Laboratory parameters related to severe disease and death in SARS‐CoV‐2 pneumonia: Retrospective analysis

Abstract

The clinical evolution of coronavirus disease 2019 (COVID‐19) is highly variable and hospitalized patients can rapidly develop conditions requiring oxygen support, intensive care unit (ICU) or high dependency unit (HDU) care. Early identification of high‐risk patients is mandatory. We retrospectively collected the medical history, symptoms, radiological, and laboratory findings of COVID‐19 patients hospitalized between February and April 2020. Laboratory data were collected at the first, last, and middle times of hospitalization. We used arterial oxygen partial pressure and fractional inspired oxygen ratio (P/F) to evaluate respiratory status. Outcomes considered were death and ICU/HDU admission. We used the χ2 or Fisher's exact test to examine differences between categorical variables. Continuous variables were analyzed using the Wilcoxon matched pairs signed‐ranks test and Mann–Whitney test sample test. Of 71 patients admitted, 92% had interstitial pneumonia, and 17% an unfavorable outcome. Negative predictors were age, cerebrovascular disease, obesity, and chronic obstructive pulmonary disease. Baseline P/F was strongly associated with all outcomes. Markers linked to immunological dysregulation like elevated neutrophil‐to‐lymphocyte ratio exhibited prognostic significance over time. A validated prognostic score comprehensive of all these conditions for early staging and management of COVID‐19 patients is urgently needed. Further studies are desirable to evaluate whether laboratory tests can target early treatment in high‐risk patients.

Routine laboratory parameters, including complete blood count, predict COVID-19 in-hospital mortality in geriatric patients

“…Strong evidence has been accumulated since the beginning of the COVID-19 pandemic that neutrophils play an important role in the pathogenesis of severe disease course and that neutrophilia represents a feasible and inexpensive biomarker of COVID-19 severity ( Wu et al, 2020 ). In COVID-19 patients, neutrophilia associated with lymphopenia was observed in patients with increased disease severity and with poor prognosis ( Picchi et al, 2021 , Yang et al, 2020 , Zhu et al, 2021 ). A number of studies showed a correlation between markers derived from standard blood count tests, such as neutrophil-to-lymphocyte ratio (NLR), derived NLR ratio (dNLR, neutrophil count divided by the result of WBC count minus neutrophil count), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) and systematic inflammatory response in a number of age-related diseases, including cancer ( Xu et al, 2021 , Ying et al, 2014 ), type 2 diabetes mellitus (T2DM) ( Tong et al, 2004 ), cardiovascular diseases (CVD) ( Bhat et al, 2013 , Ji et al, 2021 ), and stroke ( Cai et al, 2021a ).…”

Estudio de marcadores de coagulación e inflamación y variantes genéticas de trombofilia al momento de la admisión hospitalaria para predecir mortalidad en una cohorte de la primera ola de COVID-19 en Argentina

“…Valores de corte para marcadores biológicos y sus OR de asociación con un desenlace fatal. Al igual que en otros estudios clínicos, observamos que la edad, probablemente debido a una mayor presencia de comorbilidades, y el mayor índice de masa corporal se asociaron con un peor pronóstico y una mayor mortalidad en estos pacientes (30)(31)(32) . La obesidad afectaría a los pacientes con COVID-19 a través de varios mecanismos distintos.…”