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Background The risk factors, disease characteristics, severity, and mortality of COVID-19 are unclear, particularly in Egypt. Objective The objective was to analyze the patients’ characteristics, hematological, biochemical, and chest imaging findings among the cohort of patients with COVID-19 in Egypt and also to shed light on the predictors of COVID-19 severity. Patients and Methods A retrospective study was conducted on 66 patients with COVID-19 in Egypt. Medical history, imaging data (CT chest findings), and measured hematological and biochemical parameters at diagnosis were recorded in the form of complete blood counts and differential counts; CRP, ESR, serum ferritin, creatinine, and liver function tests . Results of real-time reverse transcription-polymerase chain reaction (rRT-PCR) for detection of SARS-CoV-2 RNA at diagnosis and during follow up of these patients were also recorded. Results The study included 36 patients with mild to moderate COVID-19 and 30 patients with severe/critical infection. There was a significant older age among severe (62.6 years old ±10.1SD) than mild to moderate infection (55.5 ± 10.1) (p˂0.05). Fever, dry cough, dyspnea, and sore throat malaise were highly frequent among COVID-19 patients, while headache and diarrhea were the least frequently occurring manifestations. All included cases (30 patients, 100%) with severe COVID-19 showed crazy-paving appearance (in the form of reticular and/or interlobular septal thickening) with or without GGO. There were significantly lower mean values of WBCs, lymphocytic count, total protein, and albumin among the severely infected than those who had mild to moderate COVID-19 infection, p˂0.05 for all. Additionally, there were significantly higher mean values of CRP, ESR, ferritin, ALT, and AST among patients with severe/critical COVID-19 when compared with those having mild to moderate COVID-19, p˂0.05 for all. Conclusion Among the studied demographic, clinical, hematological, biochemical, and imaging data, dyspnea, diabetes mellitus, lymphopenia, raised CRP, ESR, ferritin, ALT, AST, low albumin, and presence of CT chest findings could be considered as predictors for COVID-19 severity using binary logistic regression analysis.

Understanding the contributory role of increased fibroblast growth factor23 (FGF23) and secondary hyperparathyroidism to changes in minerals and bone metabolism among chronic kidney disease (CKD) patients is a challenge. So the present study aimed to evaluate the role of FGF23 in CKD of various grades and potential utility for early diagnosis of disturbed bone and mineral metabolism among such patients. This hospital based-cross sectional study has been conducted on 100 CKD patients of various grades. Colorimetric assays of serum urea, creatinine, phosphorous and calcium, while, ELISA assays of parathormone hormone (PTH) and FGF23, were done to all included patients. The overall results showed frequent abnormally high serum FGF23 among CKD grade 3 and 4 compared to other grades. Also there was significant positive correlation between the serum FGF234 levels and the CKD grade (r=0.21, p = 0.03). Significant positive correlations between serum levels of FGF23 vs. both urea and PTH (r=0.19, p=0.04 and r= 0.31, p=0.002 respectively) with significant negative correlations between serum FGF23 levels vs. both total calcium and eGFR (r=-0.21, p=0.02 and r=- 0.39, p=0.0001 respectively). There were non-significant correlations between serum FGF23 and age, weight, height, BMI and phosphorous (p˃0.05). FGF23 is better negative than positive predictive biomarker for calcium and phosphorous disturbances in CKD patients at cut off point 2.9 and 3.1 pg/ml respectively. In conclusion, FGF23 is an emerging biomarker in CKD and its follow up measurement could be helpful for early diagnosis of CKD-MBD.