Author(s)

Nadia El Menshawy^1*, Ghada Elsaid², Tarek Abo Zeid³, Nora A. Farag^1,4

¹Clinical Pathology Department, Hematology Unit, Faculty of Medicine, Oncology Center, Mansoura University, Mansoura, Egypt.
²Internal Medicine, Specialized Medicine Hospital, Mansoura University, Mansoura, Egypt.
³Clinical Hematology, Faculty of Medicine, Oncology Center, Mansoura University, Mansoura, Egypt.
⁴Clinical Pathology Department, Hematology Unit, Faculty of Medicine, Mansoura University, Delta University, Gamasa, Egypt.

Background: One of the most serious morbidity and mortality features in COVID-19 is thrombo-embolic manifestation with disturbed hemostasis in natural anticoagulant. Protein S plays a critical role in cytokine storming and acts as cross talk between immune status and coagulation process. So, we aimed to address its role in addition to protein C in severity and outcome of disease, with its role in vaccinated people by AstraZeneca. Methods: The present study was conducted on 70 COVID-19 positive by real-time PCR. 40 of patients had moderate symptoms of respiratory, 30 cases were admitted into ICU of Mansoura University Hospital, some of them under mechanical ventilator. In addition to 40 healthy volunteers after first dose of vaccinated AstraZenka as reference, assessment of protein C&S antigen was done by ELIZA. Results: Significant increase in total leucocytic count in COVID-19 than vaccinated volunteer with significant reduction in absolute lymphocytosis, increased neutrophilia. First significant observation was higher MPV in COVID-19 than vaccinated, in addition to significantly higher C-reactive protein in severe cases than moderate and vaccinated. Prominent interesting finding in our study was significant reduction in Protein C&S in severe cases than moderate and vaccinated. Logistic regression analysis revealed that both could be predictor of mortality outcome as CRP in COVID-19 illness. Conclusion: There was significant reduction in protein C&S in severe cases than moderate and vaccinated. Regression analysis shows that could be predictor of mortality as well as CRP, D-dimer. Large extended study and follow up are needed to assess the incidence of thromboembolism and role of protein C&S in different variety protocols of vaccination programs.

Protein C, S, COVID-19, AstraZeneca Vaccine

El Menshawy, N. , Elsaid, G. , Zeid, T. and Farag, N. (2022) Down Protein C and S Antigen Could Be Predictor of Mortality Outcome in Critical Egyptian COVID-19 Illness. Journal of Biosciences and Medicines, 10, 190-202. doi: 10.4236/jbm.2022.103018.