Baseline and early changes in laboratory parameters predict disease severity and fatal outcomes in COVID-19 patients

Addisu Gize; Yerega Belete; Melkayehu Kassa; Wondewosen Tsegaye; Gadissa Bedada Hundie; Birhan Mesele Belete; Mahteme Bekele; Berhan Ababaw; Yosef Tadesse; Bereket Fantahun; Sisay Sirgu; Solomon Ali; Anteneh Mehari Tizazu

doi:10.3389/fpubh.2023.1252358

Baseline and early changes in laboratory parameters predict disease severity and fatal outcomes in COVID-19 patients

Front Public Health. 2023 Dec 13:11:1252358. doi: 10.3389/fpubh.2023.1252358. eCollection 2023.

Affiliations

¹ School of Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
² CIHLMU Center for International Health, LMU University Hospital, LMU Munich, Germany.
³ Department of Internal Medicine, School of Medicine, College of Health Science and Medicine, Wollo University, Dessie, Ethiopia.

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) has become the worst catastrophe of the twenty-first century and has led to the death of more than 6.9 million individuals across the globe. Despite the growing knowledge of the clinicopathological features of COVID-19, the correlation between baseline and early changes in the laboratory parameters and the clinical outcomes of patients is not entirely understood.

Methods: Here, we conducted a time series cross-sectional study aimed at assessing different measured parameters and socio-demographic factors that are associated with disease severity and the outcome of the disease in 268 PCR-confirmed COVID-19 Patients.

Results: We found COVID-19 patients who died had a median age of 61 years (IQR, 50 y - 70 y), which is significantly higher (p < 0.05) compared to those who survived and had a median age of 54 years (IQR, 42y - 65y). The median RBC count of COVID-19 survivors was 4.9 × 10⁶/μL (IQR 4.3 × 10⁶/μL - 5.2 × 10⁶/μL) which is higher (p < 0.05) compared to those who died 4.4 × 10⁶/μL (3.82 × 10⁶/μL - 5.02 × 10⁶/μL). Similarly, COVID-19 survivors had significantly (p < 0.05) higher lymphocyte and monocyte percentages compared to those who died. One important result we found was that COVID-19 patients who presented with severe/critical cases at the time of first admission but managed to survive had a lower percentage of neutrophil, neutrophil to lymphocyte ratio, higher lymphocyte and monocyte percentages, and RBC count compared to those who died.

Conclusion: To conclude here, we showed that simple laboratory parameters can be used to predict severity and outcome in COVID-19 patients. As these parameters are simple, inexpensive, and radially available in most resource-limited countries, they can be extrapolated to future viral epidemics or pandemics to allocate resources to particular patients.

Keywords: COVID-19; laboratory parameters; mortality; resource-limited countries; severity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
COVID-19* / epidemiology
Cross-Sectional Studies
Humans
Middle Aged
Patient Acuity
SARS-CoV-2

Grants and funding

This research was funded by St. Paul’s Hospital Millennium Medical College. The funder had no role in designing the study, collection, analysis, and interpretation of data.