A Biochemical Analysis of Detrimental Effects of COVID-19 Severity on Multiple Organ Systems

Authors

Keywords:

Covid-19, Biochemical Tests, Kidney Disease, Lung Damage, C-reactive protein (CRP).

Abstract

To understand the impact of the COVID-19 pandemic on multiple organ system research and review is required. While the primary symptoms of COVID-19 are respiratory distress and lung injury. This study investigates liver and kidney involvement and blood parameter changes among different groups of patients. Understanding these changes is crucial because COVID-19-induced liver and renal injuries, can complicate medication dosing and increase the risk of severe drug reactions. Despite the abundance of literature on COVID-19, information is lacking regarding the prevalence and clinical significance of liver injury, renal injury, and CBC alterations in COVID-19 patients from regions with low mortality and severity rates. This study aims to report and characterize changes in these parameters during the disease, and assess the relationship between them in a cohort of 354 confirmed COVID-19 patients (198 males and 156 females) in Lahore. Chi-square and T-test were used to evaluate the hypothesis. Several parameters showed significant changes, including the RBC count in normal patients, PLT levels in normal patients, ALT levels in normal, moderate, and severe patients, AST level in moderate patients, and Creatinine amount in moderate COVID-19 patients. These results highlight COVID-19's systemic impact on these parameters, enhancing our understanding of disease severity and progression. Furthermore, this knowledge guides clinical management, aiding in the prevention of severe illness and the reduction of serious health issues like renal failure and liver damage.

References

Brienza N, Puntillo F, Romagnoli S, Tritapepe L. Acute kidney injury in coronavirus disease 2019 infected patients: a meta-analytic study. Blood Purif. 2021;50(1):35-41. https://doi. org/10.1159/000509274

Yang X, Jin Y, Li R, Zhang Z, Sun R, Chen D. Prevalence and impact of acute renal impairment on COVID-19: a systematic review and meta-analysis. Crit Care. 2020; 24(1):356. https://doi.org/10.1186/s13054-020-03065-4.8.

Stewart DJ, Hartley JC, Johnson M, Marks SD, du Pré P, Stojanovic J. Renal dysfunction in hospitalized children with COVID-19. Lancet Child Adolesc Health. 2020;4(8):e28-e29. https://doi. org/10.1016/S2352-4642(20)30178-4

Sharma PK, Aggarwal V, Sapariya N, Baweja S, Nagori R, Chabbra MK. Renal profile of COVID-19 infected patients admitted in a tertiary care hospital in Western Rajasthan. Int Surg J. 2020;7(7):2332-2336. https://doi. org/10.18203/2349-2902.isj20202845

Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney impairment is associated with in-hospital death of COVID-19 patients. MedRxiv. 2020; 97(5):829-838. https://doi.org/10.1016/j.kint.2020.03.005

Pei G, Zhang Z, Peng J, Liu L, Zhang C, Yu C, et al. Renal involvement and early prognosis in patients with COVID-19 pneumonia. J Am Soc Nephrol. 2020;31(6):1157-1165. https://doi.org/10.1681/ASN.2020030276.

Hassanein M, Radhakrishnan Y, Sedor J, Vachharajani T, Vachharajani VT, Augustine J, et al. COVID-19 and the kidney. Cleve Clin J Med. 2020;87(10):619-631. https://doi.org/ 10.3949/ccjm.87a.20072.

Hong XW, Chi ZP, Liu GY, Huang H, Guo SQ, Fan JR, et al. Characteristics of renal function in patients diagnosed with COVID-19: an observational study. Front Med. 2020;7:409. https://doi.org/10.3389/fmed.2020.00409.

