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Invited Review Articles

Biomarkers associated with COVID-19 disease progression

, , , &
Pages 389-399 | Received 05 May 2020, Accepted 14 May 2020, Published online: 05 Jun 2020
 

Abstract

The coronavirus disease 2019 (COVID-19) pandemic is a scientific, medical, and social challenge. The complexity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is centered on the unpredictable clinical course of the disease that can rapidly develop, causing severe and deadly complications. The identification of effective laboratory biomarkers able to classify patients based on their risk is imperative in being able to guarantee prompt treatment. The analysis of recently published studies highlights the role of systemic vasculitis and cytokine mediated coagulation disorders as the principal actors of multi organ failure in patients with severe COVID-19 complications. The following biomarkers have been identified: hematological (lymphocyte count, neutrophil count, neutrophil–lymphocyte ratio (NLR)), inflammatory (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT)), immunological (interleukin (IL)-6 and biochemical (D-dimer, troponin, creatine kinase (CK), aspartate aminotransferase (AST)), especially those related to coagulation cascades in disseminated intravascular coagulation (DIC) and acute respiratory distress syndrome (ARDS). New laboratory biomarkers could be identified through the accurate analysis of multicentric case series; in particular, homocysteine and angiotensin II could play a significant role.

Acknowledgements

We are grateful to Johanna Marie Chester for her language assistance.

Author contributions

GP, TO conceived of the idea for the review, searched the scientific literature and drafted the manuscript. MM searched the literature and drafted the manuscript. TO, CR and AT revised the manuscript. All authors read and approved the final manuscript.

Disclosure statement

The authors report no conflict of interest.

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