Diagnostic Value and Prognostic Significance of Laboratory Parameters in Adult COVID-19 Patients Admitted to the Intensive Care Unit by Age Group

Abstract

Aim: COVID-19 presents with heterogeneous clinical manifestations and laboratory findings across different age groups. This study aimed to investigate the diagnostic and prognostic value of laboratory parameters in adult patients with COVID-19 admitted to the Intensive Care Unit, with particular emphasis on age groups. Materials and methods: This retrospective study included 283 PCRconfirmed COVID-19 patients admitted to intensive care at Ankara Yenimahalle Training and Research Hospital between March 15 and June 15, 2020. Patients were divided into four age groups: middle-aged (45–59 years, n=49), elderly (60–74 years, n=101), advanced elderly (75–89 years, n=122), and very elderly (≥90 years, n=11). Demographic data, clinical outcomes, and laboratory parameters were collected and analysed. The predictive value of laboratory parameters for mortality was assessed using ROC curve analysis. Results: Significant differences were observed in clinical outcomes across age groups, with the highest discharge rate in the 75–89 age group and lower rates in both the 45–59 and ≥90 age groups (p <0.05). Laboratory parameters, including WBC, neutrophils, platelets, monocytes, MPV, RDW, ferritin, CRP, procalcitonin, and D-dimer, showed significant differences across age groups (p<0.05). ROC curve analysis identified CRP (cut-off: 120.8 mg/L, sensitivity: 63.5%, specificity: 61%, AUC: 0.679) and D-dimer (cut-off: 1795 ng/mL, sensitivity: 91.8%, specificity: 72%, AUC: 0.627) as significant predictors of mortality in COVID-19 patients over 45 years. Conclusion: This study demonstrates that CRP and D-dimer are reliable biomarkers for predicting mortality in elderly COVID-19 patients who require intensive care. The unexpected result that the advanced elderly group (75–89 years) had more favourable outcomes than both the younger (45–59) and the very elderly (≥90) groups was notable. These findings suggest that age-specific laboratory reference values may improve risk assessment and clinical management of COVID-19 patients in intensive care settings

Keywords

• COVID-19
• biomarkers
• intensive care
• C-reactive protein
• D-dimer
• mortality
• elderly patients

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