Haematological predictors of poor outcome among COVID-19 patients admitted to an intensive care unit of a tertiary hospital in South Africa

Chapanduka, Zivanai C.; Abdullah, Ibtisam; Allwood, Brian; Koegelenberg, Coenraad F. N.; Irusen, Elvis; Lalla, Usha; Zemlin, Annalise E; Masha, Tandi E.; Erasmus, Rajiv T; Jalavu, Thumeka P.; Ngah, Veranyuy D.; Yalew, Anteneh; Sigwadhi, Lovemore N.; Baines, Nicola; Tamuzi, Jacques L.; McAllister, Marli; Barasa, Anne K.; Magutu, V.; Njeru, Caroline; Amayo, Angela; Mureithi, Marianne; Mungania, Mary; Sono-Setati, Musa E.; Zumla, Alimuddin; Nyasulu, Peter

doi:10.1371/journal.pone.0275832

Cited by 4 publications

(2 citation statements)

References 45 publications

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“…Besides IL-6 and LDH, other laboratory parameters are cited in the literature as independent risk factors of death in COVID-19, such as neutrophil count, platelet count, CRP, D-dimers, troponin-I and low total testosterone [ 54 , 55 , 56 , 57 ].…”

Section: Discussionmentioning

confidence: 99%

Inflammation as Prognostic Hallmark of Clinical Outcome in Patients with SARS-CoV-2 Infection

Fuzio¹,

Inchingolo

Ruggieri³

et al. 2023

Life

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is often characterized by a life-threatening interstitial pneumonia requiring hospitalization. The aim of this retrospective cohort study is to identify hallmarks of in-hospital mortality in patients affected by Coronavirus Disease 19 (COVID-19). A total of 150 patients admitted for COVID-19 from March to June 2021 to “F. Perinei” Murgia Hospital in Altamura, Italy, were divided into survivors (n = 100) and non-survivors groups (n = 50). Blood counts, inflammation-related biomarkers and lymphocyte subsets were analyzed into two groups in the first 24 h after admission and compared by Student’s t-test. A multivariable logistic analysis was performed to identify independent risk factors associated with in-hospital mortality. Total lymphocyte count and CD3+ and CD4+ CD8+ T lymphocyte subsets were significantly lower in non-survivors. Serum levels of interleukin-6 (IL-6), lactate dehydrogenase (LDH), C-reactive protein (CRP) and procalcitonin (PCT) were significantly higher in non-survivors. Age > 65 years and presence of comorbidities were identified as independent risk factors associated with in-hospital mortality, while IL-6 and LDH showed a borderline significance. According to our results, markers of inflammation and lymphocytopenia predict in-hospital mortality in COVID-19.

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Section: Discussionmentioning

confidence: 99%

Inflammation as Prognostic Hallmark of Clinical Outcome in Patients with SARS-CoV-2 Infection

Fuzio¹,

Inchingolo

Ruggieri³

et al. 2023

Life

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“…Data quality assurance was undertaken by the research assistants and later verified by the supervisor of the research team to ensure data quality before analysis. Detailed information about the clinical parameters is defined in the previously published articles (Chapanduka et al, 2022;Zemlin et al, 2022).…”

Section: Data Collectionmentioning

confidence: 99%

Length of Stay Analysis of COVID-19 Intensive Care Unit Admissions Using Count Regression and Hurdle Regression Models: A Study in a Tertiary Hospital, Cape Town, South Africa

