الفهرس 
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Abstract
Covid-19 has caused a sudden significant increase in hospitalizations for pneumonia with multi organ disease. Covid -19 infections may be asymptomatic or may cause awide spectrum of symptoms, such as mild symptoms of upper respiratory tract infection also may reach to life threatening sepsis. Procalcitonin modifies the outcome of respiratory infections with regard to minimizing the use of antibiotics and duration of antibiotic treatment. Increasing concentrations especially over time indicate high risk of a severe outcome, so procalcitonin is superior to other infection markers such as C-reactive protein. The aim of the present study was to investigate the diagnostic role of changes of procalcitonin levels in Covid-19 patients in order to better predict the prognosis. The present study was conducted on 75 patients of Covid-19. The patients were selected from quarantine hospital of Tanta University, outpatient clinic and chest department. The subjects were classified into 3 groups: • group I: 25 patients of Covid-19 with mild pneumonia. • group II: 25 patients of Covid-19 with moderate pneumonia. group III: 25patients of Covid-19 with severe and critical pneumonia. Studied groups were subjected to History taking, Clinical examination, and CT chest. Routine laboratory tests (CBC, CRP, serum ferritin, D-dimer ,Culture and sensitivity of blood or sputum samples to exclude other causes of pneumonia .Specific investigations( Real-Time PCR diagnostic test for coronavirus, Serial measurements of procalcitonin levels at admission, day 3, day 5, day7 and at discharge using ELISA technique). The results of the present study revealed that: This study found that there was significant gradual increase in PCT levels in group II compared to group I and also in group III compared to group I, while there was no significant difference between groups II and III as regard procalcitonin at admission, day 3 and day5. There was significant increase among studied groups as regard PCT at day7 and discharge. In this study in group I there was significant gradual decrease in PCT levels from admission to discharge. There was significant positive correlation between procalcitonin and neutrophil at admission and day 3, also between procalcitonin and ferritin at day3 and 7, while negative correlation was found between procalcitonin and TLC at admission, days3, 5, 7 and discharge also between PCT and platelets at discharge. There was no significant correlation between procalcitonin and age, lymphocyte percent, CRP, d dimer and platelets except at discharge. There was no significant correlation between procalcitonin and neutrophil at days5, 7, discharge also there was no significant correlation between procalcitonin and ferritin at admission, day 5 and discharge. In this work in group II there was significant gradual decrease in PCT levels from admission to discharge. There was significant positive correlation between procalcitonin and TLC at day5 and discharge also between PCT and CRP at admission, day3 and discharge. There was significant positive correlation between procalcitonin and d dimer and ferritin except at admission, while negative correlation was found between procalcitonin and lymphocyte percent at discharge also between PCT and platelets except at admission. There was no significant correlation between procalcitonin and age ,TLC at admission, days 3and7 also between PCT and neutrophil percent, lymphocyte percent at admission,days3,5and7 , There was no significant correlation between procalcitonin and platelets at admission, CRP at days5,7, ferritin at admission . In this study in group III there was significant decrease in PCT levels at day 3 and day5 compared to admission, while there was significant increase in PCT levels at day 7 and discharge. There was significant positive correlation between procalcitonin and CRP at days 5, 7 and discharge, also between PCT and d dimer at discharge, while negative correlation was found between procalcitonin and d dimer at admission. There was no significant correlation between procalcitonin and age, TLC, Neutrophil, lymphocyte percent, platelet, ferritin, CRP at admission and day3, d dimer at days 3, 5 and 7. In this study there was no significant correlation between procalcitonin and age in group I, group II and group III, while in total sample there was significant positive correlation between procalcitonin and age at days5, 7 and discharge. In this study the sensitivity was 94% and the specificity was 84 % regarding PCT in moderate and severe groups versus mild group according to ROC curve.