Early predictors of severity and mortality in COVID-19 hospitalized patients

• Published in: Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina Vol. 18; no. 2; p. 384
• Main Authors: Mustafić, Sehveta, Jusufović, Edin, Hukić, Fatima, Trnačević, Emir, Divković, Anja, Trnačević, Alma
• Format: Journal Article
• Language: English
• Published: Bosnia and Herzegovina 01.08.2021
• Subjects: Aged; COVID-19 - diagnosis; COVID-19 - mortality; Female; Hospitalization; Humans; Leukocyte Count; Lymphocyte Count; Male; Middle Aged; Prospective Studies; Retrospective Studies; Severity of Illness Index; LDH; SARS-CoV-2; ferritin; O2 saturation
• ISSN: 1840-2445

Aim To identify laboratory tests for early detection and the development of more severe illness and death in COVID-19 hospitalized patients. Methods A prospective study was done on 66 hospitalized COVID-19 patients (males: 54.5%; mean age 70.1 ± 9.6 years) who were stratified into: moderate (n=36; 54.5%), severe (n=12; 18.2%), and critically ill (n=18; 27.3%). Besides clinical findings, a wide spectrum of laboratory parameters was monitored at admission and control during the first seven days of hospitalization and used to predict progression from non-severe to severe illness and to predict the final outcome. Results Critically ill patients showed a higher control value of white blood cell count, C-reactive protein, lactate dehydrogenase, ferritin, but lower lymphocyte count and O saturation. Patients with fatal outcome (23; 34.85%) showed a higher control value of neutrophil, lactate dehydrogenase, ferritin, and lower lymphocyte and O saturation. Progression from moderate to severe or critical illness was predicted by increasing lactate dehydrogenase (95% CI 0.5803 to 0.8397;p=0.003729), increase in ferritin (95% CI 0.5288 to 0.8221;p=0.03248), and by drop in O saturation (95% CI 0.5498 to 0.8179;p=0.01168). A fatal outcome was predicted by increase in ferritin (95% CI 0.5059 to 0.8195;p=0.04985), as well as by drop in O saturation (95% CI 0.5916 to 0.8803; p=0.001861). Conclusion Increase in ferritin, and drop in O saturation could be the most important prognostic parameters for the development of more severe clinical illness and death in COVID-19 hospitalized patients.