Kumar R, Chawla A, Diksha G. A Valuable insight to the novel deadly COVID-19: A Review. Res. J. Pharmacology and Pharmacodynamics.2020; 12(3):111-116. doi: 10.5958/2321-5836.2020.00021.X
10. Sevak G, Chauhan YS, Parihar N, Rathore MS. Review of Novel Corona Virus Disease (Covid-19) in India. Research Journal of Pharmacology and Pharmacodynamics.2022;14(2):99-9. doi: 10.52711/2321-5836.2022.00018
11. Al-Mayyahi RS,Al-Tumah WAG. Genetic Structure, Transmission, Clinical Characteristics, Diagnosis, Treatment and Prevention of Coronavirus Disease 2019 (COVID-19): A Review. Iraqi J Pharm Sci. 2021;30(1):56-65
12. Fruchter O, Yigla M, Kramer MR. D-dimer as a prognostic biomarker for mortality in chronic obstructive pulmonary disease exacerbation. Am J Med Sci. 2015;349(1):29-35. doi: 10.1097/MAJ.0000000000000332.
13. Reddy KS, Lsymj M. Role of the Neutrophil-Lymphocyte Count Ratio in the Diff erential Diagnosis between Pulmonary Tuberculosis and Bacterial Community-Acquired Pneumonia. J Assoc Physicians India. 2020;68(1):82.
14. Fuchs D, Gisslen M. Laboratory diagnostic value of neopterin measurements in patients with COVID-19 infection. Pteridines. 2021;32(1):1–4. Doi: 10.1515/pteridines-2021-0001
15. Werner ER, Blau N, Thöny B. Tetrahydrobiopterin: biochemistry and pathophysiology. Biochem J. 2011;438(3):397-414. doi: 10.1042/BJ20110293.
16. Akyüz E, Gökce G. Neopterin, procalcitonin, clinical biochemistry, and hematology in calves with neonatal sepsis. Trop Anim Health Prod. 2021;53(3):354. doi: 10.1007/s11250-021-02779-z.
17. Yu HH, Qin C, Chen M, Wang W, Tian DS. D-dimer level is associated with the severity of COVID-19. Thromb Res. 2020;195:219-225. doi: 10.1016/j.thromres.2020.07.047.
18. Jin YH, Cai L, Cheng ZS, Cheng H, Deng T, Fan YP, Fang C, Huang D, Huang LQ, Huang Q, Han Y, Hu B, Hu F, Li BH, Li YR, Liang K, Lin LK, Luo LS, Ma J, Ma LL, Peng ZY, Pan YB, Pan ZY, Ren XQ, Sun HM, Wang Y, Wang YY, Weng H, Wei CJ, Wu DF, Xia J, Xiong Y, Xu HB, Yao XM, Yuan YF, Ye TS, Zhang XC, Zhang YW, Zhang YG, Zhang HM, Zhao Y, Zhao MJ, Zi H, Zeng XT, Wang YY, Wang XH; , for the Zhongnan Hospital of Wuhan University Novel Coronavirus Management and Research Team, Evidence-Based Medicine Chapter of China International Exchange and Promotive Association for Medical and Health Care (CPAM). A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res. 2020;7(1):4. doi: 10.1186/s40779-020-0233-6. PMID: 32029004.
19. Patel A, Jernigan DB; 2019-nCoV CDC Response Team. Initial Public Health Response and Interim Clinical Guidance for the 2019 Novel Coronavirus Outbreak - United States, December 31, 2019-February 4, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(5):140-146. doi: 10.15585/mmwr.mm6905e1. Erratum in: MMWR Morb Mortal Wkly Rep. 2020;69(6):173.
20. Gorjipour F, Totonchi Z, Gholampour Dehaki M, Hosseini S, Tirgarfakheri K, Mehrabanian M, Mortazian M, Arasteh Manesh S, Rahab M, Shafighnia S, Taiyari S, Gorjipour F. Serum levels of interleukin-6, interleukin-8, interleukin-10, and tumor necrosis factor-α, renal function biochemical parameters and clinical outcomes in pediatric cardiopulmonary bypass surgery. Perfusion. 2019;34(8):651-659. doi: 10.1177/0267659119842470.
