الفهرس 
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Abstract
SUMMARY
COVID-19, caused by SARS-CoV-2, is a contagious life-threatening viral disease that has killed more than 5 million people worldwide to date. Attempts have been made to identify biomarker(s) to stratify disease severity and improve treatment and resource allocation.
The effectual immune response is crucial to defeat viral infections. However, exuberant immune response with features of macrophage activation syndrome (MAS) might lead to detrimental consequences in COVID-19 patients. Interleukin (IL)-18 is one of the leading cytokines in MAS which studied in COVID-19. The current study was designed with an aim to investigate the association of IL-18 with the other inflammatory markers and disease severity in COVID-19 for predicting disease prognosis.
In this cross-sectional study, 50 patients (24 males and 26 females) with confirmed positive COVID-19 by SARS-CoV-2 nucleic acid RT-PCR,admitted to Beni-Suef University Hospital from April to September 2021 were included(serum IL-18 level was measured within the first week after admission). Data regarding demographics, clinical characteristics, laboratory tests, and outcomes were collected and analyzed.
The collected data were coded then entered and analyzed taking three months using the SPSS version 22.
Our data analyses reveled that:
- CRP was significantly higher among died as compared with recoveredCOVID-19 patients (177.50 ±39.23 vs. 84.93 ±60.14, p=0.001).
- D-Dimer was significantly higher among died as compared with recoveredCOVID-19 patients (10.71 ±0.53 vs. 3.02 ±3.58, p=0.001).
- Ferritin was significantly higher among died as compared with recoveredCOVID-19 patients (866.50 ±156.73 vs. 262.56 ±341.31, p=0.001).
- Platelet count was significantly higher among recovered as compared with died COVID-19 patients (315.37 ±120.95 vs. 232.38 ±81.70, p=0.012).
- IL-18 was significantly higher among died as compared with recoveredCOVID-19 patients (292.68 ±51.22 vs. 92.33 ±62.42, p=0.001).
- Correlation test showed a significant positive strong linear relationship between IL-18 levels and the values of: CRP (r=0.757, p=0.001), D-dimer (r=0.814, p=0.001), and ferritin (r=0.822, p=0.001).
- The optimal cutoff value of IL-18 for mortality prediction in the present study was ≥ 230.75 pg/mL with 81.5%sensitivity and 57.5%specificity.
In conclusion, serum IL-18 concentrations have a significant correlation with the COVID-19 severity and other inflammatory markers, however, larger studies are needed to confirm these findings. Better characterization of role of IL-18 could constitute a therapeutic opportunity fortreatment of COVID-19.