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Early predictors of severity and mortality in COVID-19 hospitalized patients
Sehveta Mustafić1,2, Edin Jusufović2,3, Fatima Hukić1,2
1Department of Laboratory Diagnostics, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina.
Insights
Elevated ferritin and decreased oxygen saturation are key indicators for predicting severe COVID-19 illness and mortality in hospitalized patients. These laboratory tests aid in early detection and prognosis.
Area of Science:
- Infectious Diseases
- Clinical Pathology
- Biochemistry
Background:
- Hospitalized COVID-19 patients face risks of severe illness and death.
- Early identification of prognostic markers is crucial for patient management.
- Laboratory parameters offer potential insights into disease progression.
Purpose of the Study:
- To identify laboratory tests for early detection of severe COVID-19.
- To predict disease progression and patient outcomes in hospitalized individuals.
- To establish prognostic markers for COVID-19 severity and mortality.
Main Methods:
- Prospective study of 66 hospitalized COVID-19 patients.
- Stratification into moderate, severe, and critically ill groups.
- Monitoring of clinical findings and laboratory parameters during hospitalization.
Main Results:
- Critically ill patients exhibited higher white blood cell count, C-reactive protein, lactate dehydrogenase, and ferritin, with lower lymphocyte counts and oxygen saturation.
- Fatal outcomes were associated with higher neutrophil, lactate dehydrogenase, and ferritin levels, alongside lower lymphocyte counts and oxygen saturation.
- Lactate dehydrogenase, ferritin, and decreased oxygen saturation predicted progression to severe illness; ferritin and decreased oxygen saturation predicted fatal outcomes.
Conclusions:
- Increased ferritin levels and decreased oxygen saturation are significant prognostic indicators for severe COVID-19 illness.
- These parameters can help predict the development of critical illness and mortality in hospitalized COVID-19 patients.
- Ferritin and oxygen saturation monitoring can aid in early risk stratification and clinical decision-making.
Abstract:
Aim To identify laboratory tests for early detection and the development of more severe illness and death in COVID-19 hospitalized patients. Methods A prospective study was done on 66 hospitalized COVID-19 patients (males: 54.5%; mean age 70.1 ± 9.6 years) who were stratified into: moderate (n=36; 54.5%), severe (n=12; 18.2%), and critically ill (n=18; 27.3%). Besides clinical findings, a wide spectrum of laboratory parameters was monitored at admission and control during the first seven days of hospitalization and used to predict progression from non-severe to severe illness and to predict the final outcome. Results Critically ill patients showed a higher control value of white blood cell count, C-reactive protein, lactate dehydrogenase, ferritin, but lower lymphocyte count and O2 saturation. Patients with fatal outcome (23; 34.85%) showed a higher control value of neutrophil, lactate dehydrogenase, ferritin, and lower lymphocyte and O2 saturation. Progression from moderate to severe or critical illness was predicted by increasing lactate dehydrogenase (95% CI 0.5803 to 0.8397;p=0.003729), increase in ferritin (95% CI 0.5288 to 0.8221;p=0.03248), and by drop in O2 saturation (95% CI 0.5498 to 0.8179;p=0.01168). A fatal outcome was predicted by increase in ferritin (95% CI 0.5059 to 0.8195;p=0.04985), as well as by drop in O2 saturation (95% CI 0.5916 to 0.8803; p=0.001861). Conclusion Increase in ferritin, and drop in O2 saturation could be the most important prognostic parameters for the development of more severe clinical illness and death in COVID-19 hospitalized patients.
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