Serum Levels of Homocysteine, Troponin-I, and High Sensitive C-Reactive Protein in Iraqi COVID-19 patients
DOI:
https://doi.org/10.22317/jcms.v8i3.1193Keywords:
COVID-19, Homocysteine, Troponin I, C-Reactive ProteinAbstract
Objective: This study aimed to investigate if the Homocysteine has recently been proposed as a serious predictive biomarker for Covid-19 infection severity.
Method: In this case-control study, which involved 90 participants, 5 ml of venous blood specimen was reserved for each participant, to measure homocysteine, troponin-I, and high sensitive C-reactive protein in their blood, to find if there was an association between these markers levels and COVID-19 infection by using STATA version 23.
Results: The current study found a significant increase in measured values of homocysteine in patients' serum than controls P-value = 0.004 which is < alpha (0.05) with an area under the curve of 0.678, also found a significant increase in measured values of cardiac troponin-I; and hs-CRP in COVID-19 patients than controls, P-values were 0.02 and 0.00 respectively which are < alpha (0.05) with an area under the curve of 0.686 and 0.739 respectively.
Conclusion: Homocysteine has been noted as a strong predictive biomarker for COVID-19 infection severity in many articles, the current study showed that homocysteine had a moderate predictive biomarker for COVID-19 infection. Cardiac troponin-I showed a moderate predictive biomarker for COVID-19 infection, while hs-CRP was noted as a good predictive biomarker. Many studies reported an association between high levels of hs-CRP and mortality rate in COVID-19 patients.
References
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Sisó-Almirall A, Kostov B, Mas-Heredia M, Vilanova-Rotllan S, Sequeira-Aymar E, Sans-Corrales M, et al. Prognostic factors in Spanish COVID-19 patients: A case series from Barcelona. PLoS One. 2020;15(8):e0237960.
McCully KS. Homocysteine and the pathogenesis of atherosclerosis. Expert Rev Clin Pharmacol. 2015 Mar;8(2):211–9.
Hankey GJ, Eikelboom JW. Homocysteine and vascular disease. Lancet (London, England). 1999 Jul;354(9176):407–13.
Romagnoli S, Peris A, De Gaudio AR, Geppetti P. SARS-CoV-2 and COVID-19: From the Bench to the Bedside. Physiol Rev [Internet]. 2020 Jun 4;100(4):1455–66. Available from: https://doi.org/10.1152/physrev.00020.2020
Hammons A, Summers C, Woodside J, Mcnulty H, Strain JJ, Young I, et al. Folate/homocysteine phenotypes and MTHFR 677C>T genotypes are associated with serum levels of monocyte chemoattractant protein-1. Clin Immunol. 2009 Aug 1;133:132–7.
Chen C-H, Beard RS, Bearden SE. Homocysteine impairs endothelial wound healing by activating metabotropic glutamate receptor 5. Microcirculation [Internet]. 2012 May;19(4):285–95. Available from: https://pubmed.ncbi.nlm.nih.gov/22221504
Naser NH, Alibeg AAA. Exacerbation of COVID 19 in Hypertensive Patients? A review? Iraqi J Pharm Sci (P-ISSN 1683-3597, E-ISSN 2521-3512). 2021;30(2):23–30.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet [Internet]. 2020 Feb 15;395(10223):497–506. Available from: https://doi.org/10.1016/S0140-6736(20)30183-5
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet [Internet]. 2020 Feb 15;395(10223):507–13. Available from: https://doi.org/10.1016/S0140-6736(20)30211-7
Alqubbanchi FB, Al-Hamadani FY. A Pharmacoeconomics Study for Anticoagulants used for Hospitalized COVID-19 Patients in Al-Najaf Al-Ashraf city–Iraq (Conference Paper). Iraqi J Pharm Sci (P-ISSN 1683-3597, E-ISSN 2521-3512). 2021;30(Suppl.):48–59.
Ahmad M. Biomarkers in Acute Myocardial Infarction. J Clin Exp Cardiol. 2012 Nov 10;3.
Ruseva A. Laboratory diagnosis of acute myocardial infarction. Trakia J Sci. 2005;3(1):8–14.
Farah CS, Reinach FC. The troponin complex and regulation of muscle contraction. FASEB J [Internet]. 1995 Jun 1;9(9):755–67. Available from: https://doi.org/10.1096/fasebj.9.9.7601340
Sasse S, Brand NJ, Kyprianou P, Dhoot GK, Wade R, Arai M, et al. Troponin I gene expression during human cardiac development and in end-stage heart failure. Circ Res. 1993 May;72(5):932–8.
