Introduction

Coronaviruses are RNA viruses, found widely in humans, mammals, birds and bats. These viruses can cause infections of the respiratory tract, gastrointestinal system and nervous system [1-3]. In December 2019, a new coronavirus was identified in the city of Wuhan, province of Hubei in China, in patients with severe unexplained pneumonia [1]. In February 2020, the World Health Organization (WHO) assigned the name COVID-19 to designate the disease caused by this virus, initially called 2019-nCoV, then SARS-CoV-2 by the International Committee on Taxonomy of Viruses [4]. After SARS-CoV-1 in 2002 in China, then MERS-CoV in 2012 in the Arabian Peninsula responsible for often fatal respiratory distress syndromes, it is the third threat for global public health linked to a coronavirus in less than twenty years [5]. The clinical features of severe COVID-19 are similar to those of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) COVID-19 behaves differently. It has a more rapid transmission and longer incubation period both of which adds to the woe of disease containment. The aim of our study was to describe the biochemical disturbances of SARS-CoV-2 infection in a sample of patients and to compare these disturbances according to the severity of the infection.

Patients and Methods

This is a prospective comparative study, spread over a period of 4 months (March 2020-June 2020) of the biochemical disturbances of COVID-19 patients admitted to the Avicenne Military Hospital. The COVID-19 diagnosis was suspected according to WHO recommendations [6], and confirmation of the presence of SARSCoV 2 was made by PCR-RT (Polymerase Chain Reaction- Real Time) [7] and the Pneumonia Severity Index (PSI) and CURB-65 scores were calculated as suggested in the literature [8]. During the study period 169 COVID-19 patients were hospitalized at the Avicenne military hospital, 20 patients in the medical intensive care unit (severe group) and 149 patients in the COVID-19 isolation hospital (non-severe group). Each patient received, upon admission, a sample of five millilitres of whole blood on a dry tube, centrifuged at 3000 rpm for five minutes. The biochemical parameters were determined by chemiluminescence method using the Cobas Roche multiparametric analyzer. All the patients underwent a biochemical indexes: Assessment of Liver Function (AST, ALT, LDH, bilrubin, albumin), renal function (urea, creatinine), Inflammatory Biomarkers Examination (CRP, ferritinemia, pro calcitonin), blood ionogram, Cardiac markers (High-Sensitivity Troponin T).

Statistical analysis

Statistical analysis was performed using IBM SPSS Statistics V21.0. Quantitative variables are expressed as median and mean and Fisher's test was used for analysis of qualitative variables. We considered a P-value less than 0.05 as statistically significant.

Results Patients

During the study period 169 COVID-19 patients were hospitalized at the Avicenne military hospital, 20 patients in the medical intensive care unit (severe group) and 149 patients in the COVID-19 isolation hospital (non-severe group). The median age in patients was 43 (19-93 years), the 30-50 years age group accounted for 65% of patients. Males represented 90% of the study population. Thirty two patients presented with one or more co-morbidities, hypertension and diabetes mellitus was the commonest of comorbidities