Predictors of COVID-19 Severity in Elderly Patients Infected by Omicron in China, 18 December 2022-5 February 2023

Yanqing Xing; Yupeng Li; Liting Feng; Rujie Huo; Xinkai Ma; Yanting Dong; Dai Liu; Yuheng Niu; Xinrui Tian; Erjing Chen

doi:10.2147/IDR.S418622

Predictors of COVID-19 Severity in Elderly Patients Infected by Omicron in China, 18 December 2022-5 February 2023

Infect Drug Resist. 2023 Jul 11:16:4505-4518. doi: 10.2147/IDR.S418622. eCollection 2023.

Authors

Yanqing Xing¹, Yupeng Li¹, Liting Feng¹, Rujie Huo¹, Xinkai Ma¹, Yanting Dong¹, Dai Liu¹, Yuheng Niu², Xinrui Tian^#¹, Erjing Chen^#¹

Affiliations

¹ The Second Hospital of Shanxi Medical University, Taiyuan, People's Republic of China.
² The First Hospital of Shanxi Medical University, Taiyuan, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: To analyze the clinical characteristics and prognosis of patients hospitalized with non-severe, severe pneumonia and death in Omicron COVID-19.

Patients and methods: We collected clinical data from 118 patients with COVID-19 in China from 18 December, 2022 and 5 February, 2023. According to the outcome, the patients were divided into non-severe group, severe group and death group. Subsequently, we statistically analyzed the general condition, clinical manifestations, laboratory parameters, NLR, MLR, PLR and HALP of these groups. We also retrospectively analyzed the possible factors affecting the prognostic regression of patients with COVID-19.

Results: A total of 118 COVID-19 patients were enrolled in this study, including 64 non-severe patients, 38 severe patients and 16 death patients. Compared with the non-severe group, T lymphocytes, B lymphocytes, Th1, Th2, Th17, Treg cells, IgA, IgG, IgM in the severe and death groups decreased more significantly (P<0.05). The levels of myocardial markers, ALT, AST, BUN, Cr, D-dimer, fibrinogen, NLR, MLR and PLR in the severe and death groups were significantly higher than those in the non-severe group (P<0.05). The level of HALP was significantly lower than that of non-severe group (P<0.05). MLR is not only an independent risk factor for the transition from non-severe to severe disease, but also an independent risk factor for predicting the possibility of death in COVID-19 patients.

Conclusion: The analysis of COVID-19 patients in China showed that severe patients were older, more likely to have related complications, lower lymphocyte count, liver and kidney function disorder, glucose and lipid metabolism disorders, myocardial injury, and abnormal coagulation function, suggesting the need for early anticoagulant therapy. In addition, NLR, MLR, PLR and HALP can be used as biomarkers to evaluate the severity and prognosis of COVID-19 patients.

Keywords: COVID-19; Shanxi; clinical characteristics; lymphocyte subpopulation; omicron.

Grants and funding

This study was funded by Shanxi Provincial Key Research and Development Project (201903D421066) and Applied Basic Research Project of Shanxi Province, China (202203021211029).