Baseline demographic, clinical and laboratory risk factors for predicting admission to intensive care unit in patients diagnosed with COVID-19 in the emergency department

Year 2021, Volume: 3 Issue: 4, 279 - 283, 24.09.2021

Bülent Güngörer

https://doi.org/10.38053/acmj.987566

Cited By: 10

Abstract

Aim: The COVID-19 pandemic has caused very significant morbidity and mortality throughout the world. Predicting the need for intensive care in these patients is important in terms of proper planning of health services and developing cost-effective management strategies. In this study, we sough to investigate the predictability of whether patients with COVID-19 would need intensive care by looking at some clinical, hematological and biochemical parameters.
Material and Method: All of the patients who applied to the adult emergency department of our hospital with the diagnosis of COVID-19 and were hospitalized were included in the study. The age, physical examination findings, comorbidities, and first laboratory parameters of the patients admitted to our hospital between March 2020 and June 2020 were retrospectively analyzed. A multivarible logistic regression model was constructed to determine the significant predictors of admission to ICU.
Results: A total of 1,005 patients were included in the study. Logistic regression analyses revealed that age (OR: 1.094, p<0.001), chronic renal failure (OR: 4.735, p=0.036), cancer diagnosis (OR: 3.957, p=0.021), higher levels of lactate dehydrogenase (OR: 1.006, p<0.001), and ferritin (OR: 1.001, p=0.001), and lower levels of lymphocyte count (OR: 0.879, p=0.021) were the independent risk factors in predicting the intensive care unit admission of the patients
Conclusion: Age, chronic renal failure, cancer, higher levels of LDH and ferritin, and lower levels of lymphocyte are found to be independent risk factors in predicting intensive care admission for patients admitted to the emergency department with the diagnosis of COVID-19.

Keywords

age, cancer, chronic renal failure, covid-19, emergency department, ferritin, intensive care, LDH, lymphocyte

References

• Sahin D, Tanacan A, Erol SA, et al. A pandemic center’s experience of managing pregnant women with COVID‐19 infection in Turkey: A prospective cohort study. Int J Gynecol Obstetr 2020; 151: 74-82.
• Immovilli P, Morelli N, Antonucci E, Radaelli G, Barbera M, Guidetti D. COVID-19 mortality and ICU admission: the Italian experience. Critical Care 2020; 24: 1.
• Walton H, Navaratnam AV, Ormond M, Gandhi V, Mann C. Emergency medicine response to the COVID-19 pandemic in England: a phenomenological study. Emerg Med J 2020; 37: 768-72.
• Assandri R, Buscarini E, Canetta C, Scartabellati A, Viganò G, Montanelli A. Laboratory biomarkers predicting COVID-19 severity in the emergency room. Arch Med Res 2020; 51: 598-9.
• Carlino MV, Valenti N, Cesaro F, et al. Predictors of intensive care unit admission in patients with Coronavirus disease 2019 (COVID-19). Monaldi Arch Chest Dis 2020; 9.
• https://COVID19.saglik.gov.tr/Eklenti/40781/0/COVID- 9rehberiagirpnomoniardssepsisveseptik sokyontemipdf.pdf
• Prattichizzo F, de Candia P, Nicolucci A, Ceriello A. Elevated HbA1c levels in pre-COVID-19 infection increases the risk of mortality: a sistematic review and meta-analysis. Diabetes Metab Res Rev 2021: e3476.
• Zhou Y, Yang Z, Guo Y, et al. A new predictor of disease severity in patients with COVID-19 in Wuhan, China. MedRxiv 2020.03.24.20042119.
• Nie SF, Yu M, Xie T, et al. Cardiac troponin I is an independent predictor for mortality in hospitalized patients with COVID-19. Circulation 2020; 142: 608-10.
• Luo X, Zhou W, Yan X, et al. Prognostic value of C-reactive protein in patients with Coronavirus 2019. Clin Infect Dis 2020; 71: 2174-9.
• Gallo Marin B, Aghagoli G, Lavine K, et al. Predictors of COVID-19 severity: a literature review. Rev Med Virol 2021; 31: 1-10.
• Covino M, Sandroni C, Santoro M, et al. Predicting intensive care unit admission and death for COVID-19 patients in the emergency department using early warning scores. Resuscitation 2020; 156: 84-91.
• Wu C, Chen X, Cai Y, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with Coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med 2020; 180: 934-43.
• Şan İ, Gemcioğlu E, Davutoğlu M, et al. Which hematological markers have predictive value as early indicators of severe COVID-19 cases in the emergency department? Turk J Med Sci 2021; 10.3906/sag-2008-6.
• Hu H, Du H, Li J, et al. Early prediction and identification for severe patients during the pandemic of COVID-19: A severe COVID-19 risk model constructed by multivariate logistic regression analysis. J Glob Health 2020; 10: 020510.
• Lee J, Park SS, Kim TY, Lee DG, Kim DW. Lymphopenia as a biological predictor of outcomes in COVID-19 patients: a nationwide cohort study. Cancers 2021; 26; 13: 471.
• Bhargava A, Fukushima EA, Levine M, et al. Predictors for severe COVID-19 infection. Clin Infect Dis 2020; 71: 1962-8.