الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 191 |  |  |
| | | from | 191 | | |
Abstract
Coronavirus disease 2019 (COVID-19) is an infectious disease that caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2). It is a major pandemic disease and a catastrophe for humans. The main mode of transmission of the disease is respiratory droplets and may be aerosolization which occurs in close contact. The virus starts its life cycle when S protein binds to the cellular receptor ACE2 leading to a conformation change in the S protein allowing viral envelope fusion with the cell membrane through the endosomal pathway. COVID-19 disease has pulmonary and extrapulmonary manifestations. It mainly affects respiratory system and other major systems such as gastrointestinal (GI), hepatobiliary, cardiovascular, renal, and central nervous systems causing multi- organ failure. There are many risk factors affecting severity of the disease known as: Age, Sex, and associated co-morbidities as chronic kidney disease, chronic obstructive pulmonary disease and Diabetes mellitus etc. According to the severity of the symptoms, oxygen saturation and radiological results, the clinical picture classified into asymptomatic or Presymptomatic, Mild illness, Moderate illness, Severe illness, and Critical illness. Many complications are associated with Covid- 19 infection either pulmonary as acute respiratory failure and ARDS or extrapulmonary as thromboembolic complications as MI, GI, renal as AKI, CNS as stroke, Secondary invasive fungal infections and many others even ends with multiorgan failure leading to death. Diagnosis of Covid- 19 infection depends on three parameters: clinical data, laboratory tests and imaging techniques which are also used for prognosis and follow up the course of disease. Treatment of Covid-19 infection includes many regimens depending on stage of the disease either early or late and severity of infection: as antiviral drugs (e.g., remdesivir), anti-SARS-CoV-2 monoclonal antibodies (e.g., bamlanivimab/etesevimab, casirivimab/imdevimab), Convalescent Plasma, anti-inflammatory drugs (e.g., dexamethasone), immunomodulators agents (e.g., baricitinib, tocilizumab), Janus kinase (JAK) inhibitors, Baricitinib (Olumiant), Ruxolitinib and Bruton‘s tyrosine kinase inhibitors such as ibrutinib, acalabrutinib and rilzabrutinib. Also, anticoagulants have an important role in treatment as LMWH and new oral anticoagulants e.g. (Apixaban, Rivaroxaban). In our study we try to use highly sensitive, simple, available and lowcost laboratory biomarkers for prognosis and follow the patients during the course of COVID-19 infection. CBC is a common test in diagnosis and follow up the COVID-19 infection we can use parameters obtained from this simple test as NLR, PLR LMR, lymphocyte, monocyte, neutrophils and platelets count. Other laboratory tests are also used as C reactive protein, serum ferritin, LDH, procalcitonin and IL6 level and D-dimer. Our study is a prospective cohort study at which patients ‗data were observed and collected throughout the time of the study. It was conducted on 100 patients with COVID-19 at and post admission taking a duration of 6 months from May 2021 to October 2021. In our study we found that NLR and PLR had positive correlation with the disease severity while LMR had negative correlation with severity of the disease. Also, lymphocyte showed significant lymphopenia. Similarly, monocyte readings decreased significantly and high Neutrophil count associated with bad prognosis and increase mortality. When we examined other inflammatory markers, we found that CRP, serum ferritin, procalcitonin, LDH and D-dimer were high in severe disease associated with bad prognosis. On comparison between NLR, PLR AND LMR and other inflammatory marker, we found that NLR, PLR and LMR can be used instead of others because they are more reliable, easy to calculate, low cost and give the same results.