An Assessment of Biochemical biomarkers alterations in COVID-19 patients

Biochemical Biomarkers Alterations in COVID-19 Patients


  • Shehla Javaid University Institute of Medical Lab Technology, University Of Lahore, Lahore Pakistan
  • Miss Maham University Institute of Medical Lab Technology, University Of Lahore, Lahore Pakistan
  • Khizar Abbas University Institute of Medical Lab Technology, University Of Lahore, Lahore Pakistan.
  • Hafiz Muhammad Rehman University Institute of Medical Lab Technology, University Of Lahore, Lahore Pakistan
  • Sumaira Kousar University Institute of Medical Lab Technology, University Of Lahore, Lahore Pakistan.
  • Fareeha Bashir University Institute of Medical Lab Technology, University Of Lahore, Lahore Pakistan
  • Sidra Gul University Institute of Medical Lab Technology, University Of Lahore, Lahore Pakistan
  • Rahat jamil Forman Christian College, University.



COVID-19, biochemical markers, parameters, C reactive protein, ferritin, metabolic alteration


COVID-19 (coronavirus disorder 2019) is a sickness as a result of a virulent virus named SARS-CoV-2 and turned into discovered in December 2019 in Wuhan, China. Objectives: To evaluate the most common biochemical parameters those are increased in COVID-19 positive patients and ultimately can be used as a diagnostic marker for the evaluation and staging of disease. Methods: This study included 200 COVID-positive patients confirmed with PCR. The clinical profile was recorded from various conventional laboratories. Data was analyzed statistically by applying sample t test to the data. Results: Total 200 patients were included in the study. Increased levels of various biochemical parameters have been found including ferritin, CRP and d- dimmer. D-dimer was elevated in 99.5 percent (n = 199) whereas 0.5 percent (n = 1) were normal and ferritin was elevated in 65.5 percent (n = 131) and was normal in 32.5 percent (n = 65). CRP was elevated in 81.5% (n=163) patients. Variations was also seen in Electrolytes like potassium was elevated in 53 % (n=106) and was low value in 8% (n= 16) while it remained normal in normal in 39% (n= 78). Sodium ions were high in 25.5% (n=51), reduced in 37.5% (n = 75) while 375 (n=74) were normal. Chloride was elevated in 32.5% reduced in 26% while it was normal in 41.5%. The metrics that remained normal were: urea (96.5%), creatinine (66.5%), total bilirubin (84%), platelets (86.5%), and TLC (73%). Ferritin, CRP and d-dimmer had a p value lower than 0.05 showing significant results. Conclusion: This study concluded that some parameters particularly d-dimer, ferritin, C reactive protein were considered to be predictive markers for the initial diagnose of COVID-19.


Wu T, Zuo Z, Kang S, Jiang L, Luo X, Xia Z, et al. Multi-organ dysfunction in patients with COVID-19: a systematic review and meta-analysis. Aging and disease. 2020;11(4):874.

Wilder-Smith A, Chiew CJ, Lee VJ. Can we contain the COVID-19 outbreak with the same measures as for SARS? The lancet infectious diseases. 2020;20(5):e102-e7.

Naserghandi A, Allameh S, Saffarpour R. All about COVID-19 in brief. New microbes and new infections. 2020;35.

Kumar M, Patel AK, Shah AV, Raval J, Rajpara N, Joshi M, et al. First proof of the capability of wastewater surveillance for COVID-19 in India through detection of genetic material of SARS-CoV-2. Science of The Total Environment. 2020;746:141326.

Ali A, Vijayan R. Dynamics of the ACE2-SARS-CoV-2/SARS-CoV spike protein interface reveal unique mechanisms. Scientific reports. 2020;10(1):1-12.

Alimohamadi Y, Sepandi M, Taghdir M, Hosamirudsari H. Determine the most common clinical symptoms in COVID-19 patients: a systematic review and meta-analysis. Journal of preventive medicine and hygiene. 2020;61(3):E304.

Jesenak M, Brndiarova M, Urbancikova I, Rennerova Z, Vojtkova J, Bobcakova A, et al. Immune parameters and COVID-19 infection-associations with clinical severity and disease prognosis. Frontiers in cellular and infection microbiology. 2020;10:364.

Shang W, Dong J, Ren Y, Tian M, Li W, Hu J, et al. The value of clinical parameters in predicting the severity of COVID‐19. Journal of medical virology. 2020;92(10):2188-92.

Xie P, Ma W, Tang H, Liu D. Severe COVID-19: a review of recent progress with a look toward the future. Frontiers in Public Health. 2020;8:189.

Ayati N, Saiyarsarai P, Nikfar S. Short and long term impacts of COVID-19 on the pharmaceutical sector. DARU Journal of Pharmaceutical Sciences. 2020;28(2):799-805.

Wang W, Xu Y, Gao R, Lu R, Han K, Wu G, et al. Detection of SARS-CoV-2 in different types of clinical specimens. Jama. 2020;323(18):1843-4.