21. Guo SC, Xu CW, Liu YQ, Wang JF, Zheng ZW. [Changes in plasma levels of thrombomodulin and D-dimer in children with different types of Mycoplasma pneumoniae pneumonia]. Zhongguo Dang Dai Er Ke Za Zhi. 2013;15(8):619-22. Chinese.
22. Inoue Arita Y, Akutsu K, Yamamoto T, Kawanaka H, Kitamura M, Murata H, Miyachi H, Hosokawa Y, Tanaka K, Shimizu W. A Fever in Acute Aortic Dissection is Caused by Endogenous Mediators that Influence the Extrinsic Coagulation Pathway and Do Not Elevate Procalcitonin. Intern Med. 2016;55(14):1845-52. doi: 10.2169/internalmedicine.55.5924.
23. Ghahramani S, Tabrizi R, Lankarani KB, Kashani SMA, Rezaei S, Zeidi N, Akbari M, Heydari ST, Akbari H, Nowrouzi-Sohrabi P, Ahmadizar F. Laboratory features of severe vs. non-severe COVID-19 patients in Asian populations: a systematic review and meta-analysis. Eur J Med Res. 2020;25(1):30. doi: 10.1186/s40001-020-00432-3.
24. Celikbilek M, Dogan S, Ozbakır O, Zararsız G, Kücük H, Gürsoy S, Yurci A, Güven K, Yücesoy M. Neutrophil-lymphocyte ratio as a predictor of disease severity in ulcerative colitis. J Clin Lab Anal. 2013;27(1):72-6. doi: 10.1002/jcla.21564.
25. Huang H, Wan X, Bai Y, Bian J, Xiong J, Xu Y, Sang X, Zhao H. Preoperative neutrophil-lymphocyte and platelet-lymphocyte ratios as independent predictors of T stages in hilar cholangiocarcinoma. Cancer Manag Res. 2019;11:5157-5162. doi: 10.2147/CMAR.S192532.
26. Ong EZ, Chan YFZ, Leong WY, Lee NMY, Kalimuddin S, Haja Mohideen SM, Chan KS, Tan AT, Bertoletti A, Ooi EE, Low JGH. A Dynamic Immune Response Shapes COVID-19 Progression. Cell Host Microbe. 2020;27(6):879-882.e2. doi: 10.1016/j.chom.2020.03.021.
27. Giamarellos-Bourboulis EJ, Netea MG, Rovina N, Akinosoglou K, Antoniadou A, Antonakos N, Damoraki G, Gkavogianni T, Adami ME, Katsaounou P, Ntaganou M, Kyriakopoulou M, Dimopoulos G, Koutsodimitropoulos I, Velissaris D, Koufargyris P, Karageorgos A, Katrini K, Lekakis V, Lupse M, Kotsaki A, Renieris G, Theodoulou D, Panou V, Koukaki E, Koulouris N, Gogos C, Koutsoukou A. Complex Immune Dysregulation in COVID-19 Patients with Severe Respiratory Failure. Cell Host Microbe. 2020;27(6):992-1000.e3. doi: 10.1016/j.chom.2020.04.009.
28. Al-Kuraishy HM, Al-Gareeb AI, Alzahrani KJ, Cruz-Martins N, Batiha GE. The potential role of neopterin in Covid-19: a new perspective. Mol Cell Biochem. 2021;476(11):4161-4166. doi: 10.1007/s11010-021-04232-z.
29. Ozger HS, Dizbay M, Corbacioglu SK, Aysert P, Demirbas Z, Tunccan OG, Hizel K, Bozdayi G, Caglar K. The prognostic role of neopterin in COVID-19 patients. J Med Virol. 2021;93(3):1520-1525. doi: 10.1002/jmv.26472.