Interleukin-35, D-dimer, and ferritin as mortality predictive in SARS-COV-2

Document Type : Original Article


Department of Medical Laboratory Technology, College of Medical Technology, The Islamic University, Najaf, Iraq


Background: Knowing which patients would be more likely to die is crucial for making better use of the little resources available. To do this, the ability of several inflammatory indicators to identify mortality outcomes has been detected. Materials and methods: A total of 125 severe/critical COVID-19 patients were involved in this work divided into two groups based on survival, dead group (62 patients) and live group (63 patients). Between March 2022 and July 2022, these patients were admitted to Marjan medical city and Al-Sadeq hospital. Patients were determined as severe cases according to the guidelines released by National Health World. The inflammatory cytokine (IL-35) was detected by the ELISA technique.

Results: IL-35 showed no statistical differences between lived 6.85 (5.44- 8.72) ng/ml and dead 6.53 (5.82- 7.89) ng/ml patients (p= 0.79). D dimer, and ferritin increased significantly in dead patients 2467.5 (1368. 7- 3697) ng/ml and 1621.5 (792.3- 2359) ng/ml respectively compared to live patients 557 (430- 689) ng/ml and 268 (186- 449) ng/ml respectively (P < 0.0001). The ROC or area under the curve (AUC) for D-dimer was 0.89 with high sensitivity (95%) and specificity (77%). Ferritin also showed a large AUC that was 0.90 with high sensitivity and specificity (95%) and (81%) respectively. The cut off point for both D- dimer and ferritin was 693.67 ng/ml and 475 ng/ml respectively. Conclusions: IL-35 revealed no significant differences between dead and lived patients with COVID-19 (p = 79). Positive strong correlation observed between ferritin and D-dimer (r= 0.85, p< 0.0001). No correlation was found between IL-35 and both ferritin and D-dimer (p > 0.05).


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