Tools and factors predictive of the severity of COVID-19

Abstract

The outbreak of the novel coronavirus infection caused worldwide confusion. The problem with this infection is that it causes severe illness in some patients, resulting in a high rate of death if appropriate treatment is not given. If patients with severe illness that requires treatment are appropriately identified, treatment can be focused on these patients. However, in the early days of the COVID-19 outbreak, the inability to predict and diagnose the disease led to hospitals being overwhelmed. Therefore, various methods for the diagnosis of severe disease were developed early on, and various methods are still being investigated to predict high-risk patients. The currently available prediction methods are divided into those that predict the onset of severe disease and those used to determine the severity of the disease. Specifically, the main methods include genetic factors, serum humoral factors, laboratory tests, and diagnostic imaging. Since each of these factors has different features, using them in combination is likely to be advantageous.

Association of Coagulopathy and Inflammatory Biomarkers with Severity in SARS-CoV-2-Infected Individuals of the Al-Qunfudhah Region of Saudi Arabia

“…Based on the previous and current research's findings, PT, D-dimer, and PTT should be taken into consideration while assessing the coagulation disorders in SARS-CoV-2-infected patients. Furthermore, higher males' CRP (mean ± SD: male/female; 778.8 ± 181.6/693.5 ± 152.8), ferritin level (mean ± SD: male/female: 778.8 ± 181.6/693.5 ± 152.8), PT (mean ± SD: male/female; male, 15.0 ± 4.9/13.7 ± 1.6), and PTT (mean ± SD: male/female, 34.8 ± 7.1/32.5 ± 6.5) (Table 1) compared to females' in SARS-CoV-2-infected individuals observed in the current study corroborated with previous findings [34,[36][37][38]; on the other hand, lower males' D-dimer (mean ± SD: male/female; 549.0 ± 168.5/465.8 ± 159.1) and thrombocytes (mean ± SD: male/female; 197.9 ± 61.0/228.2 ± 74.3) were inconsistent with findings of the gender association with D-dimer and platelets, probably due demographic difference [39]. Moreover, Mertoglu et al reported an increased level of both inflammatory (CRP and ferritin) and coagulationdisorder biomarkers (D-dimer) in ICU patients compared to non-ICU patients, which reflects the association of disease severity with these markers [72].…”

“…Additionally, massive inflammation-mediated respiratory distress, CAC's manifestation as coagulation disorders (micro/macro-thrombi), may lead to multiple organ (kidney, brain, heart) damage in addition to damage to the lungs during disease progression has been reported. Several pieces of evidence suggest that apart from imaging methods, cytokine profiling is an invaluable tool for delineating the severity of the disease [38]; however, CRP, ferritin (inflammatory markers), and D-dimer (coagulation biomarkers) may serve as highly inexpensive and advantageous predictors/prognosticators of severity, especially, in low-medical-resource settings such as Qunfudhah [39][40][41]. Early assessment of the risk of disease severity and progression concerns the clinician [42], which necessitates the development of effective management strategies to prevent multiple organ damage and mortality outcomes; therefore, in this study, the determination of prognosticator/predictor (inflammatory and coagulation markers) of disease severity with great clinical value has been accomplished.…”