The Association of Prolactin and CRP Biomarkers with the Severity of COVID-19 in Thumbay Hospital, Ajman, UAE

Background: This study aimed to estimate the levels of C-reactive protein (CRP) and prolactin (PRL) in SARS-CoV2 infection and their association with the severity of COVID-19 among patients in Ajman, UAE. Methods and Results: This cross-sectional study was conducted in Thumbay Hospital from 2020 to 2021. The study included 71 patients (55 males and 16 females) with positive SARS-CoV-2 test results. Nasal swab specimens were collected for the COVID-19 test on the day of admission or after one day of admission. COVID-19 diagnoses and severity levels were determined according to the New Coronavirus Pneumonia Prevention and Control Program (7th edition) published by the National Health Commission of China (2020). Serum samples were collected from the patients upon admission. The PRL level was determined using the immune chemiluminescent method by the DXI 800 Beckman Coulter analyzer. The CRP level was determined using the immunoturbidimetric method by the DXC 700 AU chemistry analyzer. Among 71 COVID-19 patients, the great majority were men 55(77.5%), 38(53.5%) being of Indian nationality. In this study, most participants (50.7%) had no history of chronic illnesses. In terms of COVID-19 severity, 24(33.8%) of patients had mild cases, 27(38.0%) had moderate cases, and 20(28.2%) had severe cases. Twenty (28.2%) patients were transferred to the ICU, and 19(26.8%) were intubated. The patients' average age was 47.58 +/- 13.63, CRP level - 74.30 +/- 71.46 mg/L, and PRL level - 205.1946 +/- 168.52 ng/mL. The mean CRP level was highest in severe cases, compared to mild and moderate cases, with a statistically significant difference between mild and severe groups (P=0.000) and mild and moderate groups (P=0.004). The mean PRL level was highest in severe cases compared to mild and moderate cases; however, the differences between the groups were not significant. CRP and PRL levels were greater in the ICU patients than non-ICU patients, with statistically significant differences only for CRP. We found a moderate positive correlation between CRP level and age (r=0.458, P=0.000); a weak positive correlation between PRL level and age was not statistically significant (r=0.201, P=0.093). A moderate positive correlation between CRP level and PRL level (r=0.461, P=0.03) was statistically significant. Conclusion: The current study implies that serum CRP levels might be an important indication of COVID-19 development and severity. A more extensive study with a larger sample size is needed to validate the significance of PRL in disease severity.