doi.org/10.36721/PJPS.2022.35.2.REG.401-408.1 Pak. J. Pharm. Sci., Vol.35, No.2, March 2022, pp.401-408 401 Early forecasting of COVID-19 case progression with hematological and biochemical parameters of patients in Egypt Mohamed M A El-Sokkary 1 , Ahmed M El-Baz 2 , Rasha M El-Morsi 2 , Kristina Keuper 3 , Salah El-Hawary 4 , Ahmed Shata 5,6 and Galal Yahya 7 1 Microbiology and Immunology department, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt 2 Microbiology and Biotechnology department, Faculty of Pharmacy, Delta University for Science and Technology, Gamasa, Egypt 3 Department of Molecular Genetics, Faculty of Biology, Technical University of Kaiserslautern, Kaiserslautern, Germany 4 Mansoura University, Mansoura, Egypt 5 Pharmacology department, Faculty of Medicine, Mansoura University, Mansoura, Egypt 6 Clinical Pharmacy department, Faculty of pharmacy, Delta University for Science and Technology, Gamasa, Egypt 7 Microbiology and Immunology Department, Faculty of Pharmacy, Zagazig University, Al Sharqia, Egypt Abstract: The coronavirus pandemic 2019 (COVID-19) is changing the world and reshape all aspects of life. Side by side to global efforts to develop potential vaccines and effective drugs against COVID-19, clinical parameters scanning the prognosis of COVID-19 infection are badly required to help the clinicians in premature management of COVID-19 cases before critical progression. The main objective of our study is to specify reliable biomarkers which differentially change upon case progression and clearly reflect the extent of lung lesions. Forty-one patients from Mansoura area, confirmed for COVID-19 infection were classified according to the diameter of lung lesions measured by lung computed tomography (CT) into mild and severe cases including 66% and 34% of all patients, respectively. COVID-19 patients were followed since hospital admission for comparative studies covering measured biochemical and hematological parameters. Based on the degree of severity, five different biomarkers mainly; D-dimer, lactate dehydrogenase (LDH), C-reactive protein (CRP), lymphocytes and ferritin were found to clearly oscillate in response to COVID-19 infection and upon case transition from mild to severe. In our study, significantly higher levels of almost all the biomarkers except lymphocyte count, were detected in patients having severe complications of COVID-19 infection in contrast with non- severe patients. Keywords: COVID-19, D-dimer, lymphocytes, LDH, CRP, ferritin. INTRODUCTION COVID-19 is a pulmonary infection caused by the severe acute respiratory syndrome virus (SARS-CoV-2), a newly emerged corona virus, that was initially manifested in Wuhan city in China in December 2019 (Zhu et al., 2019; Chen et al., 2020). COVID-19 has been identified as a respiratory virus; however clinical data reported that COVID-19 can also attack other organs, such as gastrointestinal tract, liver, and nervous system and induce multiple organ failure (Liu et al., 2020; Yang et al., 2020). The clinical symptoms of COVID-19 infection exhibit some interference with many other acute respiratory infections, including severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome coronavirus (MERS) (Huang et al., 2020). The typical symptoms of COVID-19 include dry cough (76%), fatigue (44%) and fever (98%). Atypical symptoms may also comprise diarrhea (3%), headache (8%), expectoration, and hemoptysis. Moreover, COVID-19 infection may adversely affect chemosensory function, leading to loss of smell and taste, however, it frequently appears within 2 to 4 weeks after infection (Yan et al., 2020). Interestingly, some confirmed patients were identified as asymptomatic (Rodriguez-Morales et al., 2020), almost recovered after 1 week exhibiting a low fever, mild fatigue, or other mild symptoms, with no pneumonia (Huang et al., 2020). Another common abnormality could be also seen in chest CT images (e.g., bilateral multiple lobular and sub-segmental areas of consolidation), which were observed in 98% of COVID- 19 patients (Huang et al., 2020). Early diagnosis is the most rate-limiting step in the clinical outcome of the pandemic and the treatment strategy. In the same respect, biochemical markers, specifically associated with COVID-19 infection represent a high clinical impact for early diagnosis. In addition, the clinical diagnosis of COVID-19 mainly depends on the detection of virus nucleic acid by polymerase chain reaction (PCR); however, some factors including viral level and methodology of sample collection influence the PCR results. False-negative results may be also obtained in many studies, identifying variable laboratory detection data of the same COVID-19 patients (Chan et al., 2019; Huang et al., 2020). In this study, samples collected on admission to quarantine hospitals in Mansoura governorate Egypt were examined in a highly equipped private lab for hematological and other biochemical characters testing. In addition, laboratory and clinical data *Corresponding author: e-mail: m_elsokkary2022@yahoo.com