Haematological and radiological-based prognostic markers of COVID-19

Abstract

Background Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has emerged in 2019 and caused a global pandemic in 2020, manifesting in the coronavirus disease 2019 (COVID-19). The majority of patients exhibit a mild form of the disease with no major complications; however, moderate to severe and fatal cases are of public health concerns. Predicting the potential prognosis of COVID-19 could assist healthcare workers in managing the case and controlling the pandemic in an effective way. Methods Here, clinical data of COVID-19 patients admitted to two large centers in Saudi Arabia between April and June 2020 were retrospectively analysed. The objectives of the study were to search for biomarkers associated with COVID-19 mortality and predictors of the overall survival (OS) of the patients. Results More than 23% of the study subjects with available data have died, enabling the prediction of mortality in our cohort. Markers that were significantly associated with mortality in our study were older age, increased D-dimer in the blood, higher counts of WBCs, higher percentage of neutrophil, and a higher chest X-ray (CXR) score. The CXR scores were also positively associated with age, D-dimer, WBC count, and percentage of neutrophil. This supports the utility of CXR scores in the absence of blood testing. Predicting mortality based on Ct values of RT-PCR was not successful, necessitating a more quantitative RT-PCR to determine virus quantity in samples. Our work has also identified age, D-dimer concentration, leukocyte parameters and CXR score to be prognostic markers of the OS of COVID-19 patients. Conclusion Overall, this retrospective study on hospitalised cohort of COVID-19 patients presents that age, haematological, and radiological data at the time of diagnosis are of value and could be used to guide better clinical management of COVID-19 patients.

A robust COVID-19 mortality prediction calculator based on Lymphocyte count, Urea, C-Reactive Protein, Age and Sex (LUCAS) with chest X-rays

“…The ability to include CXR results is not widely available in other prediction calculators and has been included in a study 35 along with ten other parameters (symptoms, past medical history and measurables). More recently, some of the studies have included the CXR imaging in prognostic models 45 , 46 , with good accuracy; however, they have either utilised information such as electronic health records 45 including comorbidities 46 , 47 , which are not always known at the point of care, additional blood biomarkers such as D-Dimer 7 , 41 and lactate dehydrogenase 42 , which are not measured routinely during triage, or incorporated complex deep-learning methodologies 46 , affecting the explainability and simplicity of the model. Indeed, in a parallel study, we have developed a highly accurate deep-learning based model (DenResCov-19) to classify from CXR images patients positive for SARS-CoV-2, tuberculosis, and other forms of pneumonia 6 , which will be integrated into the LUCAS calculator in a future study.…”

“…The use of x-ray is widespread and is used routinely to determine severity of lung injury. Its use has been included in numerous prognostic tools 6 , and in combination with other blood markers such as D-dimer, white blood count, and neutrophils 7 . However, some biomarkers such as D-dimer are not being routinely measured during hospital admission and triage.…”

“…There are varying reports of changes in the full blood count, with it being reported that 80% of COVID-19 patients with severe symptoms and 20% of mild cases presented with lymphopenia 15 , which indicates that a low lymphocyte count is not an accurate marker taken alone 16 , 17 . Many studies have suggested the use of Interleukin 6 (IL6) 16 , Interleukin 10 (IL10) 16 , ferritin 16 , and D-Dimer 7 , 17 , since they are good discriminators of disease prognosis; but they are not routinely measured upon admission to hospital.…”

Risk factors of SARS-CoV-2 infection in cancer patients pre- and post-vaccination

“…Increases in neutrophil counts, drop in lymphocyte counts and higher NLR in COVID-19 patients are associated with poor prognosis [ 48 , 49 ]. To the best of our knowledge, no data on baseline NLR was reported in the context of SARS-CoV-2 infection in cancer patients.…”

Persistence of Anti-SARS-CoV-2 Spike IgG Antibodies Following COVID-19 Vaccines

“… 1 , 2 Infection with this coronavirus was first reported on December 31, 2019 in Wuhan, China. 2 , 3 The World Health Organization (WHO) had reported more than 517 million infected individuals and more than 6 million deaths in the world as of May 16, 2022. 4 There are currently a number of approved COVID-19 vaccines that have been developed using different biotechnological platforms and are available worldwide.…”