Li Z, Wu M, Yao J, Guo J, Liao X, Song S, et al. Caution on kidney dysfunctions of COVID-19 patients. MedRxiv. 2020. https://doi.org/10.1101/2020.02.08.20021212

Kolhe NV, Fluck RJ, Selby NM, Taal MW. Acute kidney injury associated with COVID-19: A retrospective cohort study. PLoS Med. 2020;17(10):e1003406. https://doi.org/ 10.1371/journal.pmed.1003406

Zahedi M, Yousefi M, Abounoori M, Malekan M, Tajik F, Heydari K, et al. The Interrelationship between Liver Function Test and the Coronavirus Disease 2019: A Systematic Review and Meta-Analysis. Iran J Med Sci. 2021;46(4):237-255. https://doi.org/10.30476/ijms.2021.87555.1793

Chen W, Zheng KI, Liu S, Yan Z, Xu C, Qiao Z. Plasma CRP level is positively associated with the severity of COVID-19. Ann Clin Microbiol Antimicrob. 2020; 15;19(1):18. https://doi.org/ 10.1186/s12941-020-00362-2

Wu T, Zuo Z, Kang S, Jiang L, Luo X, Xia Z, et al. Multi-organ dysfunction in patients with COVID-19: a systematic review and meta-analysis. Aging Dis. 2020;11(4):874-894. https://doi.org/10.14336/AD.2020.0520

Chaibi S, Boussier J, El Hajj W, Abitbol Y, Taieb S, Horaist C, et al. Liver function test abnormalities are associated with a poorer prognosis in COVID-19 patients: results of a French cohort. Clin Res Hepatol Gastroenterol. 2021;45(5):101556. https://doi.org/10.1016/j.clinre.2020.10.002.

Saini KS, Tagliamento M, Lambertini M, McNally R, Romano M, Leone M, et al. Mortality in patients with cancer and coronavirus disease 2019: A systematic review and pooled analysis of 52 studies. Eur J Cancer. 2020;139:43–50. https://doi.org/10.1016/j.ejca.2020.08.011.

Weber S, Hellmuth JC, Scherer C, Muenchhoff M, Mayerle J, Gerbes AL. Liver function test abnormalities at hospital admission are associated with severe course of SARS-CoV-2 infection: a prospective cohort study. Gut. 2021;70(10):1925-1932. https://doi.org/10.1136/gutjnl-2020-323800

Xu W, Huang C, Fei L, Li Q, Chen L. Dynamic changes in liver function tests and their correlation with illness severity and mortality in patients with COVID-19: A retrospective cohort study. Clin Interv Aging. 2021;16:675-685. https://doi.org/10.2147/CIA.S303629

Long VS, Ngiam JN, Chew N, Tham SM, Lim ZY, Li T, et al. Haematological profile of COVID-19 patients from a centre in Singapore. Hematology. 2021;26(1):1007-1012. https://doi.org/10.1080/16078454.2021.2005311.

Li S, Li J, Zhang Z, Tan L, Shao T, Li M, et al. COVID-19 induced liver function abnormality associates with age. Aging (Albany NY). 2020;12(14):13895-13904. https://doi.org/10.18632/aging.103720

Xie Y, Wang Z, Liao H, Marley G, Wu D, Tang W. Epidemiologic, clinical, and laboratory findings of the COVID-19 in the current pandemic: systematic review and meta-analysis. BMC Infect Dis. 2020;20(1): 640. https://doi.org/10.1186/s12879-020-05371-2.

Palladino M. Complete blood count alterations in COVID-19 patients: A narrative review. Biochem Med (Zagreb). 2021; 31(3):030501. https://doi.org/10.11613/BM.2021.030501.

Nath D, Madan U, Singh S, Tiwari N, Madan J, Agrawal R. CBC parameters and morphological alterations in peripheral blood cells in COVID-19 patients: Their significance and correlation with clinical course. Int J Health Clin Res. 2020;3(10):95-108. https://www.ijhcr.com/index.php/ijhcr/article/view/415

Lanini S, Montaldo C, Nicastri E, Vairo F, Agrati C, Petrosillo N, et al. COVID-19 disease—temporal analyses of complete blood count parameters over the course of illness, and relationship to patient demographics and management outcomes in survivors and non-survivors: a longitudinal descriptive cohort study. PLoS One. 2020;15(12):e0244129. https://doi.org/10.1371/journal.pone.0244129.

