P88 Initial routine laboratory tests can be used to predict clinical course in patients hospitalised with COVID-19

• Published in: Thorax Vol. 76; no. Suppl 2; p. A115
• Main Authors: Young, RL, Mullins, KV, Ainley, A
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Thoracic Society 08.11.2021; BMJ Publishing Group LTD
• Subjects: Coronaviruses; COVID-19; COVID-19: clinical features and risk; Laboratories; Proteins
• ISSN: 0040-6376; 1468-3296
• DOI: 10.1136/thorax-2021-BTSabstracts.198

BackgroundPrevious work has related demographic and clinical characteristics to clinical course and outcome of patients hospitalised with COVID-19.1 We sought to evaluate if initial routine laboratory test results could be utilised to predict length of inpatient stay (LOS), need for non-invasive (NIV)/invasive mechanical ventilation (IMV) and admission to an intensive care unit (ICU). We also sought to establish if C-reactive protein levels related to radiographic disease severity.MethodsA retrospective analysis was carried out on a cohort of 567 patients with a laboratory confirmed diagnosis of COVID-19 admitted during the second wave of the pandemic between April 2020 and May 2021 including descriptive statistics and multivariate and regression analysis. Radiological severity was based upon previously proposed scoring systems.2 ResultsOf the 567 patients included, 342 (60%) were male, mean age 61 years, 318 (56%) were Caucasian, 143 (25%) Asian and 35 (6%) Black. Raised admission d-dimer and urea levels correlated with longer LOS (r= 0.17 and 0.16 respectively, p<0.01). Rising C-reactive protein and d-dimer correlated with increased risk of requirement for admission to ICU (r= 0.27 and 0.19 respectively, p<0.001), need for NIV (Pearson’s correlation 0.26 and 0.15 respectively, P<0.01) and progression to IMV (r=0.15 and 0.14, p<0.05). A correlation between initial routine blood results and death was not detected. C-reactive protein correlated with radiographic disease severity (r=0.32, p<0.001).ConclusionsAbnormalities in initial laboratory test results may be utilised to risk stratify patients presenting to secondary and tertiary care with COVID-19, may help predict clinical course and in doing so facilitate more efficient and streamlined delivery of care and resource utilisation with likely significant impact on patient outcomes.ReferencesCheng D, Calderwood C, Skyllberg E, et al. Clinical characteristics and outcomes of adult patients admitted with COVID-19 in East London: a retrospective cohort analysis. BMJ Open Respiratory Research 2021;8:e000813.Monaco CG, Zaottini F, Schiaffino S, et al. Chest x-ray severity score in COVID-19 patients on emergency department admission: a two-centre study. Eur Radiol Exp. 2020;4(1):68.