Savieri,

Nyamandi,

Sigwadhi

et al. 2024

Preprint

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Objective: To evaluate the variables influencing the length of stay (LoS) for COVID-19 ICU patients at Tygerberg Hospital (Cape Town) and to identify the covariates that significantly influenced it and any potential risk factors associated with LoS. Methods and Results: Poisson, negative binomial (NB), Hurdle–Poisson, and Hurdle–NB regression models were used to model the LoS in this prospective cohort study. The fitted models were compared using the Akaike information criterion (AIC), Vuong’s test criteria, and Rootograms. Based on the chosen performance criteria, the NB model provided the best fit outperforming other candidate models. The baseline LoS count was 8 days. On average, antibiotics reduced LoS by 0.74-fold (95% CI 0.62-0.89) compared to not taking antibiotics. The second wave had a significant effect on the average LoS, which decreased by 0.36-fold (95% CI 0.14-0.93) compared to the first wave. Average LoS increased by 1.01-fold (95% CI 1.01-1.02) for every one-year increase in the age of the patient and by 1.02-fold (95% CI 1.01-1.03) for every 1 unit increase in neutrophils. A 1 ng/L increase in log (TropT) levels decreased the average LoS by 0.87-fold (95% CI 0.81-0.93) similarly, a unit increase in the PF ratio decreased the average LoS by 0.998-fold (95% CI 0.997-0.999) respectively. Conclusion: The study identified common clinical characteristics associated with length of stay in ICU for COVID-19 patients, including age at admission, PF ratio, neutrophils, TropT, Wave, and antibiotic use. These results can aid in identifying risk factors for increased length of stay, assist in healthcare systems planning, and aid in evaluating different models for analysing this type of data.

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Evaluation of the neutrophil-leukocyte index in patients with cardiac disorders and new coronavirus infection

Litvinenko¹,

Velibekov²,

Gaiduk³

et al. 2023

Almanac of Clinical Medicine

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Background: The neutrophil-leukocyte index (NLI) is an independent predictor of an unfavorable outcome in stable ischemic heart disease, as well as of mortality in patients with acute coronary syndromes and uncontrolled heart failure. A number of studies have shown the informative value of NLI for the prediction of severe course of COVID-19. NLI variability in COVID-19 with comorbid baseline physical diseases and cardiovascular disorders in particular, has not been studied. Aim: To evaluate the clinical value of NLI in hospitalized patients with COVID-19 depending on their concomitant cardiac disorders. Materials and methods: In this retrospective quantitative study we have analyzed the data from medical files of the patients with the diagnosis of new coronavirus infection confirmed by polymerase chain reaction, treated in a specialized in-patient department of infectious diseases in 2020 to 2022. Previously diagnosed cardiac disorders were defined as any past history of these disorders. The results of instrumental and laboratory work-up were assessed before treatment. Results: The analysis included 226 patients with median age of 50.0 (Q1Q3: 42.063.0) years, with 81.4% (n = 184) of them being men. Ninety four (41.6%) patients had no previously diagnosed cardiovascular disorders. Arterial hypertension by the time of admittance was present in 132 (58.4%), ischemic heart disease, in 77 (34.1%), atherosclerotic and/or post-infarct cardiosclerosis, in 82 (36.3%), and chronic heart failure, in 77 (34.1%) of the patients. In the total study group (n = 226) the median NLI was 2.6 (1.574.47). The larger was the volume of the lung involvement (assessed by computed tomography at admittance), the higher was NLI (p = 0.009, Kruskal-Wallis test). There was an association between the NLI value and the degree of respiratory failure (p 0.001, Kruskal-Wallis test). Median NLI in the patients with cardiac disorders (irrespective of their nosology) was significantly higher than that in the patients without any history of cardiovascular problems: 3.30 (2.095.42) versus 1.95 (1.423.62) (p 0.001, Mann-Whitney U-test). We found significant difference in the NLI values for each type of cardiac disorders, compared to that in the patients without history of cardiovascular disorders, including for the patients with arterial hypertension (p 0.001, Kruskal-Wallis test), ischemic heart disease (p 0.001, Mann-Whitney U-test), atherosclerotic cardiosclerosis (p = 0.001, Mann-Whitney U-test), and chronic heart failure (p = 0.040, Kruskal-Wallis test). Conclusion: We have confirmed the contribution of cardiovascular disorders to the course of COVID-19 and the clinical value of NLI as a convenient laboratory marker of the severity of infectious disease.

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Haematological predictors of poor outcome among COVID-19 patients admitted to an intensive care unit of a tertiary hospital in South Africa

Cited by 4 publications

References 45 publications

Inflammation as Prognostic Hallmark of Clinical Outcome in Patients with SARS-CoV-2 Infection

Inflammation as Prognostic Hallmark of Clinical Outcome in Patients with SARS-CoV-2 Infection

Length of Stay Analysis of COVID-19 Intensive Care Unit Admissions Using Count Regression and Hurdle Regression Models: A Study in a Tertiary Hospital, Cape Town, South Africa

Evaluation of the neutrophil-leukocyte index in patients with cardiac disorders and new coronavirus infection

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