الفهرس 
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Abstract
The sudden spread of the coronavirus (COVID-19) pandemic was a major setback for healthcare systems, businesses, and the general public. A recently-emerging contagious disease is rapidly spreading and endangering the health of a vast population. Therefore, immediate action is required on the part of the community to contain the disease. Coronavirus COVID-19 is a newly discovered virus that causes fever, coughing, sore throat, headache, difficulty breathing, and diarrhea. When it causes pneumonia, COVID-19 can be fatal for some people.
Despite numerous studies validating different COVID-19 biomarkers, no biomarker has been found to reliably predict the prognosis of patients infected with the virus. Due to their extensive biological functions, microRNAs (miRNAs) have garnered attention as potential biomarkers for the evaluation, treatment, and prognosis of numerous illnesses. Given that viral infection can change host miRNA expression and since dysregulated miRNAs have been studied extensively as indications for many infectious diseases, it is expected that miRNAs could potentially be utilized as COVID-19 biomarkers.
When fighting viruses, inflammation plays a key role in the immune system’s arsenal. Cytokine release syndrome is an increased immune response to SARS-CoV-2 defined by an excess of pro-inflammatory cytokines; a better knowledge of its role in COVID-19 sickness might aid in the development of novel immunotherapies.
This study aims to compare blood levels of miRNA-106a and miRNA-20a in healthy individuals with those of those diagnosed with COVID-19. The study’s goals included determining which cytokines caused the cytokine storm in COVID-19 and finding biomarkers associated with the disease’s progression.
Ferritin, D-dimer, C-reactive protein, and serum inflammatory cytokines (IL-10, TNF-, IFN-, and TLR-4) were measured in both the patients and the control group. Fifty COVID-19 patients and thirty healthy volunteers had their miRNA-106a and miRNA-20a expression levels checked with real-time RT-PCR.
A correlation between miRNA levels and lymphopenia, chest CT severity score (CSS) more than 19, oxygen saturation levels, and inflammatory cytokines was also examined in the study of COVID-19 patients.
Inflammatory cytokines, ferritin, D-dimer, and C-reactive protein levels in the blood were greater in the COVID-19 group compared to the control group. Compared to the control group, the COVID-19 patients’ group exhibited a downregulation of miRNA-106a and miRNA-20a blood levels (p²= 0.05).
Furthermore, our data indicate a substantial correlation between serum expression levels of miRNA-20a and lymphopenia, CSS>19, and O2 saturation level 90% in COVID-19 patients. There was a strong correlation between hypoxia and TLR-4, and a similar correlation between lymphopenia and IL-10.
According to the study, there was a strong negative correlation between miRNA-20a and TLR-4 (r = -0.30, p = 0.03).
Three biomarkers that could be used to quantify the severity of COVID-19 sickness are miRNA-20a, IL-10, and TLR-4, according to our research. Additionally, inhibiting IL-10 and TLR-4 could be a novel approach to treating people with severe COVID-19 illness.