Biomedicine: 2022; 42(3): 561-566 May - June 2022 DOI: https://doi.org/10.51248/.v42i3.1619 Biomedicine- Vol. 42 No. 3: 2022 Research article Predictive value of hematological and inflammatory markers for severity of COVID-19 Ibrahim Abdullah Mahmood 1 , Khalid Ahmed Mahmood 2 , Nahidh Kamel Alwan 2 1 Department of Physiology, AL-Nahrain University, College of Medicine, Baghdad, Iraq 2 Al-Kindy Teaching Hospital, Baghdad, Iraq (Received: March 2022 Revised: April 2022 Accepted: May 2022) Corresponding author: Ibrahim Abdullah Mahmood. Email: Ibrahemibrahem73@nahrainuniv.edu.iq ABSTRACT Introduction and Aim: Coronavirus disease 2019 (COVID–19) can cause damage to a wide variety of organs throughout the body, with the lung being its primary focus of attack. The identification of prognostic indicators in COVID-19 can be of assistance in the management of the disease, in instances that are critical or severe. The purpose of this study was to investigate the hematological and inflammatory indicators in COVID-19 patients who were hospitalized and determine how closely those markers are associated with the severity of the condition. Materials and Methods: In this cross-sectional prospective analysis, there were a total of 200 patients diagnosed with COVID-19. The demographic information and comorbidities of the patients were gathered through direct questioning. The indicators of the complete blood count were recorded for every patient. In addition, tests were performed on D-dimer, ferritin, erythrocyte sedimentation rate (ESR), lactate dehydrogenase (LDH), and C reactive protein (CRP). Systemic immune inflammation index (SII) was calculated. The association of demographic and laboratory parameters with patient’s outcome evaluated. Results: After a 30-day follow-up, 32 patients (16%) out of 200 required ICU hospitalization, with eight of them (4%) dying. Each of the following od diabetes (OR=4.2; 95 % CI= 1.8-2291, p=0.021), hypertension (OR=3.1, 95 % CI=1.21-19.11, p=0.033), D-dimmer (OR=3.22, 95 % CI=1.43-9.12, p=0.037), ferritin (OR=2.18, 95 % CI=1.4- 7.22, p=0.027), NLR (OR=3.26, 95% CI=1.5-7.18, p= 0.023), LDH (OR= 6.23, 95% CI=1.77-22.9, p=0.034), and CRP (OR=4.56, 95% CI=1.32-28.85, p=0.007), were independent risk factors for severity of COVID-19. Conclusion: The comorbidities diabetes and hypertension, as well as the levels of D-dimer, serum ferritin, NLR, LDH, and CRP, could be utilized to predict COVID-19 severity and its outcome. Keywords: SARS-CoV2; COVID-19; D-dimer; ferritin; neutrophil-lymphocyte ratio; inflammatory markers. INTRODUCTION evere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) has quickly evolved from an epidemic outbreak in Wuhan, China into a pandemic (1, 2). As of December 2, 2020, there have been more than 64 million cases worldwide and less than 1.5 million deaths (3). In immune-competent hosts, coronaviruses, which are encapsulated RNA viruses, can cause symptoms similar to the common cold (4). It does so by using a mechanism known as angiotensin-converting enzyme 2 (ACE2) and possesses a structure for binding receptors that is analogous to that of the SARS-Co V- 1 virus (5). SARS-CoV-2 is transmitted in humans through close contact or droplets, with an incubation period of nearly 5 days prior to onset of symptoms (6, 7). The disease is life-threatening in 5% of cases, especially in the elderly and in patients with multiple coexisting medical conditions with a mortality rate of 2.3% (8). COVID-19 primarily manifests itself as a respiratory tract infection causing hypoxemic respiratory failure (9). However, data published so far shows that the virus could infect multiple organ systems, including the nervous, respiratory, cardiovascular, renal, gastrointestinal, with a significant impact on the hematopoietic and immune systems. This makes SARS-COV-2 a unique virus with an undiscovered pathophysiology (10, 11). Therefore, patients with COVID-19 require close monitoring of their symptoms and laboratory parameters, in addition to early hospitalization and treatment in severe cases. Therefore in this study we aimed to investigate the predictive role of hematological and inflammatory markers in predicting COVID-19 severity. MATERIALS AND METHODS Study design and setting This cross-sectional prospective study included 200 SARS-CoV-2 patients admitted and treated at Al- Kindy Teaching Hospital, Baghdad from April 2021 through July, 2021. Nasopharyngeal swab of each patient was subjected to specific SARS-CoV-2 real- time polymerase chain reaction (RT-PCR) and if tested positive diagnosed as having SARS-CoV-2. For patients’ negative for RT-PCR, clinical diagnosis S 561