To Analyse Inflammatory Biomarkers Like S. Ferritin, ESR, CRP & D-Dimer during COVID-19 Infection in Diabetics

Sandhya Gautam, Vivek Yadav, Snehlata Verma, Chhaya Mittal

Abstract: Aims and Objectives: To analyse the various inflammatory markers of Covid infection in diabetic and non-diabetic patients. Introduction: COVID-19 pandemic caused by SARS-CoV-2 emphasises inflammation's vital role in disease progression. Inflammation significantly impacts COVID-19, affecting the immune system and blood clotting. ESR, CRP, and D-Dimer are key markers revealing inflammation and clotting issues, shedding light on the disease's complexity. ESR often rises, indicating systemic inflammation, particularly in severe cases with cytokine storms causing organ damage. Monitoring ESR helps gauge inflammation's intensity, guiding treatment for severe cases. CRP levels frequently increase, signalling acute inflammation and early disease progression. High CRP levels correlate with disease severity, especially lung complications. It can serve as a prognostic indicator. COVID-19 poses thrombotic risks, with elevated D-dimer levels indicating hypercoagulability and worse outcomes. Monitoring D-dimer helps assess thrombotic risks and guide anticoagulation therapy. These biomarkers are crucial for early detection of inflammation and clotting issues, aiding in identifying high-risk patients and guiding clinical management. Understanding inflammation and clotting dynamics can inform targeted therapies, like anti-inflammatory and anticoagulant treatments, to mitigate disease progression. Longitudinal studies are needed to track these biomarkers' changes during COVID-19 infection. Incorporating ESR, CRP, and D-dimer into clinical practice improves patient care and helps combat the pandemic. This scientific article explores their significance in COVID-19, offering insights into disease severity and potential treatments. Material & Methods: In this single-centred retrospective case-control study, 162 COVID-19 patients admitted to SVBP hospital from March 2020 to June 2021 were evaluated. After exclusions, 81 COVID-positive diabetic patients were selected as cases, and 81 COVID-positive non-diabetic patients served as controls. Demographics, clinical details, laboratory results, and imaging were recorded. Patients were categorised by HbA1c levels. Various investigations, including ESR, CRP, LFT, KFT, HbA1c, and radiological assessments (HRCT severity score and CXR PA Views), were conducted. Statistical analysis utilised the chi-square test (95% confidence interval, p-value < 0.05) to assess associations. Results: In the diabetic group, mean serum ferritin was 918.92 (SD = 424.23), D-dimer was 5.54 (SD = 2.85), CRP was 76.51 (SD = 39.95), and ESR was 42.01 (SD = 9.66). In the non-diabetic group, mean serum ferritin was 822.91 (SD = 424.23), D-dimer was 3.11 (SD = 2.85), CRP was 65.27 (SD = 39.95), and ESR was 22.81 (SD = 9.66). Statistical analysis revealed a non-significant association for serum ferritin (p = 0.244), a significant association for D-dimer (p = 0.001), a non-significant association for CRP (p = 0.082), and a significant association for ESR (p = 0.001).

Keywords: COVID-19, SARS-CoV-2, inflammatory biomarkers, Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP), D-Dimer, inflammation, coagulation, disease severity