Laboratory predictors of death from coronavirus disease 2019 (COVID-19) in the area of Valcamonica, Italy

Abstract

<jats:title>Abstract</jats:title><jats:sec id="j_cclm-2020-0459_s_999_w2aab3b7c57b1b6b1aab1c16b1Aa"><jats:title>Background</jats:title><jats:p>Comprehensive information has been published on laboratory tests which may predict worse outcome in Asian populations with coronavirus disease 2019 (COVID-19). The aim of this study is to describe laboratory findings in a group of Italian COVID-19 patients in the area of Valcamonica, and correlate abnormalities with disease severity.</jats:p></jats:sec><jats:sec id="j_cclm-2020-0459_s_998_w2aab3b7c57b1b6b1aab1c16b2Aa"><jats:title>Methods</jats:title><jats:p>The final study population consisted of 144 patients diagnosed with COVID-19 (70 who died during hospital stay and 74 who survived and could be discharged) between March 1 and 30, 2020, in Valcamonica Hospital. Demographical, clinical and laboratory data were collected upon hospital admission and were then correlated with outcome (i.e. in-hospital death vs. discharge).</jats:p></jats:sec><jats:sec id="j_cclm-2020-0459_s_997_w2aab3b7c57b1b6b1aab1c16b3Aa"><jats:title>Results</jats:title><jats:p>Compared to patients who could be finally discharged, those who died during hospital stay displayed significantly higher values of serum glucose, aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), urea, creatinine, high-sensitivity cardiac troponin I (hscTnI), prothrombin time/international normalized ratio (PT/INR), activated partial thromboplastin time (APTT), D-dimer, C reactive protein (CRP), ferritin and leukocytes (especially neutrophils), whilst values of albumin, hemoglobin and lymphocytes were significantly decreased. In multiple regression analysis, LDH, CRP, neutrophils, lymphocytes, albumin, APTT and age remained significant predictors of in-hospital death. A regression model incorporating these variables explained 80% of overall variance of in-hospital death.</jats:p></jats:sec><jats:sec id="j_cclm-2020-0459_s_996_w2aab3b7c57b1b6b1aab1c16b4Aa"><jats:title>Conclusions</jats:title><jats:p>The most important laboratory abnormalities described here in a subset of European COVID-19 patients residing in Valcamonica are highly predictive of in-hospital death and may be useful for guiding risk assessment and clinical decision-making.</jats:p></jats:sec>

Ferritin in the coronavirus disease 2019 (COVID‐19): A systematic review and meta‐analysis

“…A total of 777 records were collected by the databases and manual searching. After the exclusion of the duplicates, review articles, case reports, pre‐printed versions without peer‐review, and irrelevant studies by title or abstract screening, 187 studies remained for full‐text review; 52 studies 6,17‐67 were finally included into the meta‐analysis, and 18 studies were included in the qualitative synthesis (Figure 1). A total of 52 records involving 10 614 COVID‐19 patients confirmed between December 25, 2019, and June 1, 2020, were included.…”

Prevalence and Associated Risk Factors of Mortality Among COVID-19 Patients: A Meta-Analysis

“…The highest number of mortality for COVID-19 infection was observed in Europe. Among the the European region, the highest mortality was observed in Italy [16,61] followed by Spain [63,64]. The case fatality rate was also highest in USA [54,55].…”

Intranasal exposure of African green monkeys to SARS-CoV-2 results in acute phase pneumonia with shedding and lung injury still present in the early convalescence phase

“…Coagulation dysfunction is a consistent observation in human COVID-19 and has been associated with disease severity [18][19][20][21][22]. Here, we performed a limited analysis of blood clotting times (PT and aPTT) and circulating brinogen levels to begin to characterize the coagulopathy in SARS-CoV-2-infected AGMs.…”

“…Transient increases in aPTT and in circulating brinogen levels were observed during the acute phase of infection. Increases in PT and/or aPTT have been linked to severe human COVID-19 cases in some but not all studies [18][19][20][21][22]. However, nearly all severe COVID-19 cases have been associated with high levels of brinogen [20][21][22].…”