Prognostic Value of Baseline Biochemical Parameters Among Severe COVID-19 Patients Admitted to an Intensive Care Unit of a Tertiary Hospital in South Africa.

Abstract

BackgroundData on biochemical markers and their association with mortality rates observed in patients with severe COVID-19 disease admitted to Intensive Care Units (ICUs) in sub-Saharan Africa are scanty. We performed an evaluation of baseline routine biochemical parameters as prognostic biomarkers in COVID-19 patients admitted to ICU. MethodsDemographic, clinical and laboratory data were collected prospectively on patients with PCR-confirmed COVID-19 admitted to the adult ICU in a tertiary hospital in Cape Town, South Africa, between October 2020 and February 2021. Robust Poisson regression methods and receiver operating characteristic (ROC) curve were used to explore the association of biochemical parameters with severity and mortality. ResultsA total of 82 patients [(median age 53.8 years (IQR: 46.4-59.7)] were enrolled, of whom 27 (33%) were male. The median duration of ICU stay was 10 days (IQR: 5-14); 54/82 (66% CFR) patients died. Baseline lactate dehydrogenase (LDH) (aRR: 1.002, 95%CI: 1.0004-1.004; P = 0.016) and N-terminal pro B-type natriuretic peptide (NTProBNP) (aRR: 1.0004, 95%CI: 1.0001-1.0007; P = 0.014) were both independent risk factors of a poor prognosis with optimal cut-off values of 449.5 U/L (sensitivity: 1; specificity: 0.43) and 551 pg/mL (sensitivity: 0.49; specificity: 0.86), respectively.ConclusionLDH and NTProBNP appear to be promising predictors of COVID-19 poor prognosis in the ICU. Larger sample size studies are required to confirm the validity of this combination of biomarkers.