{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T07:13:34Z","timestamp":1773213214791,"version":"3.50.1"},"reference-count":54,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T00:00:00Z","timestamp":1664409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Taif University, Taif, Saudi Arabia","award":["TURSP-2020\/127"],"award-info":[{"award-number":["TURSP-2020\/127"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Aim: The study evaluated the correlations between cytokine levels, liver function markers, and neuropilin-1 (NRP-1) expression in patients with COVID-19 in Egypt. The study also aimed to evaluate the accuracy sensitivity, specificity, and area under the curve (AUC) of the tested laboratory parameters in identifying COVID-19 infection and its severity. Patients and Methods: Fifty healthy subjects and 100 confirmed patients with COVID-19 were included in this study. COVID-19 patients were separated into two groups based on the severity of their symptoms. Serum ALT, AST, albumin, C-reactive protein (CRP), interleukin (IL)-1\u03b2, IL-4, IL-6, IL-18, IL-35, prostaglandin E2 (PGE2), and thromboxane A2 (TXA2) were estimated. We measured the gene expression for nuclear factor-kappa B p50 (NF-\u03baB p50) and nuclear factor-kappa B p65 (NF-\u03baB p65) and NRP-1 in blood samples using quantitative real-time polymerase chain reaction (qRT-PCR). AUC and sensitivity and specificity for cytokine levels and NF-\u03baB p50 and NF-\u03baB p65 and NRP-1 in identifying COVID-19 infection were also determined in both moderate and severe patient groups using receiver-operating characteristic curve (ROC) analysis. Results: All patients with COVID-19 showed higher serum activities of liver enzymes, levels of CRP, IL-1\u03b2, IL-4, IL-6, IL-18, IL-35 PGE2, and TXA2, and mRNA expression of NF-\u03baB p50, NF-\u03baB p65, and NRP-1 than healthy subjects. The severe group exhibited a significant increase in serum ALT, AST and IL-6 and a significant decrease in albumin, IL-1\u03b2, TXA2, and NF-\u03baB p65 levels compared to the moderate group. In all patients (moderate and severe), all cytokines were positively correlated with NF-\u03baB p50, NF-\u03baB p65 and NRP-1 expression levels. Serum ALT and AST were positively correlated with CRP, cytokines (IL-4, IL-6, IL-18, IL-35 and TXA2), and NF-\u03baB p50 and NF-\u03baB p65 expression levels in both moderate and severe groups. They were also positively correlated with serum IL-1\u03b2 level in the severe COVID-19 patient group and with NRP-1 expression in the moderate group. Using the logistic regression analysis, the most important four statistically significant predictors associated with COVID-19 infection in the study were found to be IL-6, TAX2, NF-\u03baB p50 and NF-\u03baB p65. ROC analysis of these variables revealed that three of them had AUC &gt; 0.8. In moderate cases, AUC of the serum TXA2 level and NF-\u03baB p65 expression were 0.843 (95% CI 0.517\u20130.742, p &lt; 0.001) and 0.806 (95% CI 0.739\u20130.874, p &lt; 0.001), respectively. In the severe group, AUC of serum IL-6 level was 0.844 (95% CI 0.783\u20130.904, p &lt; 0.001). Moreover, Il-6 had a sensitivity of 100% in both moderate and severe groups. Conclusions: This study concluded that liver injury in patients with COVID-19 may be strongly attributed to the cytokines storm, especially IL-6, which was positively correlated to NF-\u03baB p50, NF-\u03baB p65 and NRP-1 mRNA expression levels. Moreover, ROC analysis revealed that IL-6, TXA2, and NF-\u03baB p65 could be useful in predicting the possibility of infection with COVID-19, and IL-6 could be of possible significance as a good predictor of the severity and disease progress. However, RT-qPCR for SARS-CoV-2 detection is essential to confirm infection and further clinical studies are required to confirm this elucidation.<\/jats:p>","DOI":"10.3390\/vaccines10101636","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T04:09:36Z","timestamp":1664424576000},"page":"1636","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Correlations between Cytokine Levels, Liver Function Markers, and Neuropilin-1 Expression in Patients with COVID-19"],"prefix":"10.3390","volume":"10","author":[{"given":"Salma A.","family":"El Kazafy","sequence":"first","affiliation":[{"name":"Biotechnology Department, Faculty of Postgraduate Studies for Advanced Sciences, Beni-Suef University, Beni-Suef 62521, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7989-5318","authenticated-orcid":false,"given":"Yasser M.","family":"Fouad","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Minia University, Minia 61519, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azza F.","family":"Said","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Faculty of Medicine, Minia University, Minia 61519, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hebatallah H.","family":"Assal","sequence":"additional","affiliation":[{"name":"Department of Chest Medicine, Faculty of Medicine, Cairo University, Cairo 11562, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2998-247X","authenticated-orcid":false,"given":"Tarek M.","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Physiology, College of Medicine, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amr E.","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Biotechnology Department, Faculty of Postgraduate Studies for Advanced Sciences, Beni-Suef University, Beni-Suef 62521, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Basem H.","family":"Elesawy","sequence":"additional","affiliation":[{"name":"Department of Pathology, College of Medicine, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3781-9709","authenticated-orcid":false,"given":"Osama M.","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Physiology Division, Zoology Department, Faculty of Science, Beni-Suef University, Beni-Suef 62521, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e00028-20","DOI":"10.1128\/CMR.00028-20","article-title":"Coronavirus Disease 2019\u2013COVID-19","volume":"33","author":"Dhama","year":"2020","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_2","unstructured":"World Health Organization (2021, March 03). WHO Coronavirus Disease (COVID-19) Dashboard. 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