mohammad heidarvand

Some risk causes may be associated with the severity of COVID-19. The central host-pathogen factors might affect infection are human receptor angiotensin-converting enzyme 2 (ACE2), trans-membrane protease serine 2 (TMPRSS2), and SARS-CoV-2 surface spike (S)-protein. The main purpose of this study was to determine the differences in the expression the metalloproteinases-2  (MMP-2), MMP-9, ACE2, and TMPRSS2 genes and their correlation with lymphopenia in the mild and severe types of the COVID-19 patients. Eighty-eight patients, aged 36 to 60 years old with the mild (n=44) and severe (n=44) types of COVID-19 were enrolled. Total RNA was isolated from the peripheral blood mononuclear cells (PBMCs). The changes of MMP-2, MMP-9, ACE2 and TMPRSS2 gene expression in PBMCs from mild and severe COVID-19 patients were examined by the real time-quantitative polymerase chain reaction (RT-qPCR) assay and, compared between the groups. Data were collected from May 2021 to March 2022. The mean age of the patients in both groups was 48 (interquartile range, 36–60), and there were no appreciable differences in age or gender distribution between the two groups. The present study showed that a significant increase in the expression of ACE2, TMPRSS2, MMP-2, and MMP-9 genes in the severe type of the COVID-19 patients compared, to the mild type of the COVID-19 patients. Overall, it suggests the expression levels of these genes on the PBMC surface in the immune system are susceptible to infection by SARS-COV-2 and therefore could potentially predict the patients’ outcome.

Coronavirus Disease (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) was first discovered in China in late 2019 and spread rapidly worldwide. This study aimed to correlate positive real time Reverse Transcriptase Polymerase Reaction (RT-PCR) results after one month of follow-up with laboratory findings of the same patients at hospital admission to predict clinical outcome and diagnosis.

We conducted a retrospective study on the laboratory findings of 299 adult patients suspected of COVID-19. Patients were admitted to hospital from March 21 to May 25, 2021 with final follow-up of one month for each patient. After one month of follow-up, 233 patients recovered; however, in 64 patients the symptoms worsened. For these patients RT-PCR was performed and some patients needed chest Computed Tomography (CT) imaging and were hospitalized. We extracted laboratory findings of these 64 patients and correlated the results of their RT-PCR with their laboratory findings.

Based on our findings, severe cases are middle-aged adults (P=0.001) with lymphopenia (P<0.001), decreased levels of white blood cells (WBCs) (P<0.001), and platelets (P=0.007) count along with elevated COVID-19 IgG antibody (P=0.002) and Erythrocyte Sedimentation Rate (ESR) (P<0.001).

RT-PCR is not necessary at admission; instead, some routine hematology examinations and serological tests can predict the prognosis of COVID- 19 disease.