Predictive Model of Severity in SARS CoV-2 Patients at Hospital Admission Using Blood-Related Parameters

Blood test alterations are crucial in SARS CoV-2 (COVID-19) patients. Blood parameters, such as lymphocytes, C reactive protein (CRP), creatinine, lactate dehydrogenase, or D-dimer, are associated with severity and prognosis of SARS CoV-2 patients. This study aims to identify blood-related predictors of severe hospitalization in patients diagnosed with SARS CoV-2.

Observational retrospective study of all rt-PCR and blood-test positive (at 48 hours of hospitalization) SARS CoV-2 diagnosed inpatients between March-May 2020. Deceased and/or ICU inpatients were considered as severe cases, whereas those patients after hospital discharge were considered as non-severe. Multivariate logistic regression was used to identify predictors of severity, based on bivariate contrast between severe and mild inpatients.

The overall sample comprised 540 patients, with 374 mild cases (69.26%), and 166 severe cases (30.75%). The multivariate logistic regression model for predicting SARS CoV-2 severity included lymphocytes, C reactive protein (CRP), creatinine, total protein levels, glucose and aspartate aminotransferase as predictors, showing an area under the curve (AUC) of 0.895 at a threshold of 0.29, with 81.5% of sensitivity and 81% of specificity.

Our results suggest that our predictive model allows identifying and stratifying SARS CoV-2 patients in risk of developing severe medical complications based on blood-test parameters easily measured at hospital admission, improving health-care resources management and distribution.