Characteristics and Outcomes of Patients Infected with SARS-CoV-2 in Israel: Correlation between Laboratory Findings on Admission to Emergency Department and Subsequent Respiratory Failure

Isr Med Assoc J. 2020 Oct;22(10):605-611.

Abstract

Background: There is limited clinical information on coronavirus disease-19 (COVID-19) patients in Israel.

Objectives: To describe the characteristics, outcomes, and potential associations of hospitalized COVID-19 patients in Israel.

Methods: We conducted a single-center, retrospective study of 58 consecutive laboratory-confirmed COVID-19 patients admitted to Laniado Hospital, Israel, between 14 March 2020 and 14 May 2020. Demographic, clinical, and laboratory data on admission were collected and analyzed, and the association to subsequent respiratory failure was assessed.

Results: Mean age of patients was 70.7 ± 16.9 years (53% males, 47% females.); 74% had at least one co-morbidity. Most patients were of Jewish Ashkenazi descent. During hospitalization 15 patients (mean age 78.18 ± 10.35 years); 80% male, 73% Sephardi descent developed respiratory failure rates of 60% occurring on average 10.6 days following intubation. Laboratory tests at admission displayed a significant increase in C-reactive protein (CRP) and creatine kinase (CK) and a decrease in absolute lymphocyte count (ALC) in patients who eventually developed respiratory failure (163.97 mg/L, 340.87 IU/L, 0.886 K/μl vs. 50.01 mg/L and 123.56 IU/L, 1.28 K/μl, respectively). Multivariate logistic analysis revealed an integrated parameter of CRP, CK, and ALC highly correlated with respiratory failure. Receiver operating characteristic curve revealed the area under the curve of CRP, CK, and ALC and the integrated parameter to be 0.910, 0.784, and 0.754, respectively. CRP was the strongest predictor to correlate with respiratory failure.

Conclusions: CRP, CK, and ALC levels on admission could possibly be used to detect high-risk patients prone to develop respiratory failure.

MeSH terms

  • Academic Medical Centers
  • Aged
  • Aged, 80 and over
  • C-Reactive Protein / analysis
  • COVID-19
  • Cohort Studies
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / prevention & control
  • Creatine Kinase / analysis
  • Diagnostic Tests, Routine / methods
  • Disease Progression*
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Humans
  • Israel
  • Laboratories, Hospital / organization & administration
  • Logistic Models
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Outcome Assessment, Health Care
  • Pandemics / prevention & control
  • Pandemics / statistics & numerical data
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / prevention & control
  • ROC Curve
  • Respiratory Insufficiency / diagnosis
  • Respiratory Insufficiency / mortality*
  • Respiratory Insufficiency / therapy
  • Retrospective Studies
  • Severe Acute Respiratory Syndrome / diagnosis*
  • Severe Acute Respiratory Syndrome / therapy*
  • Survival Rate

Substances

  • C-Reactive Protein
  • Creatine Kinase