Investigation of poor prognostic markers in COVID-19 patients hospitalized from emergency department

Abstract

INTRODUCTION: On March 11. 2020. the World Health Organization declared COVID-19 (Coronavirus Disease-2019) outbreak a pandemic. The surge in the number of infected patients has strained healthcare systems globally. The insufficient number of hospital and ICU (intensive care unit) beds has caused a serious problem in patient care and follow-up worldwide. METHODS: We determined patients who were admitted to the emergency department and hospitalized with a preliminary diagnosis of COVID-19 between March 11, 2020 and November 15, 2020. We recorded all subjects' admission vital signs, anamnesis, physical examination notes, laboratory tests and notes describing the hospital stay from the hospital information system. Patients discharged without requiring ICU admission were included in the good clinical prognosis (GCP) group. Patients who were admitted to the ICU or died in hospital were included in the poor clinical prognosis (PCP) group. RESULTS: When hematological and biochemical parameters were compared, white cell, neutrophil, platelet counts, glucose, urea, creatinine and bilirubin levels were significantly higher and lymphocyte count, hemoglobin, hematocrit, sodium and chlorine levels were lower in the PCP group. Moreover, sedimentation, C Reactive Protein (CRP), ferritin, High Sensitive Troponin I, D-dimer and lactate levels were significantly higher among patients with a poor prognosis. DISCUSSION AND CONCLUSION: We assessed and identified the more important potential early indicators of prognosis mentioned in the literature that are applicable in the emergency setting. In light of this information, we aimed to establish a basis for the development of future scoring systems.

Keywords

• Emergency Medicine
• Prognosis
• Biomarkers
• COVID-19

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