Hematological and serum biochemistry parameters as a prognostic indicator of severally ill versus mild Covid-19 patients: A study from tertiary hospital in North India

Abstract

Background/objectives In, India coronavirus disease (COVID-19) cases are on the rise in terms of the total number of cases. Findings on clinical and hematological parameters alone carry no significance apart from telling patients present status and hence are diminutive. This study aims to assess the hematological and serum biochemistry parameters and correlate them with the presenting symptoms and severity of disease which can help predict the need for intensive care unit (ICU) care, help in triage, assess the severity of the disease which will help clinicians decide their future course of action and further improve patients clinical outcome. Methods A total of 200 COVID-19 positive patients were included. Hematological and serum biochemistry parameters were recorded for the patients at the time of admission and categorized as mild, moderate, and severely ill based on clinical status and then admitted into various wards. Results Total leucocyte count (TLC) was significantly different and higher in severely ill patients (13,200 ± 6,999.2) compared to cases presented with mild and moderate symptoms (12,100 ± 6,488.41& 8,788.20 ± 4,954.32, p = 0.001). The mean difference of TLC, Neutrophil% (N%), Lymphocyte% (L%) and Monocyte (M%) was significantly different between mild and moderate symptoms cases (p = 0.030, p = 0.002, p = 0.004 & p = 0.003). Between groups comparison of moderate vs. severely ill cases showed a significant difference in TLC (p = 0.000), N% (p = 0.000), L% (0.000), and L/N ratio (p = 0.002). The serum ionic calcium (Ca), random blood sugar (RBS), C-reactive protein (CRP), fibrinogen, prothrombin (PT), International Normalized Ratio (INR), ferritin, and Lactate Dehydrogenase (LDH) level also differed significantly between mild, moderate and severely ill cases (p = 0.001, p=<0.001, p = 0.002, p=<00.1, p = 0006, p = 0.005, p=<0.001 and p=<0.001) respectively. Comparison of the mild vs. severely ill cases showed a significant difference in urea, fibrinogen, and procalcitonin (PCT) level (p = 0.005, p = 0.000 & p = 0.048) respectively. Conclusion The preliminary findings of this study suggest hematological and serum biochemistry parameters could be used as a screening tool to identify patients requiring intensive care and thus allowing clinical stratification and triage at the time of presentation.

Clinical Features of Early Stage COVID-19 in a Primary Care Setting

“…Dubey et al reported that calcium levels were lower in patients with mild symptoms but higher in patients with moderate symptoms. They did not detect abnormalities in the levels of sodium and potassium ions ( 52 ). Our study shows that the chloride ( p = 0.032) and calcium ( p = 0.032) ion levels are slightly lower in the positive group than in the negative group.…”

CRP and LDH Levels Can Be Used for Support the COVID-19 Diagnose in Intensive Care Unit Patients

“…CRP is slightly higher in women than in men (16). CRP value increases in patients with COVID-19 (17). Studies show that the amount of CRP in plasma increases due to inflammation in COVID-19 patients (18).…”

Alteraciones hematológicas como consecuencia de COVID-19 y sus vacunas

“…En particular, una disminución en el recuento de linfocitos, mostró ser un marcador importante entre los días 9 y 12 después de la admisión, que lo convirtió en un factor predictor de mal pronóstico para los pacientes. Por su parte, Dubey y colaboradores [5] en un hospital en India, evaluaron los parámetros hematológicos en 200 pacientes categorizados con infección leve, moderada y severa. El estudio mostró diferencias significativas en el recuento total de leucocitos (p=0,001), siendo la leucocitosis mayor en los pacientes con infección severa en comparación con los otros dos grupos, al igual que la linfopenia (p=0,001) y la relación leucocitos/neutrófilos (p=0,003), hallazgos similares a los encontrados por Yang y colaboradores [6] en un grupo de 78 pacientes con COVID-19, con excepción del recuento total de leucocitos, que no mostró diferencia significativa al comparar los resultados entre los diferentes grupos de pacientes.…”