Poor Prognostic Biochemical Markers Predicting Fatalities Caused by COVID-19: A Retrospective Observational Study From a Developing Country

Abstract

Background and objectives Infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are rapidly spreading, posing a serious threat to the health of people worldwide, resulting in the World Health Organization officially declaring it a pandemic. There are several biochemical markers linked with predicting the severity of coronavirus disease. This study aims to identify the most effective predictive biomarker such as C-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH), procalcitonin (PCT), and D-dimer, among others, in predicting the clinical outcome of the disease. Materials and methods This study was conducted as a retrospective, observational, multi-centric study, including all admitted COVID-19 positive patients only. The disease outcome was followed along with the hospital course of every patient at the time of analysis. Baseline laboratory investigations of all patients were monitored both at admission and discharge. A comparative analysis was done between the survivors (n=263) and non-survivors (n=101). Statistical analysis was conducted using IBM SPSS Statistics for Windows Version 25 (Armonk, NY: IBM Corp.). Results Of 364 patients, 65.7% were in the isolation ward, and 34.3% were in the intensive care unit; 72.3% of patients survived, while 27.7% of patients died. The mean age of the study population was 52.6 ± 15.8 years with female patients significantly younger than male patients (p=0.001) and 50 to 75 years being the most common age group (p=0.121). Among the survivors versus non-survivors of COVID-19, there were significant differences in total leukocyte count (p<0.001), neutrophil count, (p<0.001), lymphocyte count (p<0.001), urea (p<0.001), serum bicarbonate (p=0.001), CRP levels (p<0.001), LDH (p=0.013), and D-dimer (p<0.001) at admission. At discharge, the laboratory values of non-surviving patients showed significant leukocytosis (p<0.001), neutrophilia (p<0.001), lymphocytopenia (p<0.001), decreased monocytes (p<0.001), elevated urea and creatinine (p<0.001), hypernatremia (p<0.001), decreased serum bicarbonate levels (p<0.001), elevated CRP level (p=0.040), LDH (p<0.001), 1 2 3 4 4 4 5

Role of Biochemical Markers in Invasive Ventilation of Coronavirus Disease 2019 Patients: Multinomial Regression and Survival Analysis

“…This may be due to the fact that COVID-19 patients often develop acute kidney injury (AKI) after hospitalization and this is accompanied by a high mortality rate [1]. Another study suggested high urea and creatinine with severe patients [16], while our results also showing urea (75% vs 53%) and creatinine (64% vs 43%) in the invasive vs non-invasively ventilated groups, respectively. Thrombocytopenia was present slightly more in nonsurvived patients in our results, like previous studies suggesting consumptive coagulopathy in deceased patients leading to thrombocytopenia but thrombocytosis in survived patients [6].…”

Potential Diagnostic and Prognostic Values of Hematological Biomarkers in COVID-19‎ ‎

“…They assessed likewise patients in survivors and non-survivor groups. They reported that there was a significant difference in TLC (p<0.001), ANC (p<0.001) and ALC (p<0.001) [10].…”

Correlation of refractory hypoxemia with biochemical markers and clinical outcomes of COVID-19 patients in a developing country: A retrospective observational study

“…While Herold et al have associated mechanical ventilation most accurately with CRP (AUC: 0.860) followed by LDH, PCT, and ferritin [28]. Although, D-dimer was an effective predictor of mortality in COVID-19 specified by various studies [36,37]. Overall, mortality predictions have been mostly associated in the literature with LDH, followed by CRP, D-dimer, moderately associated with NLR and PCT, and least associated with serum ferritin [38,39].…”