Background Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) constitutes a major health burden worldwide due to high mortality rates and hospital bed shortages. SARS-CoV-2 infection is associated with several laboratory abnormalities. We aimed to develop and validate a risk score based on simple demographic and laboratory data that could be used on admission in patients with SARS-CoV-2 infection to predict in-hospital mortality. Methods Three cohorts of patients from different hospitals were studied consecutively (developing, validation, and prospective cohorts). The following demographic and laboratory data were obtained from medical records: sex, age, hemoglobin, mean corpuscular volume (MCV), platelets, leukocytes, sodium, potassium, creatinine, and C-reactive protein (CRP). For each variable, classification and regression tree analysis were used to establish the cut-off point(s) associated with in-hospital mortality outcome based on data from developing cohort and before they were used for analysis in the validation and prospective cohort. The covid-19 score was calculated as a sum of cut-off points associated with mortality outcome. Results The developing, validation, and prospective cohorts included 129, 239, and 497 patients, respectively (median age, 71, 67, and 70 years, respectively). The following cut of points associated with in-hospital mortality: age > 56 years, male sex, hemoglobin < 10.55 g/dL, MCV > 92.9 fL, leukocyte count > 9.635 or < 2.64 103/µL, platelet count, < 81.49 or > 315.5 103/µL, CRP > 51.14 mg/dL, creatinine > 1.115 mg/dL, sodium < 134.7 or > 145.4 mEq/L, and potassium < 3.65 or > 6.255 mEq/L. The AUC of the covid-19 score for predicting in-hospital mortality was 0.89 (0.84–0.95), 0.850 (0.75–0.88), and 0.773 (0.731–0.816) in the developing, validation, and prospective cohorts, respectively (P < 0.001The mortality of the prospective cohort stratified on the basis of the covid-19 score was as follows: 0–2 points,4.2%; 3 points, 15%; 4 points, 29%; 5 points, 38.2%; 6 and more points, 60%. Conclusion The covid-19 score based on simple demographic and laboratory parameters may become an easy-to-use, widely accessible, and objective tool for predicting mortality in hospitalized patients with SARS-CoV-2 infection.

Introduction: Laboratory test play an essential role in the early detection and diagnosis in an Emergency Department. Laboratory tests are common w COVID-19, however, they are also encountered in diseases with similar presentation as COVID-19 but other etiopathogeneses. The aim: To compare morphology, procalcitonin, and C-reactive protein in patients admitted with the diagnosis of COVID-19 to the Infectious Hospital to the patients with the discharge diagnosis of pneumonia admitted to the Emergency Department in January and February 2019. Material and methods: The study group consisted of 46 COVID-19 patients (60.9% male) aged 63.3±15.3 and 48 pneumonia patients (56.3% male) aged 75.0±13.7. The COVID-19 patients were admitted to the Infectious Department of Boleslawiec County Hospital or were discharged from the Emergency Departments to the Infectious Departments. The age, gender, leucocyte count, lymphocyte count and percentage, hemoglobin, mean corpuscular volume, platelets number, procalcitonin level and c-reactive protein were retrieved from medical electronic records. Results: The hematology tests did not reveal significant differences in lymphocyte count and percentage, however the white cells number was significantly higher in pneumonia than in COVID-19 group. C-reactive protein did not differ between groups. There was a trend to the higher level of procalcitonin in pneumonia group and hemoglobin level in COVID-19 group. Mean corpuscular volume and leucocyte number were significantly higher in the pneumonia group. Conclusions: 1. Lower leucocyte number and lower mean corpuscular volume of erytrocyte in COVID-19 patients than in pneumonia patients may reflect differences in the reaction of the host to infectious factors or indicate predisposing factors to COVID-19 infection. 2. Further studies are indicated to confirm and explain obtained results.

Background: During the COVID-19 pandemic, the number of admissions to the emergency department (ED) due to a primary diagnosis of atrial fibrillation (AF) has decreased when compared to pre-pandemic times. The principal aim of the study was to assess the frequency of SARS-CoV-2 infections and sinus rhythm restoration among patients who arrived at the ED with AF. Secondary aims included determining whether patients arriving at the ED principally due to AF delayed their presentations and whether the frequency of successful cardioversion for AF was decreased during the pandemic period. Materials and Methods: A retrospective analysis of medical records of patients admitted to two hospital EDs due to AF during July–December 2019 (pre-pandemic period) versus July–December 2020 (pandemic period) was performed. Results: During the study periods, 601 ED visits by 497 patients were made due to the primary diagnosis of AF. The patients were aged 71.2+/−13.5 years and 51.3% were male. The duration of an AF episode before the ED admission was 10 h (4.5–30 h) during the pandemic period vs. 5 h (3–24 h) during the non-pandemic period (p = 0.001). A shorter duration of the AF episode before ED admission was associated with the successful restoration of the sinus rhythm. During the pandemic period, among patients with short-lasting AF who were not treated with Phenazolinum, the restoration of the sinus rhythm was more frequent in the Copernicus Memorial Hospital than in the University Hospital (p = 0.026). A positive SARS-CoV-2 test was found in 5 (1%) patients, while 2 other patients (0.5%) had a prior diagnosis of COVID-19 disease noted in their medical history. Conclusions: 1. The number of AF episodes treated in these two EDs was lower during the pandemic than non-pandemic period. 2. The patients with AF appeared at the ED later after AF onset in the pandemic period. 3. Successful cardioversion of atrial fibrillation was more frequent during the pre-pandemic period in one of the two hospitals. 4. A difference of approaches to the treatment of short-lasting AF episodes between EDs during the pandemic period may exist between these two EDs. 5. The patients with SARS-CoV-2 infection during the second wave of the COVID-19 pandemic constituted a small percentage of the patients admitted to EDs due to an AF episode.

Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection could result in different laboratory abnormalities. The prediction of the outcome based on simple demographics and laboratory parameters could be useful for clinical purposes. The objective of the study is to develop and validate a score (Covid19-score) based on demographics and laboratory findings, performed at hospital admission in patients with a SARS-CoV-2 infection confirmed on a reverse transcriptase-polymerase chain reaction of the nasopharyngeal swab, to predict in-hospital mortality.Methods: Three cohorts of patients from three different hospitals were studied consecutively. The studied data came from patients’ electronic records. On the basis of the retrospective analysis of the mortality in the developing cohort from the first hospital the cut-off points predicting in-hospital mortality for gender, age, hemoglobin, mean corpuscular volume, platelet count, leukocyte count, sodium, potassium, creatinine level, C-reactive protein level were found and Covid19-score as a sum of points was calculated for each patient. The area under the receiver operating characteristic curve (AUC) of the Covid19-score for predicting survival to hospital discharge was counted. The Covid19-score was validated using data of patients from a second hospital. The significance of Covid19-score was confirmed on the prospective cohort of patients collected from a third hospital,Results: AUC of the Covid19-score for predicting survival to hospital discharge was 0.89 (0.84-0.95) p<0.001 in developing cohort, 0.850 (0.75-0.88) p<0.001 in validation cohort and 0.773 (0.731-0.816) p<0.001 in the prospective cohort.Conclusion: The Covid19-score is useful in predicting the clinical outcome for hospitalized patients with SARS-CoV-2 infection

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