LAUSR

IL-6 was significantly raised in severe versus mild COVID-19 patients, likely due to its role in cytokine storms, a key contributor to multi-organ failure and acute respiratory distress. [...]IL-6 levels correlate to pre-existing risk factors of severe disease, eg hypertension.1-3 AST levels also demonstrated a high correlation to COVID-19 mortality risk and strongly predicted systemic inflammation, and liver injury via direct viral invasion of cholangiocytes.4'5 Interestingly, CK-MB rose early in the disease course before returning to normal range, though levels were still higher in severe patients than mild (p<0.05) .4 CK-MB is a known predictor of cardiac damage through direct invasion of cardiomyocytes via ACE2 receptor.6 The late bloomers, D-dimer, troponin and creatinine were all markedly increased in severe patients from day 7 onwards and were associated with coagulopathy, cardiac disease and renal impairment respectively. Subsequently, these patients had poorer outcomes with higher mortality rates.1'4'7-9 For general giants, severe cases presented with higher neutrophil and lower lymphocyte counts compared to mild, confirming the potential of neutrophil-lymphocyte ratio as a predictor of disease severity (Fig 2).1'2'4'7'10 High serum ferritin levels were associated with development of ARDS and cytokine storm, suggesting this marker may indicate a transition towards hyper-inflammatory state in severe COVID-19 cases.1 Conclusion Our study compiles key immunological markers and their temporal importance in COVID-19 disease progression.