Haematological and radiological-based prognostic markers of COVID-19

Suliman A Alsagaby; Abdulrhman Aljouie; Talal H Alshammari; Shabir Ahmad Mir; Fahad A Alhumaydhi; Waleed Al Abdulmonem; Hesham Alshaalan; Hassan Alomaish; Rayyan Daghistani; Ali Alsehawi; Naif Khalaf Alharbi

doi:10.1016/j.jiph.2021.09.021

Haematological and radiological-based prognostic markers of COVID-19

J Infect Public Health. 2021 Nov;14(11):1650-1657. doi: 10.1016/j.jiph.2021.09.021. Epub 2021 Sep 30.

Affiliations

¹ Department of Medical Laboratories Sciences, College of Applied Medical Sciences, Majmaah University, AL-Majmaah 11932, Saudi Arabia. Electronic address: s.alsaqaby@mu.edu.sa.
² Bioinformatics Section, King Abdullah Medical Research Center, Riyadh, Saudi Arabia; Health Informatics, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh, Saudi Arabia. Electronic address: aljouieab@ngha.med.sa.
³ Department of Medical Laboratories Sciences, College of Applied Medical Sciences, Majmaah University, AL-Majmaah 11932, Saudi Arabia; King Khaled General Hospital in Hafar Albaten, Saudi Arabia. Electronic address: t.abosaad.82@gmail.com.
⁴ Department of Medical Laboratories Sciences, College of Applied Medical Sciences, Majmaah University, AL-Majmaah 11932, Saudi Arabia. Electronic address: s.mir@mu.edu.sa.
⁵ Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia. Electronic address: f.alhumaydhi@qu.edu.sa.
⁶ Department of Pathology, College of Medicine, Qassim University, Buraydah, Saudi Arabia. Electronic address: waleedmonem@qumed.edu.sa.
⁷ Department of Medical Imaging, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia. Electronic address: AlomaishHas@NGHA.MED.SA.
⁸ Department of Medical Imaging, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia. Electronic address: ShalanH@NGHA.MED.SA.
⁹ Department of Medical Imaging, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia. Electronic address: DaghistaniRa@NGHA.MED.SA.
¹⁰ Department of Medical Imaging, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia. Electronic address: AlSehaiwAl@NGHA.MED.SA.
¹¹ Department of Infectious Disease Research, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. Electronic address: harbina2@ngha.med.sa.

Abstract

Background: Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has emerged in 2019 and caused a global pandemic in 2020, manifesting in the coronavirus disease 2019 (COVID-19). The majority of patients exhibit a mild form of the disease with no major complications; however, moderate to severe and fatal cases are of public health concerns. Predicting the potential prognosis of COVID-19 could assist healthcare workers in managing cases and controlling the pandemic in an effective way. Therefore, the objectives of the study were to search for biomarkers associated with COVID-19 mortality and predictors of the overall survival (OS).

Methods: Here, clinical data of 6026 adult COVID-19 patients admitted to two large centers in Saudi Arabia (Riyadh and Hafar Al-Batin cities) between April and June 2020 were retrospectively analysed.

Results: More than 23% of the study subjects with available data have died, enabling the prediction of mortality in our cohort. Markers that were significantly associated with mortality in this study were older age, increased d-dimer in the blood, higher counts of WBCs, higher percentage of neutrophil, and a higher chest X-ray (CXR) score. The CXR scores were also positively associated with age, d-dimer, WBC count, and percentage of neutrophil. This supports the utility of CXR scores in the absence of blood testing. Predicting mortality based on Ct values of RT-PCR was not successful, necessitating a more quantitative RT-PCR to determine virus quantity in samples. Our work has also identified age, d-dimer concentration, leukocyte parameters and CXR score to be prognostic markers of the OS of COVID-19 patients.

Conclusion: Overall, this retrospective study on hospitalised cohort of COVID-19 patients presents that age, haematological, and radiological data at the time of diagnosis are of value and could be used to guide better clinical management of COVID-19 patients.

Keywords: COVID-19; Haematology; Marker; Prognosis; Radiology.

MeSH terms

Adult
Aged
COVID-19*
Humans
Pandemics
Prognosis
Retrospective Studies
SARS-CoV-2