Christensen H, Johannesen HH, Christensen AF, Bendtzen K, Boysen G. Serum cardiac troponin I in acute stroke is related to serum cortisol and TNF-α. Cerebrovasc Dis. 2004;18(3):194–9.
Ishii J, Cui W, Kitagawa F, Kuno T, Nakamura Y, Naruse H, et al. Prognostic value of the combination of cardiac troponin T and B-type natriuretic peptide after initiation of treatment in patients with chronic heart failure. Clin Chem. 2003;49(12):2020–6.
Thompson D, Pepys MB, Wood SP. The physiological structure of human C-reactive protein and its complex with phosphocholine. Structure. 1999 Feb;7(2):169–77.
Ponti G, Manfredini M, Oliva G, Ozben T, Fontana C, Tomasi A. Predicting COVID-19 Hospitalized Patients’ Outcome with Homocysteine. J Clin Cardiol. 2021;2(1).
Ponti G, Roli L, Oliva G, Manfredini M, Trenti T, Kaleci S, et al. Homocysteine (Hcy) assessment to predict outcomes of hospitalized Covid-19 patients: a multicenter study on 313 Covid-19 patients. Clin Chem Lab Med. 2021;59(9): E354–7.
Ibrahimagić O, Smajlović D, Dostović Z, Vidović M, Tupković E, Kunić S. COMMENT ON AN ARTICLE: “Homocysteine as a potential predictor of cardiovascular risk in patients with COVID-19“. Med Hypotheses. 2020;143.
Yang Z, Shi J, He Z, Lü Y, Xu Q, Ye C, et al. Predictors for imaging progression on chest CT from coronavirus disease 2019 (COVID-19) patients. Aging (Albany NY). 2020;12(7):6037.
Tillett WS, Francis Jr T. Serological reactions in pneumonia with a non-protein somatic fraction of pneumococcus. J Exp Med. 1930;52(4):561.
Morley JJ, Kushner I. Serum C‐reactive protein levels in disease. Ann N Y Acad Sci. 1982;389(1):406–18.
Potempa LA, Rajab IM, Hart PC, Bordon J, Fernandez-Botran R. Insights into the use of C-reactive protein as a diagnostic index of disease severity in COVID-19 infections. Am J Trop Med Hyg. 2020;103(2):561.
Yan L, Zhang H, Goncalves J. An interpretable mortality prediction model for COVID-19 patients. Nat. Mach. Intell. 2, 283–288 (2020).
Li J, Wang L, Liu C, Wang Z, Lin Y, Dong X, et al. Exploration of prognostic factors for critical COVID-19 patients using a nomogram model. Sci Rep. 2021;11(1):1–6.
Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol 2020;5:e200950. JAMA Cardiol. 2020;5(7):802–10.
Romagnoli S, Peris A, De Gaudio AR, Geppetti P. SARS-CoV-2 and COVID-19: From the Bench to the Bedside. Physiol Rev. 2020 Jun;100(4):1455–66.
Sisó-Almirall A, Kostov B, Mas-Heredia M, Vilanova-Rotllan S, Sequeira-Aymar E, Sans-Corrales M, et al. Prognostic factors in Spanish COVID-19 patients: A case series from Barcelona. PLoS One. 2020;15(8):e0237960.
McCully KS. Homocysteine and the pathogenesis of atherosclerosis. Expert Rev Clin Pharmacol. 2015 Mar;8(2):211–9.
Hankey GJ, Eikelboom JW. Homocysteine and vascular disease. Lancet (London, England). 1999 Jul;354(9176):407–13.
Romagnoli S, Peris A, De Gaudio AR, Geppetti P. SARS-CoV-2 and COVID-19: From the Bench to the Bedside. Physiol Rev [Internet]. 2020 Jun 4;100(4):1455–66. Available from: https://doi.org/10.1152/physrev.00020.2020
Hammons A, Summers C, Woodside J, Mcnulty H, Strain JJ, Young I, et al. Folate/homocysteine phenotypes and MTHFR 677C>T genotypes are associated with serum levels of monocyte chemoattractant protein-1. Clin Immunol. 2009 Aug 1;133:132–7.
