1. Introduction
Coronavirus disease 2019 (COVID-19) is a respiratory infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel emergent virus that was first recognized in Wuhan, China, and since then has rapidly spread worldwide [1]. Although most patients infected with COVID-19 are either asymptomatic or only have a mild disease, approximately one-third of patients have more severe disease caused by an acute respiratory distress syndrome, which may lead to the need for mechanical ventilation (MV) and admission to an intensive care unit or even death [2]. According to the current data of the World Health Organization, the number of infected people and deaths has increased to 63,921,921 and 1,480,622, respectively (December 2019-November 2020) [3].
The nucleic acid real-time polymerase chain reaction (PCR) test has become the standard method for the diagnosis of SARS-CoV-2 infection [3]. This process can take up to 2-3 h. The reported diagnostic accuracy of real-time PCR is between 60% and 80% [4]. These real-time PCR test kits have several limitations. Despite the increasing demand for PCR testing, diagnostic delays remain a challenging problem in patients with COVID-19 pneumonia because of increasing numbers of patients, prolonged testing process, high cost, need for certified laboratories, and the need for experienced personnel. In addition, the reported false negativity rates may be as high as 20% [4]. Therefore, considering the current lack of a rapid and reliable testing method, particularly in countries where test availability is low, supportive laboratory tests should be used to establish a diagnosis if possible. The rapid diagnosis of COVID-19 infection using simple laboratory tests will initiate treatment and break the transmission chain [4], [5]. Several supportive laboratory tests may help in the diagnosis of COVID-19 infection, including leukopenia, lymphopenia, neutrophil to lymphocyte ratio (NLR) elevation, D-dimer elevation, and ferritin elevation [6], [7], [8]. A study has reported that neutralizing antibodies play a crucial role in identifying COVID-19 infection [9]. Another study claimed that serum S100B protein could be a crucial marker in the diagnosis of severe COVID-19 [10]. However, Zeng et al. reported that serum interleukin (IL)-2 receptor, IL-6, IL-8, IL-10, tumor necrosis factor-alpha (TNF-α), ferritin, procalcitonin lactate dehydrogenase, and high-sensitive C-reactive protein (hsCRP) were higher in critically ill patients than moderate and severe patients [11].
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Leukocytes play a fundamental role in defense of the immune system during bacterial or viral infection. When the body encounters a viral or bacterial infection, leukocytes provide an immune response. It causes the release of free oxygen radicals that destroy the cell wall of the virus and disrupt its structure by producing a high number of neutrophils. Whereas lymphocytes, the cornerstone of immunity to viral infections, increase the release of CD8 + T lymphocytes and reduce the release of CD4 + T lymphocytes. Thus, it suppresses cellular immunity and lymphopenia, thus increasing NLR [8], [12]. In severe patients, proinflammatory cytokine stimulates Th1, leading to an excessive immune response and uncontrolled release of cytokines and chemokines such as IL-6 [13].
In this study, we aimed to compare inflammatory parameters such as hemogram, CRP, procalcitonin, and ferritin between real-time PCR-positive and -negative patients admitted to our hospital.
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Category: WHY
