Impacts of Demographic and Clinical Characteristics on Disease Severity and Mortality in Patients with Confirmed COVID-19

Abstract

Background We investigated potential predictive factors for mortality and disease severity from demographic and clinical data, comorbidities, and laboratory findings in patients with confirmed COVID-19 who were consecutively admitted to our tertiary hospital. Methods In this retrospective, single-center, observational study, we enrolled consecutive 540 adult patients who had COVID-19 confirmed by a molecular method. Patients were categorized into three groups based on disease severity. Patients’ demographic and clinical characteristics, mortality rates, and mortality-associated factors were analyzed. Results The overall mortality rate was 4.3% (23/540). Disease severity was mild in 40.9% (n = 221), severe in 53.7% (n = 290), and critical in 5.4% (n = 29) of the patients. There were significant differences among groups in terms of median white blood cell (WBC), hemoglobin, neutrophil, lymphocyte, and thrombocyte counts, as well as C-reactive protein (CRP), procalcitonin, lactate dehydrogenase (LDH), creatinine, albumin, D-dimer, ferritin, troponin, and fibrinogen levels. Furthermore, there were significant differences between surviving and non-surviving patient groups in terms of median WBC, hemoglobin, neutrophil, and lymphocyte counts, as well as CRP, procalcitonin, LDH, creatinine, albumin, D-dimer, and ferritin levels. CRP level (odds ratio [OR]: 1.020, 95% confidence interval [CI]: 1.009–1.032; p < 0.001), and CURB-65 score (OR: 4.004, 95% CI: 1,288–12,447; p = 0.017) were independently associated with disease severity and mortality. Conclusion On admission, WBC, neutrophil, lymphocyte, and platelet counts can be used to predict disease severity in patients with COVID-19. CRP, ferritin, LDH, creatinine, troponin, D-dimer, fibrinogen, and albumin levels can also be used to predict disease severity in these patients. Finally, elevated CRP level and high CURB-65 score were predictors of disease severity and mortality.

The radiographic assessment of lung edema score of lung edema severity correlates with inflammatory parameters in patients with coronavirus disease 2019—Potential new admission biomarkers to predict coronavirus disease 2019 worsening

“…Consequently, the RALE score also positively correlated with the neutrophil-to-lymphocyte ratio, a common prognostic marker of COVID-19 progression ( 20 , 21 ). Overall, these results suggest that COVID-19 severity is accompanied by an elevated neutrophil count and a low lymphocyte count, which is in agreement with recently published data ( 24 ).…”

“…Although a link between platelet counts and COVID-19 severity has been broadly described, these findings remain controversial. Indeed, while several reports indicated that platelet counts were lower in patients with severe COVID-19 than in peers with mild disease ( 22 – 24 ), the opposite has also been reported in patients with compromised lung function ( 25 ). We found that the admission platelet counts positively correlated with the RALE score, indicating that patients with a greater degree of compromised lung function have elevated platelet counts.…”

COVID-19 outcomes associated with clinical and demographic characteristics in patients hospitalized with severe and critical disease in Peshawar

“…The severity of any given disease depends on the population's demographic and clinical characteristics [17]. Therefore, we aimed to study these factors to understand COVID-19 in detail.…”

The Associations of Iron Related Biomarkers with Risk, Clinical Severity and Mortality in SARS-CoV-2 Patients: A Meta-Analysis

“…In all relevant studies, the hemoglobin levels were found to be lower in severe groups than those in controls [7,10,24] or non-severe groups [22,[25][26][27][28][29]. However, in the comparisons between severity [7,10,15,[17][18][19]23,24,[30][31][32][33][34][35][36][37] and mortality [10,30,[38][39][40][41], there was not a consistent numerical magnitude relationship between them. In addition, studies on TIBC [8,10,12,13] and TSAT [8,13] only refer to mortality.…”