Document Type : Original Article
Authors
1
Chemistry Department, Faculty of Science, Helwan University, Cairo,Egypt.
2
Biochemistry and Molecular Biology Department, National Hepatology Tropical Medicine Research Institute, GOTHI, Cairo, Egypt.
3
Chemistry Department, Faculty of Science, Helwan University, Ain Helwan, 11795, Cairo, Egypt.
4
Radiology Department, Faculty of Medicine, Cairo University, Giza, Egypt.
5
Hepatology and Gastroenterology Department, Ahmed Maher Teaching Hospital, Cairo, Egypt.
6
Teaching fellow of Physiotherapy at El Sahel Teaching hospital.
7
Researcher of chest diseases Department of Internal Medicine Research Institute of Medicine and Clinical Studies, National Research Center.
Abstract
Respiratory, multiorgan, and heart failure are the causes of mortality from COVID-19 so this pandemic has increased interest in the biochemical processes that explain the complex interactions between infectious pathogens and human hosts. The virus's entry activates the immune system, including various toll-like receptor (TLR) pathways that result in the secretion of proinflammatory cytokines. This study aims to find meaningful COVID-19 biomarkers outside of conventional biochemical examinations. Patients and Methods: This study registered 100 people (n = 100), including 75 COVID-19 patients receiving care at the El Sahel Teaching Hospital and 25 healthy controls. We used RT-PCR, computed tomography (CT) scans, and biochemical routine profile tests like d-dimer, c-reactive protein (CRP), ferritin, and lactate dehydrogenase (LDH) to confirm that the COVID-19 virus was real. We measured toll-like receptor-4 (TLR-4) and toll-like receptor-9 (TLR-9) using the sandwich enzyme-linked immunosorbent assay (sandwich ELISA) method. Results: The results showed that there were statically significant differences in WBC, HCT, neutrophil, lymphocyte, monocyte, HbA1C, FBS, PPBS, and also COVID-19 profile biochemical tests except LDH. In the cases of TLR-4 and TLR-9, a significant difference appeared among the studied groups. We observed a highly significant correlation in the case of TLR-9 with ferritin and CRP. This study used ROC curves to measure the diagnostic accuracy of COVID-19. This study allowed for the accurate diagnosis of COVID-19 patients, with an AUC of 0.87 in the case of TLR-4 and 0.94 in the case of TLR-9. The ROC curve determined the cutoff points, and we measured the sensitivity and specificity of both TLR4 and TLR9 to be 80% and 79% for TLR-4, and 92% and 100% for TLR-9. Conclusion and Summary: TLR-4 and TLR-9 are effective biomarkers to distinguish between healthy and those with COVID-19 with acceptable sensitivity and specificity.
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