GET THE APP

Laboratory Based Mortality Prediction in Covid-19 patients | Abstract
Logo

International Journal of Medical Research & Health Sciences (IJMRHS)
ISSN: 2319-5886 Indexed in: ESCI (Thomson Reuters)

Abstract

Laboratory Based Mortality Prediction in Covid-19 patients

Author(s):Sherif Sabry*, Kerollos N. Naguib, Mohamed A. Hamila and Ahmed Yassin

Background: Several markers were linked to adverse clinical outcomes in critically ill patients with COVID-19. Previous reports showed that elevated Neutrophil-to-Lymphocyte Ratio (NLR), C-Reactive Protein (CRP), D-dimer, vitamin D levels, and serum ferritin are associated with worse outcomes and increased mortality of critically ill patients with COVID-19; however, evidence is still insufficient to implement the predictive values of these markers in the management algorithm for the patients. Objectives: To evaluate the predictive value of five blood markers on the outcomes of critically ill COVID-19 patients. Methods: We performed a prospective study that included 40 critically ill patients with COVID-19 (COVID severity index ≥ 8) who were admitted to the Intensive Care Unit (ICU) of a tertiary hospital in Egypt. Blood samples for the studied markers were collected within two days of admission. Results: Forty patients were included, with a mean age of 55.6 ± 9.9 years and equal gender distribution. Nearly 62.5% of the patients needed mechanical ventilation, with mean days of ventilation of 15 days. The SOFA score after 48 hours was 9 ± 2.8. Fifty-five percent of participants needed high doses of vasopressors. The mean length of stay in the ICU was 17.7 days ± 5.5 days, and the mortality occurred in 55% of participants. There was a trend towards an association between mortality and male sex, presence of diabetes mellites, bilateral infiltration of lungs, and heart failure. After admission, the serum CRP, ferritin, D-dimer, NLR, and SOFA score after 48 hours had a significant role in the prediction of mortality. Both NLR and D-dimer had the highest area under the curve and sensitivity (95.5% for NLR vs. 90.9% for D-dimer), specificity (100% for both), PPV, and NPV at a cut-off value of 5.5 and 0.85 for both, respectively. Besides, the vitamin D level after 48 hours had a significant role in predicting mortality at a cut-off ≤ 18. Conclusions: CRP, NLR, and D-dimer were found to be reliable predictors of COVID-19 outcomes, including critical illness and mortality. Elevated serum ferritin and vitamin D an be used as supplementary predictors but cannot be relied on as independent predictors. The interpretation of these biomarkers should be correlated with many demographic and clinical factors


Select your language of interest to view the total content in your interested language

Archive
Scope Categories
  • Clinical Research
  • Epidemiology
  • Oncology
  • Biomedicine
  • Dentistry
  • Medical Education
  • Physiotherapy
  • Pulmonology
  • Nephrology
  • Gynaecology
  • Dermatology
  • Dermatoepidemiology
  • Otorhinolaryngology
  • Ophthalmology
  • Sexology
  • Osteology
  • Kinesiology
  • Neuroscience
  • Haematology
  • Psychology
  • Paediatrics
  • Angiology/Vascular Medicine
  • Critical care Medicine
  • Cardiology
  • Endocrinology
  • Gastroenterology
  • Infectious Diseases and Vaccinology
  • Hepatology
  • Geriatric Medicine
  • Bariatrics
  • Pharmacy and Nursing
  • Pharmacognosy and Phytochemistry
  • Radiobiology
  • Pharmacology
  • Toxicology
  • Clinical immunology
  • Clinical and Hospital Pharmacy
  • Cell Biology
  • Genomics and Proteomics
  • Pharmacogenomics
  • Bioinformatics and Biotechnology