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-1720. https://doi.org/10.1056/NEJMoa2002032

Benede-Ubieto R, Estevez-Vazquez O, Flores-Perojo V, Macias-Rodriguez RU, Ruiz-Margáin A, Martinez-Naves E, et al. Abnormal liver function test in patients infected with coronavirus (SARS-CoV-2): a retrospective single-center study from Spain. J Clin Med. 2021;10(5):1039. https://doi.org/10.3390/jcm10051039.

Formica V, Minieri M, Bernardini S, Ciotti M, D'Agostini C, Roselli M, et al. Complete blood count might help to identify subjects with a high probability of testing positive for SARS-CoV-2. Clin Med. 2020;20(4):e114 -e119. https://doi.org/10.7861/clinmed.2020-0373.

Elderdery AY, Elkhalifa AM, Alsrhani A, Zawbaee KI, Alsurayea SM, Escandarani FK, et al. Complete Blood Count Alterations of COVID-19 Patients in Riyadh, Kingdom of Saudi Arabia. J Nanomater. 2022;2022: 6529641. https://doi.org/10.1155/2022/6529641

Wen W, Su W, Tang H, Le W, Zhang X, Zheng Y, et al. Immune cell profiling of COVID-19 patients in the recovery stage by single-cell sequencing. Cell Discov. 2020;6(31). https://doi.org/10. 1038/s41421-020-0168-9

Djakpo DK, Wang Z, Zhang R, Chen X, Chen P, Antoine MMLK. Blood routine test in mild and common 2019 coronavirus (COVID-19) patients. Biosci Rep. 2020;40(8). https://doi.org/ 10.1042/BSR20200817.

Akhtar A, Akhtar S, Bakhtawar B, Kashif AA, Aziz N, Javeid MS. COVID-19 detection from CBC using machine learning techniques. Int J Technol Innov Manag (IJTIM). 2021;1(2):65-78. DOI: https://doi.org/ 10.54489/ijtim.v1i2.22

Liu SL, Wang SY, Sun YF, Jia QY, Yang CL, Cai PJ, et al. Expressions of SAA, CRP, and FERR in different severities of COVID-19. Eur Rev Med Pharmacol Sci. 2020;11386-11394. https://doi.org/10.26355/eurrev_202011_23631.

Akdogan D, Guzel M, Tosun D, Akpinar O. Diagnostic and early prognostic value of serum CRP and LDH levels in patients with possible COVID-19 at the first admission. J Infect Dev Ctries. 2021;15(06):766-772. https://doi.org/10.3855/jidc.14072.

Debi H, Itu ZT, Amin MT, Hussain F, Hossain MS. Association of serum C-reactive protein (CRP) and D-dimer concentration on the severity of COVID-19 cases with or without diabetes: a systematic review and meta-analysis. Expert Rev Endocrinol Metab. 2022;17(1):83-93. https://doi.org/10.1080/17446651.2022.2002146.

Bhadarge G, Bankar N, Hadke S. Study of liver function test, haematological parameters and Crp derangements in COVID-19 patients. Biosc Biotech Res Comm. 2021;36-40. ID: covidwho-1468901.

Mocharla H, Mocharia R, Hodes ME. Coupled reverse transcription-polymerase chain reaction (RT-PCR) as a sensitive and rapid method for isozyme genotyping. Gene. 1990;93(2):271–275. https://doi.org/10. 1016/0378-1119(90)90235-J

Chaudhary R, Dubey A, Sonker A. Techniques used for the screening of hemoglobin levels in blood donors: current insights and future directions. J Blood Med. 2017;8:75. https://doi.org/ 10.2147/JBM.S103788.

