Role of time-normalized laboratory findings in predicting COVID-19 outcome

Abstract

ObjectivesThe pandemic COVID-19 currently reached 213 countries worldwide with nearly 9 million infected people and more than 460,000 deaths. Although several Chinese studies, describing the laboratory findings characteristics of this illness have been reported, European data are still scarce. Furthermore, previous studies often analyzed the averaged laboratory findings collected during the entire hospitalization period, whereas monitoring their time-dependent variations should give more reliable prognostic information.MethodsWe analyzed the time-dependent variations of 14 laboratory parameters in two groups of COVID-19 patients with, respectively, a positive (40 patients) or a poor (42 patients) outcome, admitted to the San Raffaele Hospital (Milan, Italy). We focused mainly on laboratory parameters that are routinely tested, thus, prognostic information would be readily available even in low-resource settings.ResultsStatistically significant differences between the two groups were observed for most of the laboratory findings analyzed. We showed that some parameters can be considered as early prognostic indicators whereas others exhibit statistically significant differences only at a later stage of the disease. Among them, earliest indicators were: platelets, lymphocytes, lactate dehydrogenase, creatinine, alanine aminotransferase, C-reactive protein, white blood cells and neutrophils.ConclusionsThis longitudinal study represents, to the best of our knowledge, the first study describing the laboratory characteristics of Italian COVID-19 patients on a normalized time-scale. The time-dependent prognostic value of the laboratory parameters analyzed in this study can be used by clinicians for the effective treatment of the patients and for the proper management of intensive care beds, which becomes a critical issue during the pandemic peaks.

B-Type Natriuretic Peptide Concentrations, COVID-19 Severity, and Mortality: A Systematic Review and Meta-Analysis With Meta-Regression

“…Thus, 44 studies in 18,856 COVID-19 patients, 14,569 (53% males, mean age 48 years) with low severity or survivor status and 4,287 (59% males, mean age 61 years) with high severity or non-survivor status, were included in the final analysis ( Figure 1 and Table 1 ) ( 7 , 21 – 63 ). Thirty-two studies were conducted in Asia ( 7 , 22 , 24 , 26 , 27 , 29 , 31 – 33 , 35 , 38 – 46 , 48 , 50 , 51 , 53 – 55 , 57 – 63 ), eight in Europe ( 25 , 28 , 30 , 34 , 47 , 49 , 52 , 56 ), three in America ( 23 , 36 , 37 ), and one in Africa ( 21 ). Thirty-two studies were retrospective ( 7 , 21 – 23 , 27 , 29 , 31 – 39 , 41 – 45 , 48 , 50 , 51 , 53 , 55 , 57 – 63 ), eight prospective ( 24 , 30 , 46 , 47 , 49 , 52 , 54 , 56 ), whereas the remaining four did not report the study design ( 25 , 26 , 28 , 40 ).…”

“…Thirty-two studies were retrospective ( 7 , 21 – 23 , 27 , 29 , 31 – 39 , 41 – 45 , 48 , 50 , 51 , 53 , 55 , 57 – 63 ), eight prospective ( 24 , 30 , 46 , 47 , 49 , 52 , 54 , 56 ), whereas the remaining four did not report the study design ( 25 , 26 , 28 , 40 ). Clinical endpoints included disease severity based on current clinical guidelines in 15 studies ( 21 , 24 , 33 , 39 – 41 , 43 , 48 , 54 , 55 , 57 – 59 , 62 , 63 ), hospitalization in one ( 37 ), ICU transfer in three ( 32 , 44 , 49 ), or need for mechanical ventilation in one ( 23 ), and survival status in 24 studies ( 7 , 22 , 25 – 31 , 34 – 36 , 38 , 42 , 45 – 47 , 50 – 53 , 56 , 60 , 61 ). Sixteen studies reported plasma BNP concentrations ( 23 , 24 , 26 , 33 , 35 …”

“…Clinical endpoints included disease severity based on current clinical guidelines in 15 studies ( 21 , 24 , 33 , 39 – 41 , 43 , 48 , 54 , 55 , 57 – 59 , 62 , 63 ), hospitalization in one ( 37 ), ICU transfer in three ( 32 , 44 , 49 ), or need for mechanical ventilation in one ( 23 ), and survival status in 24 studies ( 7 , 22 , 25 – 31 , 34 – 36 , 38 , 42 , 45 – 47 , 50 – 53 , 56 , 60 , 61 ). Sixteen studies reported plasma BNP concentrations ( 23 , 24 , 26 , 33 , 35 – 37 , 45 , 48 , 50 , 51 , 54 , 56 – 58 , 62 ), whereas the remaining 28 reported plasma NT-proBNP concentrations ( 7 , 21 , 22 , 25 , 27 – 32 , 34 , 38 – 44 , 46 , 47 , 49 , 52 , 53 , 55 , 59 – 61 , 63 ). Only one study reported cumulative 7-day mean plasma NT-proBNP concentrations ( …”

“…Sixteen studies reported plasma BNP concentrations ( 23 , 24 , 26 , 33 , 35 – 37 , 45 , 48 , 50 , 51 , 54 , 56 – 58 , 62 ), whereas the remaining 28 reported plasma NT-proBNP concentrations ( 7 , 21 , 22 , 25 , 27 – 32 , 34 , 38 – 44 , 46 , 47 , 49 , 52 , 53 , 55 , 59 – 61 , 63 ). Only one study reported cumulative 7-day mean plasma NT-proBNP concentrations ( 34 ), whereas another reported BNP concentrations on initial presentation to the emergency department ( 37 ). The remaining 42 studies reported BNP or NT-proBNP concentrations within the first 24–48 h from admission.…”

Hematological findings in adult patients with SARS CoV‐2 infection at Tygerberg Hospital Cape Town South Africa

“…Widely available routine basic laboratory parameters, accessible in low resource settings could facilitate prediction of disease severity and outcome in COVID-19. 5,9,18 This study aimed to assess the hematological parameters in early COVID-19 and their correlation with outcome in a resourceconstrained setting.…”