Comprehensive Laboratory Data Analysis to Predict the Clinical Severity of Coronavirus Disease 2019 in 1,952 Patients in Daegu, Korea

Abstract

Background: Laboratory parameter abnormalities are commonly observed in COVID-19 patients; however, their clinical significance remains controversial. We assessed the prevalence, characteristics, and clinical impact of laboratory parameters in COVID-19 patients hospitalized in Daegu, Korea. Methods:We investigated the clinical and laboratory parameters of 1,952 COVID-19 patients on admission in nine hospitals in Daegu, Korea. The average patient age was 58.1 years, and 700 (35.9%) patients were men. The patients were classified into mild (N=1,612), moderate (N = 294), and severe (N = 46) disease groups based on clinical severity scores. We used chi-square test, multiple comparison analysis, and multinomial logistic regression to evaluate the correlation between laboratory parameters and disease severity.Results: Laboratory parameters on admission in the three disease groups were significantly different in terms of hematologic (Hb, Hct, white blood cell count, lymphocyte%, and platelet count), coagulation (prothrombin time and activated partial thromboplastin time), biochemical (albumin, aspartate aminotransferase, alanine aminotransferase, lactate, blood urea nitrogen, creatinine, and electrolytes), inflammatory (C-reactive protein and procalcitonin), cardiac (creatinine kinase MB isoenzyme and troponin I), and molecular virologic (Ct value of SARS-CoV-2 RdRP gene) parameters. Relative lymphopenia, prothrombin time prolongation, and hypoalbuminemia were significant indicators of CO-VID-19 severity. Patients with both hypoalbuminemia and lymphopenia had a higher risk of severe COVID-19.Conclusions: Laboratory parameter abnormalities on admission are common, are significantly associated with clinical severity, and can serve as independent predictors of CO-VID-19 severity. Monitoring the laboratory parameters, including albumin and lymphocyte count, is crucial for timely treatment of COVID-19.

Antioxidant/anti‐inflammatory effect of Mg2+ in coronavirus disease 2019 (COVID‐19)

“…Moreover, the severity of COVID‐19 cases are related to respiratory insufficiency or acute respiratory distress syndrome (indicator: low O 2 saturation); coagulopathies (indicator: elevated D‐dimer, prothrombin time prolongation); inflammation (indicator: elevated CRP (an indicator of active acute inflammation), IL‐6); multi‐organ damage: liver damage (indicator: hypoalbuminemia), and lymphopenia. 3 , 72 , 135 Thus, these symptoms can be reduced by Mg 2+ supplementation. For instance, it has been observed that concomitant supplementation of vitamin D, vitamin B12, and Mg 2+ in COVID‐19 patients can decrease ICU admission incidence and O 2 therapy requirements.…”

Potential of Endogenous Oxytocin in Endocrine Treatment and Prevention of COVID-19

“…In severe cases, particularly in the elderly, the virus can interact with the immune system to induce an excessive innate immune response, or even a cytokine storm, which can disrupt the epithelial cells in the lung and the gas-blood barrier, leading to the acute respiratory distress syndrome (ARDS). At the same time, the virus also attacks lymph tissue and then causes lymphopenia that prevents the virus from clearance ( 48 – 50 ). Correspondingly, relative lymphopenia, cytokine storm, and multiple organ failure become significant indicators of COVID-19 severity and therapeutic targets.…”

Implications of SARS-CoV-2 infection on the clinical, hematological, and inflammatory parameters in COVID-19 patients: A retrospective cross-sectional study

“…[ 32 ]. Yoo et al showed that the hypoalbuminemia and abnormal AST levels were prominent in severe COVID-19 patients, and abnormal albumin levels were strongly correlated with COVID-19 severity with 78% of patients in the severe group having hypoalbuminemia [ 13 ].…”

“…Laboratory parameters may be more objective than clinical parameters in evaluating the patient’s condition. It has been reported that abnormal levels of laboratory markers such as C-reactive protein (CRP), D-dimer, lactate dehydrogenase (LDH), interleukin (IL)-6, and fibrinogen correlate with disease severity [ [13] , [14] , [15] , [16] ]. To date, the relationship between clinical severity and disease progression in different age groups is unclear.…”