الفهرس 
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Abstract
The coronavirus disease 19 (COVID-19) is a highly contagious and pathogenic viral illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that caused worldwide pandemic and a shocking loss of human life globally. Numerous sources have confirmed the quick human-to-human transfer. The expression of neutrophil and monocyte CD11b, as well as neutrophil CD64, has demonstrated good power in differentiating severe septic from non-septic ICU patients (trauma, operation, intoxication, cerebral hemorrhage), as well as in differentiating infection from disease flare in individuals with autoimmune illness.
The present study was carried out in the Clinical Pathology Department, Faculty of Medicine, El-Minia University Hospital. It was conducted through the period from November 2021 to June 2022. The aim of this study was to Study of CD 64 and CD 11b expression on neutrophils and monocytes in covid-19 patients and correlate their expression with the disease severity. The study included 60 Covid-19 patients and 20 apparently healthy individuals as control group.
The selected subjects included in the study were divided into two groups.
1. group I (patient group): it included sixty (60) patients diagnosed Covid-19 patients by PCR and was subdivided into 2 subgroups:
• group Ia: 30 (Non – ICU) Covid-19 patients. Their ages ranged from 20 to 84 years. This group included 15 males (50%) and 15 females (50%).
• group Ib: 30 Covid-19 patients admitted to ICU (intensive care unit) with respiratory complications. Their ages ranged from 25 to 87 years. This group included 17 males (56.7%) and 13 females (43.3%).
2. group II (control group): It included 20 apparently healthy individuals matched for age and sex. Their ages ranged from 25 to 85 years. This group included 11 males (55%) and 9 females (45%).
Inclusion Criteria:
• PCR positive RNA of Covid-19.
All subjects included in the study were subjected to the following:
1) Careful history taking:
Considering age, occupation, residence, duration of disease, presence of fever, cough, dyspnea and co-morbidities.
2) Examinations:
Temperature by thermometer and oxygen saturation by pulse Oximeter.
3) Laboratory Investigations:
• Routine investigations: Included complete blood count (CBC) with differential, prothrombin concentration (PC), international normalized ratio (INR), D-dimer, random blood glucose, serum ferritin, C-reactive protein (CRP), renal and liver function tests.
• Special investigations: Included assay of percentage of both CD64 and CD11b expression on neutrophils and monocytes in peripheral blood of patients and control by Flow Cytometry.
The results of this study were summarized as follow:
• There was no statistically significant difference between the studied groups regarding the age, sex and DM, random blood glucose and serum ferritin level.
• There was statistically significant difference when comparing hypertension among all groups with no statistically significant difference when comparing it between patient subgroups.
• There was statistically significant difference in hemoglobin & platelets when comparing them among all groups but there was no statistically significant difference in hemoglobin between group Ia & group Ib and no statistically significant difference in platelets when comparing group Ia and both group Ib and control group
• There was statistically high significant difference in absolute lymphocytic & neutrophilic counts when comparing them among all groups, but there was no statistically significant difference between group Ia & group Ib regarding absolute neutrophilic count.
• There was statistically significant difference in absolute monocytic count and direct bilirubin level when comparing them between group Ib and control group but there was no statistically significant difference among all groups and between group Ia and both group Ib and control group.
• There was statistically high significant difference in PC & INR when comparing them in group Ia and control group and statistically significant difference when comparing them among all groups and between group Ib and control group but there was no statistically significant difference when comparing group Ia to group Ib.
• There was statistically significant difference in the level of serum urea & creatinine and also high significant difference in CRP & D- dimer when comparing them among all groups but there was no statistically significant difference when comparing them in group Ia to group Ib
• There was statistically significant difference in the level of both serum albumin & AST when comparing them between group Ia and control group but there was no statistically significant difference when comparing them among all groups and between group Ib and both group Ia and control group.
• There was statistically significant difference in the level of ALT & total bilirubin when comparing them among all groups and between group Ib and control group but there was no statistically significant difference when comparing them between group Ia and both group Ib and control group.
• There was statistically high significant difference in oxygen saturation when comparing it among all groups and between group Ib and both group Ia and control group, also there was statistically significant difference when comparing it in group Ia and control group.
• There was high significant difference in CD64 expression on neutrophils and monocytes when comparing it among all groups and between control group and both group Ia and group Ib but there was no statistically significant difference when comparing group Ia and group Ib.
• There was no statistically significant difference in CD11b expression on neutrophils when comparing it among all groups, between group Ia & Ib and between control group and both group Ia and group Ib .
• There was significant positive correlation between CD64 expression on neutrophils and both absolute lymphocytic count & CRP in group Ia.
• There was significant positive correlation between CD64 expression on neutrophils and (direct bilirubin (D.B) and absolute monocytic count) in group Ib
• There was significant negative correlation between CD11b expression on neutrophils and (total leucocytic count, absolute neutrophilic count and oxygen saturation) in group Ib.
• There was also significant negative correlation between CD11b expression on neutrophils and (absolute lymphocytic count, absolute monocytic count, blood urea and serum creatinine) in group Ia.
• There was statistically significant difference in CD11b expression on monocytes when comparing it among all groups and between control group and both group Ia and group Ib, but there was no statistically significant difference when comparing group Ia to group Ib
• There was significant negative correlation between CD64 expression on monocytes and both hemoglobin level & CRP in group II.
• There was also significant positive correlation between CD64 expression on monocytes and (absolute monocytes count and serum ferritin level), while there was also significant negative correlation between CD64 expression on monocytes and serum albumin level in group Ia.
• There was Significant negative correlation between CD11b expression on monocytes and both absolute monocytes count in group Ia and oxygen saturation in group Ib.
• There was also significant negative correlation between CD11b expression on monocytes and serum albumin level in group II.