Research Article

Estimation of Biochemical and Hematological Markers as Predictors of Disease Severity, Multiorgan Injury, and ICU Requirement in Hospitalized COVID-19 Patients in Al-Najaf Province: A Prospective Cohort Study

Abstract

Background: COVID-19 has been shown to cause a variety of complications throughout the body and can be classified as a ’total illness’ with multi-organ involvement. Determining which patients will develop life-threatening illnesses will greatly improve physicians’ ability to identify high-risk individuals and institute preventive medicine. Therefore, this research aimed to determine if laboratory biomarker data collected at the time of admission can correlate with the severity of COVID-19 illness, and to develop appropriate cut offs for predicting organ dysfunction and determining which patients will require admission to ICUs. Methods: A prospective  observational study of 135 patients confirmed with COVID-19 via RT-PCR (90 non-severe/ 45 severe) and 45 healthy participants, measuring bloodwork/radiologic evaluations within 24 hours of hospital admission, and again on 5–7 days post-admission. A comparison of all common laboratory diagnostics to identify differences between patients of varying disease severity (by RT-PCR). Bloodwork was obtained at 24 hours post-admission, and repeated on days 5–7. Evaluating blood work parameters included: IL-6, CRP, Ferritin, ALT, AST, Troponin, CK-MB, BNP, Creatinine, D-dimer, Complete Blood Count with Neutrophil to Lymphocyte Ratio (NLR), Lactate, Bicarbonate. Data analysis utilized the Mann-Whitney U Test, ROC curve analysis, and multivariable logistic regression to calculate odds ratios (ORs). Results: People with often severe or critically ill experiences had more significantly raised levels of various measurements than did any other patient group examined or that of healthy control subjects (p < 0.001). Among these measurements were the elevations of: IL-6, CRP, ferritin, AST, ALT, troponin, BNP, D-dimer, lactate levels within all patients who were sufficiently sick or critical versus all other groups; as well, the level of bicarbonate was greatly decreased vs. the other two groups. The NLR had clearly very good predictive value for ICU beds for all patients with an area under the curve (AUC) of 0.73 (95% CI: 0.64 to 0.82) with a cut-off value of 4.5 (Sensitivity = 76%, Specificity = 68%). Patients having an AST level greater than twice the upper limit of normal (ULN) are at grossly increased risk of dying within 60 days (Odds Ratio (OR) = 34.2; p < 0.001). Mild elevation of troponin occurred in 12% of patients in the non-severe group and may indicate underlying myocardial injury not being clinically detected. The above findings are consistent with both D-dimer (more than 1.5 ug/mL) and ferritin (more than 800 ng/mL) being independent predictors of the critically ill population. Conclusion: We found that routine biochemical and haematological parameter measurements taken at the time of admission are useful as early indicators of risk in COVID-19 patients. In particular, IL-6, NLR, AST, ferritin and D-dimer were able to provide valuable predictive data regarding disease severity, organ involvement and whether there will be a need for intensive care, thereby assisting with timely and appropriate clinical decision-making and intervention. 

Author Affiliation:

Mohammed Zuheir Hassan (ORCID): Department of Aesthetic and Laser Techniques, College of Health and Medical Technology, University of Alkafeel, Najaf, Iraq.
Ammar K. Madlool: Department of Aesthetic and Laser Techniques, College of health and medical techniques / Kufa, Al-Furat Al-Awsat Technical University, Iraq. 
Haider Abdul-Moneem Al-Mothafer: Department of Anesthesia Techniques, College of health and medical techniques / Kufa, Al-Furat Al-Awsat Technical University, Iraq.
Ali Jabbar Radhi (ORCID)*: College of Pharmacy, University of Alkafeel, Najaf, Iraq; ARCPMS University of AlKafeel, Najaf, Iraq.

How To Cite: M.Z. Hassan, A.K. Madlool, H.A. Al-Mothafer and A.J. Radhi. Estimation of Biochemical and Hematological Markers as Predictors of Disease Severity, Multiorgan Injury, and ICU Requirement in Hospitalized COVID-19 Patients in Al-Najaf Province: A Prospective Cohort Study. Current Research in Health Sciences, 4(1):5–10, 2026. https://doi.org/10.58613/crhs412