History

As of March 2022, more than 6 million people have died globally as a consequence of the extremely infectious viral disease produced by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spread quickly around the world when the first instances of this mostly respiratory viral infection were initially recorded in Wuhan, Hubei Province, China, in late December 2019. As a result, the World Health Organization (WHO) was forced to declare it a worldwide pandemic on March 11, 2020. One of the most serious complication is cytokine storm which  is term describe  several disorders of immune dysfunction characterized by constitutional symptoms, systemic inflammation, and multiorgan dysfunction that can lead to multiorgan failure if inadequately treated.  Aim of the study Comparison between inflammatory mediators in COVID 19 PATIENTS on dexamethasone and enoxaparin VS patients on dexamethasone only;  Study the anti-inflammatory effects of enoxaparin; estimate  the prognostic significance of IL6 & IL8 in COVID 19 patients. Methods: Total 70 iraqi patients with confirmed , severe COVID-19 infection admitted to RCU was done into two groups , 45 patients on dexamethasone and enoxaparin (group II ) and 25 patients  on dexamethasone only ( group I ). blood sample from each group collected in the first day and seventh day of admission. Results: The levels of all studied parameters in patients received mono treatment of dexamethasone showed significant reduction in the levels of CRP and LDH and a significant increase in the level of lymphocytes in the seventh day comparing with the results obtained in the first day whereas all other parameters showed non-significant differences in their levels between the seventh and first day . Patients received a combination therapy of dexamethasone and Enoxaparin showed significant reduction in the levels of D-dimer, LDH, IL-6 and IL-8 with significant elevation in the levels of lymphocytes at the seventh day of treatment in comparison with the levels of these parameters in the first day. Conclusion Percentage of patients recovered after receiving the combination therapy were (73.3%) which is higher than that for patients receiving only dexamethasone. With interested correlation between treatment and the recovery of patients , the anti-inflammatory action of enoxaparin in addition to its anti-coagulant effect.