Biomarkers associated with COVID-19 disease progression

The SARS-COVID 19 pandemic is a scientific, medical and social challenge. The complexity of the virus is centred on the unpredictable clinical course of the disease that can rapidly develop, causing severe and deadly complications. The identification of effective laboratory biomarkers able to classify patients based on their risk is imperative in being able to guarantee prompt treatment. The analysis of recently published studies highlights the role of systemic vasculitis and cytokine mediated coagulation disorders as the principal actors of multi organ failure in patients with severe COVID-19 complications. The following biomarkers have been identified: haematological (lymphocyte count, neutrophil count, neutrophil-lymphocyte-ratio (NLR), and Hhemoglobin ), inflammatory (C-Reactive Protein (CRP), Erythrocyte Sedimentation Rate (ESR), procalcitonin(PCT )), immunological (IL-6 ) and biochemical (D-Dimer, Troponin, CK, AST ), especially those related to coagulation cascades in disseminated intravascular coagulation (DIC) and acute respiratory distress syndrome (ARDS). New laboratory biomarkers could be identified through the accurate analysis of multicentric case series; in particular, homocysteine and angiotensin II could play a significant role.