Assessment of Serum Levels of Homocysteine, Ang 1-7, and Plasminogen Activator Inhibitor-1 Protein in Samples of Coronavirus Disease 2019 Patients in Iraq

Background: The coronavirus disease 2019 (COVID-19) pandemic is a difficult situation in terms of science, medicine, and society due to the easy ways of transmission of the coronavirus. More attention has been focused on using biomarkers in emergency rooms for coronavirus infection screening and early diagnosis. A potential thrombotic disease biomarker is homocysteine (Hcy), whereas Angiotensin (1-7) induces vasodilation and anti-inflammation and the primary blocker of plasma plasminogen activator is plasminogen activator inhibitor-1 (PAI-1). Methods: In this study, which involved 128 participants (88 patients and 40 control), to determine whether Hcy, Ang 1-7, and PAI-1 protein are associated with COVID-19 infection, 5 ml of venous blood in gel tubes were collected. Enzyme-linked immunosorbent assay was used to measure these biomarkers in the blood of these participants, and SPSS version 27 and Graph prism 9 were used to compute statistical results. Results: In this study, Hcy and PAI-1 levels in patients' serums were higher than in healthy people, while Hcy and PAI-1 were higher than in healthy subjects. A receiver operating characteristic analysis (ROC) determined cutoff values for Hcy (10.3), Ang 1-7 (89.6), and PAI-1 (4.89), respectively, at area under the ROC Curve of 0.71, 0.27, and 0.9, respectively. Results of logistic regression show that Ang 1-7 is an independent parameter, while Hcy and PAI-1 are dependent factors. Conclusions: In conclusion, patients with COVID-19 had significantly elevated Hcy and PAI-1 levels and infections were more severe. The concentrations of Ang 1-7 biomarker in the serum of patients with severe outcomes were significantly lower than those in healthy.