Covid-19: contribution of clinical characteristics and laboratory features for early detection of patients with high risk of severe evolution

Abstract

Background: The aim of this study was to identify early clinical and laboratory predictive factors of a severe coronavirus disease 2019 (COVID-19). Methods: A retrospective study was conducted on adult patients hospitalized for COVID-19 in our hospital. Diagnosis was based on a positive real-time reverse transcription-polymerase chain reaction (RT-PCR) on nasopharyngeal samples. The cohort was divided into two groups, i. e. a favorable evolution (FE) group and an unfavorable evolution (UFE) group, including intensive care unit (ICU) and deceased patients. Results: A total of 198 patients were enrolled in the study, with 138 FE (70%) and 60 UFE (30%). Older age, male gender, comorbidities and dyspnea at admission constituted significantly worse prognosis factors. Among laboratory features, lymphocyte and platelet counts as well as corrected glomerular filtration rate were significantly lower in UFE patients, while neutrophil to lymphocyte ratio, inflammation biomarkers, creatinine, aspartate aminotransferase, lactate dehydrogenase (LDH), glycemia and D-dimer were significantly higher. Procalcitonin and LDH appeared as the most accurate variables according to receiver operating characteristic curves. Conclusions: This Belgian study revealed clinical and laboratory features able to predict high risk of ICU requirement, or even death, at admission time. These results provide a potential tool for patient's triage in a context of pandemic.

Evolution of COVID-19 in patients with autoimmune rheumatic diseases

“…Our study demonstrated that patients who had multiple comorbidities were seen to have a higher severity of COVID-19. Thus, more varieties of comorbidities were also associated with increased severity in the AIRD group of patients, similar to the general population [16,17].…”

“…The median time from symptoms onset to admission was 25 (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) Laboratory results showed that 60% of the patients with SLE, 33.3% with RA and the only one Rhupus patient developed lymphopenia, while 28.6% (6/21) had lymphopenia at entry. The median level of lymphocyte counts at entry was 1.41×10 9 /L.…”

Clinical characteristics and analysis of risk factors for disease progression of COVID-19: A retrospective Cohort Study

“…Wang et al 's study 10 showed that male, elder age, diabetes cardiovascular diseases, chills, dyspnea, SO 2 value of ≤93%, WBC counts of >10×10 9 /L and large consolidated opacity on CT images were all risk factors for aggravation of illness. Edith Sepulchre et al 11 found that older age, male gender, comorbidities and dyspnea at admission constituted significantly worse prognosis factors. Feng He et al 12 found that older age, Wuhan exposure history, diarrhea, chronic kidney disease, elevated myoglobin, elevated white blood cell and C-reactive protein were independent risk factors for severe patients with COVID-19.…”

Precision Medicine and Public Health: New Challenges for Effective and Sustainable Health

“…Despite the majority of individuals with COVID-19 exhibiting only mild symptoms or even being asymptomatic, there are patients who develop serious complications, underlining the fact that it is crucial to identify who is at higher risk of a worse prognosis and to recognize reliable outcome predictors in a timely manner for improving patient management. As a result, the personalized medicine approach appears to be highly appropriate for the study of COVID-19, considering the wide spectrum of severity and variable phenotypes [ 147 ], including asymptomatic, mildly symptomatic, severe symptomatic requiring hospitalization, and respiratory failure due to acute respiratory distress syndrome (ARDS) [ 148 ]. Omics-scale studies on SARS-CoV-2 are quickly emerging and have a huge potential to resolve the infection pathophysiology [ 149 ], highlighting biologic pathways, modifiable risk factors, and critical information to allow early interventions [ 150 , 151 ].…”