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Abstract : Corona Virus Disease-2019 (COVID-19) is a globally a main healthcare threat disease, millions of people dead with it, so it is important to understanding the role of D-dimer and ferritin levels as a result of the response to disease. Both proteins mostly rely on severity of the COVID-19 disease. COVID-19 induced hyper inflammation which are a chief reason of disease severity and death via “cytokine storm” elevated level of Interleukin-6 (IL-6), Interleukin-10(IL-10) and Tumor Necrosis Factor Alpha (TNF-α) associated with decreased Interferon gamma (IFN-γ) due to decrease in T-cell count [1]. Follow up D-dimer level and ferritin level for six months, in addition to the association between D-dimer & ferritin with COVID-19 severity in COVID-19 recovered patients. Follow up inflammatory cytokine (IL-6) level and regulatory cytokine (IL-10) level for three months after COVID-19 recovery and the connection between IL-6 and IL-10 levels in COVID-19 recovered patients. In addition to the correlation between cytokines levels COVID-19 with genders and COVID-19 severity. The nasopharyngeal swab to confirm recovery by reverse transcriptase real-time PCR technique. Detection of D-dimer levels via using ARCHITECT D- dimer auto analyzer, detection of Ferritin levels via using Maglumi Fully Auto Operator’s Manual, while IL-6 and IL-10 levels via using Enzyme Linked Immune Sorbent Assay (ELISA). The results found that, comparison between studied groups show significant increased (P ≤ 0.01) in D-dimer level (mg/L), serum ferritin (ng/mL) level, IL-6 & IL-10 (pg/ml) level in COVID-19 recovered patients groups as compared with apparently control group, also a significant differences (P≤ 0.05) in D-dimer, ferritin, IL-6 &IL-10 between studied groups. The comparison of D-dimer, ferritin, IL-6 & IL-10 level between mild, moderate and severe groups had shown significant differences at P≤0.01. Contrariwise, D-dimer levels decline after treatments, with highly correlation was observed between D-dimer & ferritin levels in patients groups, finally, highly significant correlation coefficient between IL-6 & Il-10 levels. Both gender affected with COVID-19. Markedly increased in D-dimer in COVID-19 recovered patients which may play as a risk factor for thrombosis. Interestingly, High levels of ferritin associated with COVID-19 recovered patients could be considered as an inflammatory factor. Finally, significant correlation between ferritin and D-dimer levels in studied groups and could be used as diagnostic biomarker for COVID-19. Elevated in serum concentration of IL-6, IL-10 in all age groups and both gender correlated with COVID-19 severity.

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