The impact of laboratory features and comorbidities on the prognosis of patients with Covid-19

Year 2021, Volume: 4 Issue: 2, 142 - 146, 28.03.2021

Ahmet Sarıcı , Nurcan Kırıcı Berber , Ozlem Çağaşar , Soykan Biçim Furkan Çağan , Özkan Ulutaş , Harika Gözükara , Yusuf Yakupoğulları , İlhami Berber

https://doi.org/10.32322/jhsm.839303

Cited By: 1

Abstract

Objective: Demographic and laboratory values predicting clinical severity in Covid-19 patients have been a matter of curiosity since the beginning of the disease. We aimed to show the relationship between the severity of Covid-19 disease and comorbidities, clinical and laboratory features of the patients.
Material and Methods: The data of Covid-19 patients diagnosed with polymerase chain reaction (PCR), were analyzed retrospectively. The patients were divided into 3 groups according to their clinical severity as mild, moderate and severe. Comorbidities and the Charlson Comorbidity Index (CCI) at the time of diagnosis were calculated for each patient from the patients' records. Demographic data, laboratory values, comorbidity and CCI scores were compared between the patient groups. The effect of CCI on survival and length of hospital stay was examined.
Results: One hundred and four patients were included in the trial. The most common comorbid disease in the patients included in the trial was hypertension. The moderate-severe stage patients were statistically significantly older (p<0,001). The CCI was found to be statistically significantly different between mild, moderate and severe groups (p<0,001). When CCI increases by one unit, the risk of death increases by 1.193 times (p=0.017). Older age, WBC, neutrophil count, BUN, creatinine, AST, potassium level, CRP, procalcitonin, aPTT, fibrinogen, d-dimer, and ferritin levels were found to be higher in the clinically severe patient group. Lymphocyte and eosinophil counts, total protein, albumin and sodium levels were found to be lower in the clinically severe patient group.
Conclusion: This trial showed that calculating the CCI score in Covid-19 patients can be useful in predicting the severity of the disease. Examination of CCI, age, WBC, neutrophil, lymphocyte, eosinophil counts, BUN, creatinine, AST, total protein, albumin, sodium, potassium level, CRP, procalcitonin, aPTT, fibrinogen, d-dimer and ferritin levels at the time of diagnosis can be suggested.

Keywords

Covid-19, Charlson Comorbidity Index, Mortality, Prognosis, Laboratory features

References

• Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395: 507-13.
• Stokes EK, Zambrano LD, Anderson KN, et al. Coronavirus Disease 2019 Case Surveillance - United States, January 22-May 30, 2020. MMWR Morb Mortal Wkly Rep 2020; 69: 759-65.
• Liao D, Zhou F, Luo L, et al. Haematological characteristics and risk factors in the classification and prognosis evaluation of COVID-19: a retrospective cohort study. Lancet Haematol 2020; 7: 671-8.
• Zhao Q, Meng M, Kumar R, et al. The impact of COPD and smoking history on the severity of COVID-19: A systemic review and meta-analysis. J Med Virol 2020; 92: 1915-21.
• Singh AK, Gupta R, Ghosh A, Misra A. Diabetes in COVID-19: Prevalence, pathophysiology, prognosis and practical considerations. Diabetes Metab Syndr 2020; 14: 303-10.
• Matsushita K, Ding N, Kou M, et al. The Relationship of COVID-19 Severity with Cardiovascular Disease and Its Traditional Risk Factors: A Systematic Review and Meta-Analysis. Glob Heart 2020; 15: 64.
• Ssentongo P, Ssentongo AE, Heilbrunn ES, Ba DM, Chinchilli VM. Association of cardiovascular disease and 10 other pre-existing comorbidities with COVID-19 mortality: A systematic review and meta-analysis. PLoS One 2020; 15: e0238215.
• Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40: 373-83.
• Siddiqi HK, Mehra MR. COVID-19 illness in native and immunosuppressed states: A clinical-therapeutic staging proposal. J Heart Lung Transplant 2020; 39: 405-7.
• Chen G, Wu D, Guo W, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest 2020; 130: 2620-9.
• Christensen DM, Strange JE, Gislason G, et al. Charlson Comorbidity Index Score and Risk of Severe Outcome and Death in Danish COVID-19 Patients. J Gen Intern Med 2020; 35: 2801-3.
• Sun Y, Dong Y, Wang L, et al. Characteristics and prognostic factors of disease severity in patients with COVID-19: The Beijing experience. J Autoimmun 2020; 112: 102473.
• Wendel Garcia PD, Fumeaux T, Guerci P, et al. Prognostic factors associated with mortality risk and disease progression in 639 critically ill patients with COVID-19 in Europe: Initial report of the international RISC-19-ICU prospective observational cohort. EClinicalMedicine 2020; 25: 100449.
• Bastug A, Bodur H, Erdogan S, et al. Clinical and laboratory features of COVID-19: Predictors of severe prognosis. Int Immunopharmacol 2020; 88: 106950.