The Relationship Between Laboratory Findings and Mortality in COVID-19 Patients Requiring Intensive Care

Ilkay Bahceci; Filiz Mercantepe; Omer Faruk Duran; Soner Yildiz; Kazim Sahin

doi:10.7759/cureus.41194

The Relationship Between Laboratory Findings and Mortality in COVID-19 Patients Requiring Intensive Care

Cureus. 2023 Jun 30;15(6):e41194. doi: 10.7759/cureus.41194. eCollection 2023 Jun.

Authors

Ilkay Bahceci¹, Filiz Mercantepe², Omer Faruk Duran¹, Soner Yildiz¹, Kazim Sahin¹

Affiliations

¹ Department of Clinical Microbiology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, TUR.
² Department of Internal Medicine, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, TUR.

Abstract

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shows a wide clinical manifestation from asymptomatic infection to life-threatening respiratory failure. This study aimed to determine the relationship between the survival and demographic data, comorbidity status, and laboratory parameters of coronavirus disease 2019 (COVID-19) patients requiring intensive care.

Material and methods: We retrospectively analyzed 236 patients requiring intensive care whose diagnosis was confirmed by the SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) test. The patients were divided into two groups in terms of survival. Demographic data; procalcitonin and C-reactive protein (CRP) levels; leukocyte, lymphocyte, and neutrophil counts in hemogram and neutrophil-to-lymphocyte ratio (NLR) levels; and lower respiratory and blood cultures were examined, and the relationships between these parameters and survival were evaluated with hypothesis testing.

Results: In the study, 156 (66.1%) males and 80 (33.9%) females, a total of 236 patients, were included. Sixty-seven (28.3%) surviving patients were determined as Group 1, and 169 (71.7%) deceased patients were determined as Group 2. A statistically significant difference was found between the groups in terms of mean age (p<0.001) and gender distribution (p=0.011). In laboratory parameters, a significant difference was observed between the groups in lymphocyte count (p=0.001), NLR (p<0.001), and procalcitonin levels (p<0.001). Although leukocyte (p=0.075), neutrophil (p=0.031), and CRP (p=0.112) levels were higher in Group 2, there was no statistical difference. Mortality was found to be higher in patients with comorbidity (p=0.012) or co-infection (p=0.002).

Conclusion: High levels of neutrophil count, NLR, and procalcitonin; low lymphocyte count; the presence of comorbidity; and secondary bacterial infection were found to be associated with mortality in COVID-19 patients in the intensive care unit.

Keywords: biomarker; covid-19; laboratory parameters; mortality; pandemic.