Early predictors of severity and mortality in COVID-19 hospitalized patients

Abstract

<p><strong>Aim <br /></strong>To identify laboratory tests for early detection and the development of more severe illness and death in COVID-19 hospitalized patients.<br /><strong>Methods</strong> <br />A prospective study was done on 66 hospitalized COVID-19 patients (males: 54.5%; mean age 70.1 ± 9.6 years)<br />who were stratified into: moderate (n=36; 54.5%), severe (n=12; 18.2%), and critically ill (n=18; 27.3%). Besides clinical findings, a wide spectrum of laboratory parameters was monitored at admission and control during the first seven days of hospitalization and used to predict progression from non-severe to severe illness and to predict the final outcome.<br /><strong>Results</strong> <br />Critically ill patients showed a higher control value of white blood cell count, C-reactive protein, lactate dehydrogenase,<br />ferritin, but lower lymphocyte count and O2 saturation. Patients with fatal outcome (23; 34.85%) showed a higher control value of neutrophil, lactate dehydrogenase, ferritin, and lower lymphocyte and O2 saturation. Progression from moderate to severe or critical illness was predicted by increasing lactate dehydrogenase (95% CI 0.5803 to 0.8397;p=0.003729), increase in ferritin (95% CI 0.5288 to 0.8221;p=0.03248), and by drop in O2 saturation (95% CI 0.5498 to 0.8179;p=0.01168). A fatal outcome was predicted by increase in ferritin (95% CI 0.5059 to 0.8195;p=0.04985),<br />as well as by drop in O2 saturation (95% CI 0.5916 to 0.8803; p=0.001861).<br /><strong>Conclusion</strong> <br />Increase in ferritin, and drop in O2 saturation could be the most important prognostic parameters for the development of<br />more severe clinical illness and death in COVID-19 hospitalized patients.</p>