Significance of initial clinical laboratory parameters as prognostic factors in patients with COVID 19

Abstract

Background/Aim. COVID 19 is a predominantly respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of this study was to determine whether there are significant variables which could predict severe clinical picture and fatal outcome in COVID 19 patients. Methods. The research involved 632 patients who were treated at the University Medical Center Kragujevac at the Clinic for Infectious Diseases, in the period from June 2020 to February 2021. All patients were divided into two groups according to the need for oxygen therapy (Sat 02 < 94. Results. Our results showed that high BMI was singled out as a risk factor for the development of a severe clinical picture [BMI [ORadjusted = 1.263; 95% CI = 1.117 - 1.427; p < 0.001]]. Prothrombin time (ORadjusted = 1.170; 95% CI = 1.004 - 1.364; p = 0.045), as well as low albumin values (ORadjusted = 0.878; 95% CI = 0.804 - 0.958; p = 0,003) had a predictive significance for the development of severe clinical picture. Factors that were of predictive importance in patients with fatal outcome were CRP (ORadjusted = 1.010; 95% CI = 1.001 - 1.019; p = 0.031), LDH (ORadjusted = 1.004; 95% CI = 1.001 - 1.006; p = 0.002). X-ray of the lungs (ORadjusted = 1.394; 95% CI = 1.170 - 1.661; p < 0.001). Conclusion. Research has shown that routine, clinical-laboratory parameters can be important in the early detection of patients with a potentially severe clinical picture and fatal outcome. In patients with a mild clinical picture, CRP, LDH, ferritin, and serum albumin levels may indicate timely disease progression. Monitoring of parameters of essential importance for the timely clinical assessment of patients with COVID 19, and thus the timely application of adequate therapeutic protocols in the treatment of these patients.

Importance of Demographic and Clinical Features in Evaluating the Severity of COVID-19 in Hospitalized Patients: A Serbian Retrospective Study in the First Pandemic Year

“…While the results of Turkish researchers show that, except for saturation, both high CRP and low albumin are good predictors of mortality [21], our results also show that high CRP, as well as low albumin and hypoproteinemia on admission, show significant differences between patients who had mild/moderate and severe disease. Our results are in agreement with other authors whose research shows that high CRP and low albumin values are important for the development of a severe form of the disease [26,27], indicating the development of cytokine storms in patients with COVID-19. Furthermore, our patients with severe disease already had significant elevated CK on admission.…”

Systemic inflammatory indexes (NLR, DNLR, PLR and SII) role in predicting COVID-19 progression

“…CRP has been shown to be a good marker of COVID-19 disease severity (20,21). CRP had significantly higher levels in patients with severe COVID-19 compared with mildly infected patients.…”

The laboratory parameters in predicting the severity and death of COVID-19 patients: Future pandemic readiness strategies

“…Specific markers, such as lymphocytopenia, neutropenia, elevated serum liver enzymes, LDH, CRP, and ferritin, have been associated with an elevated risk of severe disease [ 66 , 70 , 71 ]. Elevated levels of CRP and reduced albumin levels are crucial indicators of severe disease progression [ 72 , 73 ], indicating the development of cytokine storm in COVID-19 patients.…”