THE PHYSIOLOGICAL IMPACT OF IMMUNIOHEMATOLOGICAL AND LIFESTYLE FACTORS ON COVID-19 SEVERITY: A CASE–CONTROL INVESTIGATION

Abstract

Background: Coronavirus disease (COVID-19) has triggered stern medical crises universally and it is branded by severe respiratory suffering that can tempts inflammatory reaction and shows a broad range of clinical representations from minor to stern disease. Numerous biochemical and hematological, immunological, and lifestyle-inclined factors may add to the disease severity and clinical results. Objectives:  This study attempted to assess the connection between blood groups, smoking and some chosen laboratory biomarkers, which include to ferritin, lactate dehydrogenase (LDH), creatine kinase-MB (CK MB), pro-inflammatory cytokines (IL-6, D-dimer, TNF-α, and C-reactive protein [CRP]), with COVID-19 severity. Methods:   A total of 150 male participants were enrolled and classified into control (n = 50), mild COVID 19 (n = 50), and severe COVID-19 (n = 50) groups. The age of all participants ranged between 40 and 55 years. Blood group distribution, smoking status, and serum levels of LDH, CK-MB, ferritin, D-dimer, IL-6, TNF-α, and CRP were analyzed. Data were expressed as mean values, and statistical significance was considered at p < 0.05. Results: Smoking prevalence differed significantly across the studied groups (χ² test, p < 0.001), with smokers being more frequent among patients with severe COVID-19 (70%) compared with mild cases (50%) and controls (20%), whereas non-smokers predominated in the control group (80%) relative to mild (50%) and severe cases (30%). The distribution of ABO blood groups and Rh factor differed significantly among control, mild, and severe COVID-19 groups (χ² = 38.36, df = 16, p = 0.0013), with blood group A being the most prevalent among COVID-19 patients, particularly in mild and severe cases. Mean serum LDH levels were significantly higher in mild (360.94 ± 78.64) and severe cases (503.28 ± 105.66) compared with controls (156.68 ± 30.82) (p < 0.001). CK-MB levels were elevated in mild (5.71 ± 12.12) and severe patients (4.64 ± 13.76) relative to controls (1.60 ± 2.64) (p < 0.001). Ferritin concentrations were higher in mild (429.28 ± 63.84) and severe cases (526.68 ± 106.74) than in controls (262.48 ± 69.57) (p < 0.001). Pro-inflammatory markers IL-6, TNF-α, and CRP were markedly elevated in severe cases (9.91 ± 18.66, 29.25 ± 9.72, and 6.06 ± 15.88, respectively) compared with mild and control groups (p < 0.001–0.00001). Additionally, D-dimer levels were significantly increased in severe cases (473.24 ± 143.45) compared with mild (260.88 ± 155.36) and control groups (163.32 ± 62.82) (p < 0.00001). Conclusion:  Blood group type, smoking, and elevated inflammatory, coagulation, and tissue damage biomarkers are strongly associated with COVID-19 severity, highlighting their potential role as predictors of disease progression.