Prognostic factors for predicting severity and mortality in hospitalized COVID-19 patients

J Clin Lab Anal. 2022 Mar;36(3):e24216. doi: 10.1002/jcla.24216. Epub 2022 Jan 25.

Abstract

Background: Coronavirus disease 2019, COVID-19, has reached all the corners of the world and was declared by the WHO as a global pandemic and public health emergency of international concern on the January 31, 2020. Allocating quick and specific biomarkers to predict the disease severity upon admission to hospital became a crucial need. This study, therefore, aimed at exploring the relationship between laboratory results in COVID-19 patients admitted to hospital and the final outcome in these patients.

Methods: Retrospective analysis was performed on the medical records of 310 COVID-19-positive patients admitted to Uhod Hospital, the referral hospital in the area of Madinah, Kingdom of Saudi Arabia, between the April 13 and the July 29, 2020. The association of laboratory results with the survival/mortality outcomes was studied.

Results: It was demonstrated that lymphopenia, prolonged aPTT, high INR, high D. dimer and high CK are valuable prognostic predictors of the severity of the disease at early stages that can determine the outcome. Based on the results of the multiple logistic regression, the variables that are associated with death outcome are aPTT, HR, RR, ALT and CK level CONCLUSION: It is proposed to perform these tests on admission to hospital for moderate to severe COVID-19 patients to improve the management of those cases and reduce mortality.

Keywords: COVID-19; coagulation cascade; creatine kinase; hematocrit; lactate dehydrogenase; lymphopenia.

MeSH terms

  • Adult
  • Aged
  • Biomarkers / blood
  • COVID-19* / diagnosis
  • COVID-19* / epidemiology
  • COVID-19* / mortality
  • COVID-19* / physiopathology
  • Creatine Kinase / blood
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Partial Thromboplastin Time
  • Prognosis
  • Retrospective Studies
  • SARS-CoV-2
  • Saudi Arabia

Substances

  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D
  • Creatine Kinase