Docherty AB, Harrison EM, Green CA, Hardwick HE, Pius R, Norman L, et al. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. bmj. 2020;369.

Aggarwal S, Garcia-Telles N, Aggarwal G, Lavie C, Lippi G, Henry BM. Clinical features, laboratory characteristics, and outcomes of patients hospitalized with coronavirus disease 2019 (COVID-19): early report from the United States. Diagnosis. 2020;7(2):91-6.

Buckner FS, McCulloch DJ, Atluri V, Blain M, McGuffin SA, Nalla AK, et al. Clinical features and outcomes of 105 hospitalized patients with COVID-19 in Seattle, Washington. Clinical Infectious Diseases. 2020;71(16):2167-73.

Wan S, Xiang YI, Fang W, Zheng Y, Li B, Hu Y, et al. Clinical features and treatment of COVID‐19 patients in northeast Chongqing. Journal of medical virology. 2020;92(7):797-806.

Gupta N, Agrawal S, Ish P, Mishra S, Gaind R, Usha G, et al. Clinical and epidemiologic profile of the initial COVID-19 patients at a tertiary care centre in India. Monaldi archives for chest disease. 2020;90(1).

Garg S, Kim L, Whitaker M, O'Halloran A, Cummings C, Holstein R, et al. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019-COVID-NET, 14 States, March 1-30, 2020. Morbidity and mortality weekly report. 2020;69(15):458.

Terpos E, Ntanasis‐Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, et al. Hematological findings and complications of COVID‐19. American journal of hematology. 2020;95(7):834-47.

He X, Yao F, Chen J, Wang Y, Fang X, Lin X, et al. The poor prognosis and influencing factors of high D-dimer levels for COVID-19 patients. Scientific reports. 2021;11(1):1-7.

Fan BE. Hematologic parameters in patients with COVID-19 infection: a reply. American journal of hematology. 2020.

Chen G, Wu DI, Guo W, Cao Y, Huang D, Wang H, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. The Journal of clinical investigation. 2020;130(5):2620-9.

Giamarellos-Bourboulis EJ, Netea MG, Rovina N, Akinosoglou K, Antoniadou A, Antonakos N, et al. Complex immune dysregulation in COVID-19 patients with severe respiratory failure. Cell host & microbe. 2020;27(6):992-1000.

Hsu PP, Sabatini DM. Cancer cell metabolism: Warburg and beyond. Cell. 2008;134(5):703-7.

Linkins LA, Takach Lapner S. Review of D‐dimer testing: good, Bad, and Ugly. International Journal of Laboratory Hematology. 2017;39:98-103.

Querol-Ribelles JM, Tenias JM, Grau E, Querol-Borras JM, Climent JL, Gomez E, et al. Plasma d-dimer levels correlate with outcomes in patients with community-acquired pneumonia. Chest. 2004;126(4):1087-92.

Dai R-X, Kong Q-H, Mao B, Xu W, Tao R-J, Wang X-R, et al. The mortality risk factor of community acquired pneumonia patients with chronic obstructive pulmonary disease: a retrospective cohort study. BMC pulmonary medicine. 2018;18(1):1-10.

Zhang C, Shi L, Wang FS. Liver injury in COVID-19: management and challenges [published online ahead of print, 2020 Mar 4]. Lancet Gastroenterol. Hepatol. 2020.

Hoffmann M, Kleine‐Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, et al. H., Nitsche A., Müller MA, Drosten C., Pöhlmann S. Cell. 2020;181:271.

Yan R, Zhang Y, Li Y, Xia L, Guo Y, Zhou Q. Structural basis for the recognition of SARS-CoV-2 by full-length human ACE2. Science. 2020;367(6485):1444-8.

Chai X, Hu L, Zhang Y, Han W, Lu Z, Ke A, et al. Specific ACE2 expression in cholangiocytes may cause liver damage after 2019-nCoV infection. biorxiv. 2020.

Guan W-j, Ni Z-y, Hu Y, Liang W-h, Ou C-q, He J-x, et al. Clinical characteristics of coronavirus disease 2019 in China. New England journal of medicine. 2020;382(18):1708-20.

Han X, Ye Q. Kidney involvement in COVID‐19 and its treatments. Journal of medical virology. 2021;93(3):1387-95.

Mardani R, Vasmehjani AA, Zali F, Gholami A, Nasab SDM, Kaghazian H, et al. Laboratory parameters in detection of COVID-19 patients with positive RT-PCR; a diagnostic accuracy study. Archives of academic emergency medicine. 2020;8(1).



DOI: 10.54393/pbmj.v5i1.321
Published: 2022-01-31

How to Cite

Javaid, S. ., Maham, M., Abbas, K. ., Rehman, H. M., Kousar, S. ., Bashir, F. ., Gul, S. ., & jamil, R. (2022). An Assessment of Biochemical biomarkers alterations in COVID-19 patients: Biochemical Biomarkers Alterations in COVID-19 Patients. Pakistan BioMedical Journal, 5(1), 327–331.



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