Zhang M, Gu L, Zheng P, Chen Z, Dou X, Qin Q, et al. Improvement of cell counting method for Neubauer counting chamber. J Clin Lab Anal. 2020;34(1). https://doi.org/10.1002/JCLA.23024

Chhabra G. Automated hematology analyzers: Recent trends and applications. J Lab Physicians. 2018;10(1):15. https://doi.org/10.4103/ JLP.JLP_124_17

Cheuiche AV, Soares AA, Camargo EG, Weinert LS, Camargo JL, Silveiro SP. Comparison between IDMS-traceable Jaffe and enzymatic creatinine assays for estimation of glomerular filtration rate by the CKD-EPI equation in healthy and diabetic subjects. Clin Biochem. 2013;46(15):1423–1429. https://doi.org/10.1016/j.clinbiochem.2013.05.067

Dousari AS, Hosseininasab SS, Dousari FS, Fuladvandi M, Satarzadeh N. The impact of COVID-19 on liver injury in various age. World J Virol. 2023;12(2):91. https://doi.org/10.5501/WJV.V12.I2.91

Ali N. Elevated level of C-reactive protein may be an early marker to predict risk for severity of COVID-19. J Med Virol. 2020;92(11):2409. https://doi.org/10.1002/JMV.26097

de Lima IC, de Menezes DC, Uesugi JHE, Bichara CNC, da Costa Vasconcelos PF, Quaresma JAS, et al. Liver Function in Patients with Long-Term Coronavirus Disease 2019 of up to 20 Months: A Cross-Sectional Study. Int J Environ Res Public Health. 2023;20(7). https://doi.org/10.3390/IJERPH20075281/S1

Cosgun MS. Bilirubin levels as an independent predictor of myocarditis in patients with COVID-19. Egypt Heart J. 2021;73(1):1–6. https://doi.org/10.1186/S43044-021-00234-W/FIGURES/2

Cui B, Luo Y, Tian P, Peng F, Lu J, Yang Y, et al. Stress-induced epinephrine enhances lactate dehydrogenase A and promotes breast cancer stem-like cells. J Clin Invest. 2019;129(3):1030. https://doi.org/10.1172/JCI121685

Panimathi R, Gurusamy E, Mahalakshmi S, Ramadevi K, Kaarthikeyan G, Anil S. Impact of COVID-19 on Renal Function: A Multivariate Analysis of Biochemical and Immunological Markers in Patients. Cureus. 2022;14(2). https://doi.org/10. 7759/CUREUS.22076

Ye B, Deng H, Zhao H, Liang J, Ke L, Li W. Association between an increase in blood urea nitrogen at 24 h and worse outcomes in COVID-19 pneumonia. Ren Fail. 2021;43(1):347. https://doi.org/10.1080/0886022X.2021.1879855

Pozdnyakova O, Connell NT, Battinelli EM, Connors JM, Fell G, Kim AS. Clinical Significance of CBC and WBC Morphology in the Diagnosis and Clinical Course of COVID-19 Infection. Am J Clin Pathol. 2021;155(3):364–375. https://doi.org/10.1093/AJCP/AQAA231

Waggiallah HA, Khalid AMA M, Suliman AM, Abdallah EI, Abakar MAA, Elbasheir MM, et al. Influence of COVID-19 on lymphocyte and platelet parameters among patients admitted intensive care unit and emergency. Eur Rev Med Pharmacol Sci. 2022;26 (7):2579-2585. https://doi.org/10.26355/eurrev_202204_28495.

Yan B, Yang J, Xie Y, Tang X. Relationship between blood eosinophil levels and COVID-19 mortality. World Allergy Organ J. 2021;14(3):100521. https://doi.org/10.1016/J.WAOJOU.2021.100521

Toori KU, Qureshi MA, Chaudhry A, Safdar MF. Neutrophil to lymphocyte ratio (NLR) in COVID-19: A cheap prognostic marker in a resource constraint setting. Pak J Med Sci. 2021;37(5):1435. https://doi.org/10.12669/PJMS.37.5.4194

Downloads

Published

2023-10-30

How to Cite

Umar, M., Tahir, M., & Shabbir, C. A. (2023). A Biochemical Analysis of Detrimental Effects of COVID-19 Severity on Multiple Organ Systems. TSF Journal of Biology , 1(2), 28–45. Retrieved from https://tsfjb.com/ojs/index.php/tsfjb/article/view/15