COVID-19 Severity and Mortality in Two Pandemic Waves in Poland and Predictors of Poor Outcomes of SARS-CoV-2 Infection in Hospitalized Young Adults

Abstract

SARS-CoV-2 variants pose a significant threat to global public health. However, their influence on disease severity, especially among young adults who may exhibit different clinical characteristics, is debatable. In this retrospective study of 229 young adults hospitalized with COVID-19, we investigated the differences between Poland’s second and third waves of the pandemic. To identify potential predictors of severe COVID-19 in young adults, we analyzed patient characteristics and laboratory findings between survivors and non-survivors and we performed logistic regression to assess the risk of death, mechanical ventilation, and intensive care unit treatment. We found no increase in COVID-19 severity comparing the third and second waves of the pandemic, indicating that the alpha variant had no influence on disease severity. In addition, we found that factors, such as obesity, comorbidities, lung involvement, leukocytosis, neutrophilia, lymphopenia, higher IG count, the neutrophil-to-lymphocyte ratio, C-reactive protein, procalcitonin, interleukin-6, D-Dimer, lactate dehydrogenase, high-sensitive troponin I, creatine kinase-myocardial band, myoglobin, N-terminal-pro-B-type natriuretic peptide, creatinine, urea and gamma-glutamyl transferase, lower estimated glomerular filtration rate, albumin, calcium and vitamin D3, possibly a decrease in red blood cell counts, hemoglobin and hematocrit, and an increase in creatine kinase during hospitalization may be associated with poor outcomes of COVID-19.

Integration of individualized and population-level molecular epidemiology data to model COVID-19 outcomes

“…These findings were confirmed by Moutchia et al. 100 , 101 and Ziuzia-Januszewska et al 100 , 101 Interestingly, Ziuzia-Januszewska et al. also found that there was no significant difference in mortality between the second and third wave, thereby concluding that Alpha had no effect on disease severity, which was also confirmed by our results.…”

Interleukin-6 and Neutrophil–Lymphocyte Ratio in Predicting Outcome of Confirmed COVID-19 Patients

“…The same results were also obtained in the studies of Ziuzia-Januszewska, et al (2022) and Cunningham, et al (2020), who found no significant age difference in mortality. 12,13 However, young adult patients are still believed to survive better because they have fewer risk factors, such as comorbidities.…”

“…These results were similar to prior study that showed no significant differences in type 2 diabetes mellitus and hypertension, although the frequency of non-survivors was greater than survivors. 12 Meanwhile, several other studies have shown that the presence of diabetes is strongly associated with the risk of death, the use of mechanical ventilation, and the need for ICU care. Even in young adults, diabetes plays a role as a risk factor for more severe clinical COVID-19.…”

Dapsone Lowers Neutrophil to Lymphocyte Ratio and Mortality in COVID-19 Patients Admitted to the ICU

“…In total, 13 studies have been published this year alone (2022) that independently showed that higher NLR in COVID-19 patients entering the hospital was a strong predictor of in-hospital worsening or death [ 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. Chart review showed this to be the case also at our ICU, independently of whether dapsone was given or not.…”