COVID-19 is a contagious disease caused by the SARS-CoV-2 virus. Due to its similarity to SARS-CoV, the coronavirus disease (COVID-19) was initially referred to as SARS-CoV-2 Disease 2019. It has mortality rate appears to be approximately 3.8%. Acute lung injuries cause acute respiratory distress syndrome (ARDS) in most patients, which is the most prominent clinical feature of COVID-19. Adhesion molecules, immune cells, inflammatory cells, and cytokines significantly influence acute lung injury. This study aimed to assess the serum level of (TNF-alpha, IL-10, and procalcitonin ) in COVID-19 patients compared to its level in healthy controls, to know the correlation between serum levels of these markers and clinical severity of COVID-19 disease, also to evaluate their role in the prognosis and to assess the using of TNF-alpha, IL-10, and procalcitonin as a predictable test for early detection of the patient who suspected to have COVID-19 disease. Serum level of TNF-alpha, IL-10, and procalcitonin was measured in 58 patients with COVID-19, ages ≥ 18 years, who attended the COVID-19 ward in Baghdad teaching hospital and outpatient clinic in Baghdad City, during the period from January 2021 to the end of May 2021, compared with 30 healthy controls matched in ages and sex to the patients, using Enzyme Linked Immuno-Sorbent Assay (ELISA) technique. TNF-alpha, IL-10, and procalcitonin serum levels were all substantially higher in patients than in healthy controls, with respective means and standard deviations of (14.62 5.32 compared 6.670 2.052) pg/ml, (13.053 7.822 versus 3.117 0.415) pg/ml, and (0.075 0.06 versus 0.035 0.011) ng/ml. There was a significant variation in serum level of TNF-alpha, IL-10, and procalcitonin between severe and non-severe patients with a higher mean ± SD for a severe group, (17.645±5.48 versus 11.147±2) pg/ml, (18.88±7.169 versus 6.396±1.34 ) pg/ml and (0.099±0.073 versus 0.047±0.0142) ng/ml, respectively. The higher levels were also observed in patients with poor outcomes with AUC in the ROC curve equal to (0.89, 0.92, and 0.83) for TNF-alpha, IL-10, and procalcitonin, respectively. Patients' elevated TNF-alpha, IL-10, and procalcitonin serum levels compared to the control group indicated the host’s immune responses against the coronavirus infection. The serum concentration of TNF-alpha and IL-10 might be considered a reflective sign of the COVID-19 severity. These findings indicate different immuno-regulatory events during SARS-CoV-2 infection, which may be helpful in the early detection of severe COVID-19-infected patients.
The cytokine markers procalcitonin, IL-10, and TNF-alpha are used as a reliable tests for the early identification of those who may have severe COVID-19. This study aimed to measure the levels of (TNF-alpha, IL-10, and procalcitonin ) in the serum of COVID-19 patients compared to their levels in healthy controls. Also, to know the correlation between serum levels of (TNF-alpha, IL-10 and procalcitonin ) and clinical severity of COVID-19 disease.
