Determination of Inflammatory and Liver Markers in COVID-19 Infected Patients from Allama Iqbal Teaching Hospital Dera Ghazi Khan

Abstract

Background: In resource-constrained hospitals, readily available inflammatory and hepatic biomarkers can aid bedside assessment of COVID-19, but local evidence on their short-term trajectories is limited. Objective: To compare serum ferritin, C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) between PCR-confirmed COVID-19 inpatients and healthy controls, and to characterize within-patient changes across the first three inpatient weeks. Methods: We conducted a retrospective cohort with repeated measures at Allama Iqbal Teaching Hospital, Dera Ghazi Khan. Consecutive inpatients with SARS-CoV-2 RT-PCR positivity (n=100) and healthy controls (n=50) were included. Standardized venipuncture, centrifugation, and platform assays (cobas pure 6000; HumaClot for D-dimer) were used. Cases were sampled at weeks 1–3; controls provided a single baseline sample. Primary outcomes were between-group differences at week 3 and within-patient week-wise changes. Results: Compared with controls, cases showed escalating elevations over weeks 1–3. By week 3, means (vs controls) were: ferritin 1897.25 vs 90.21 ng/mL; CRP 159.58 vs 4.20 mg/L; D-dimer 1017.93 vs 69.66 ng/mL FEU; LDH 800.72 vs 61.82 U/L; ALT 233.54 vs 24.20 U/L; AST 106.58 vs 28.40 U/L; ALP 259.27 vs 94.40 U/L. Reported paired tests within cases indicated significant week-to-week increases for ferritin and ALT, with the largest relative gains in ferritin (≈21× control), CRP (≈38×), D-dimer (≈15×), and LDH (≈13×) by week 3 Conclusion: Routine biomarkers demonstrate a coherent, week-by-week rise in hyperinflammation, tissue injury, and coagulopathy among hospitalized COVID-19 patients. Serial CRP, ferritin, LDH, and D-dimer, interpreted alongside liver enzymes, may support monitoring and triage pending prospective outcome-linked validation.