Chen C-H, Beard RS, Bearden SE. Homocysteine impairs endothelial wound healing by activating metabotropic glutamate receptor 5. Microcirculation [Internet]. 2012 May;19(4):285–95. Available from: https://pubmed.ncbi.nlm.nih.gov/22221504
Naser NH, Alibeg AAA. Exacerbation of COVID 19 in Hypertensive Patients? A review? Iraqi J Pharm Sci (P-ISSN 1683-3597, E-ISSN 2521-3512). 2021;30(2):23–30.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet [Internet]. 2020 Feb 15;395(10223):497–506. Available from: https://doi.org/10.1016/S0140-6736(20)30183-5
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet [Internet]. 2020 Feb 15;395(10223):507–13. Available from: https://doi.org/10.1016/S0140-6736(20)30211-7
Alqubbanchi FB, Al-Hamadani FY. A Pharmacoeconomics Study for Anticoagulants used for Hospitalized COVID-19 Patients in Al-Najaf Al-Ashraf city–Iraq (Conference Paper). Iraqi J Pharm Sci (P-ISSN 1683-3597, E-ISSN 2521-3512). 2021;30(Suppl.):48–59.
Ahmad M. Biomarkers in Acute Myocardial Infarction. J Clin Exp Cardiol. 2012 Nov 10;3.
Ruseva A. Laboratory diagnosis of acute myocardial infarction. Trakia J Sci. 2005;3(1):8–14.
Farah CS, Reinach FC. The troponin complex and regulation of muscle contraction. FASEB J [Internet]. 1995 Jun 1;9(9):755–67. Available from: https://doi.org/10.1096/fasebj.9.9.7601340
Sasse S, Brand NJ, Kyprianou P, Dhoot GK, Wade R, Arai M, et al. Troponin I gene expression during human cardiac development and in end-stage heart failure. Circ Res. 1993 May;72(5):932–8.
Christensen H, Johannesen HH, Christensen AF, Bendtzen K, Boysen G. Serum cardiac troponin I in acute stroke is related to serum cortisol and TNF-α. Cerebrovasc Dis. 2004;18(3):194–9.
Ishii J, Cui W, Kitagawa F, Kuno T, Nakamura Y, Naruse H, et al. Prognostic value of combination of cardiac troponin T and B-type natriuretic peptide after initiation of treatment in patients with chronic heart failure. Clin Chem. 2003;49(12):2020–6.
Thompson D, Pepys MB, Wood SP. The physiological structure of human C-reactive protein and its complex with phosphocholine. Structure. 1999 Feb;7(2):169–77.
Ponti G, Manfredini M, Oliva G, Ozben T, Fontana C, Tomasi A. Predicting COVID-19 Hospitalized Patients’ Outcome with Homocysteine. J Clin Cardiol. 2021;2(1).
Ponti G, Roli L, Oliva G, Manfredini M, Trenti T, Kaleci S, et al. Homocysteine (Hcy) assessment to predict outcomes of hospitalized Covid-19 patients: a multicenter study on 313 Covid-19 patients. Clin Chem Lab Med. 2021;59(9):E354–7.
Ibrahimagić O, Smajlović D, Dostović Z, Vidović M, Tupković E, Kunić S. COMMENT ON AN ARTICLE: “Homocysteine as a potential predictor of cardiovascular risk in patients with COVID-19“. Med Hypotheses. 2020;143.
Yang Z, Shi J, He Z, Lü Y, Xu Q, Ye C, et al. Predictors for imaging progression on chest CT from coronavirus disease 2019 (COVID-19) patients. Aging (Albany NY). 2020;12(7):6037.
Tillett WS, Francis Jr T. Serological reactions in pneumonia with a non-protein somatic fraction of pneumococcus. J Exp Med. 1930;52(4):561.
Morley JJ, Kushner I. Serum C‐reactive protein levels in disease. Ann N Y Acad Sci. 1982;389(1):406–18.
Potempa LA, Rajab IM, Hart PC, Bordon J, Fernandez-Botran R. Insights into the use of C-reactive protein as a diagnostic index of disease severity in COVID-19 infections. Am J Trop Med Hyg. 2020;103(2):561.
Yan L, Zhang H, Goncalves J. An interpretable mortality prediction model for COVID-19 patients. Nat. Mach. Intell. 2, 283–288 (2020).
Li J, Wang L, Liu C, Wang Z, Lin Y, Dong X, et al. Exploration of prognostic factors for critical COVID-19 patients using a nomogram model. Sci Rep. 2021;11(1):1–6.
Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol 2020;5:e200950. JAMA Cardiol. 2020;5(7):802–10.
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