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Published on: December 19, 2020
Haematological and radiological-based prognostic markers of COVID-19
Suliman A Alsagaby1, Abdulrhman Aljouie2, Talal H Alshammari3
1Department of Medical Laboratories Sciences, College of Applied Medical Sciences, Majmaah University, AL-Majmaah 11932, Saudi Arabia.
Insights
Predicting COVID-19 mortality is crucial. Age, d-dimer, white blood cell counts, and chest X-ray scores are key indicators for patient survival and prognosis in coronavirus disease 2019.
Area of Science:
- Medical research
- Infectious diseases
- Public health
Background:
- The COVID-19 pandemic, caused by SARS-CoV-2, presents a spectrum of illness severity, with moderate to fatal cases posing significant public health challenges.
- Effective management and pandemic control rely on accurate prediction of patient prognosis.
- Identifying biomarkers for COVID-19 mortality and overall survival (OS) is essential for clinical decision-making.
Purpose of the Study:
- To identify biomarkers associated with COVID-19 mortality.
- To determine predictors of overall survival (OS) in hospitalized COVID-19 patients.
Main Methods:
- Retrospective analysis of clinical data from 6026 adult COVID-19 patients.
- Data collected from two major centers in Saudi Arabia between April and June 2020.
- Evaluation of various clinical, laboratory, and radiological markers, including d-dimer, WBC counts, neutrophil percentage, and chest X-ray (CXR) scores.
Main Results:
- Over 23% mortality rate observed in the study cohort.
- Significant mortality predictors identified: older age, elevated d-dimer, increased white blood cell (WBC) counts, higher neutrophil percentage, and higher CXR scores.
- CXR scores demonstrated a positive correlation with age, d-dimer, WBC count, and neutrophil percentage, suggesting utility in the absence of blood tests.
- RT-PCR Ct values were not successful in predicting mortality; quantitative RT-PCR is recommended.
- Age, d-dimer concentration, leukocyte parameters, and CXR score were confirmed as prognostic markers for OS.
Conclusions:
- Age, hematological parameters, and radiological findings at diagnosis are valuable for guiding clinical management of hospitalized COVID-19 patients.
- These factors can aid in predicting prognosis and improving patient outcomes.
- Further research into quantitative viral load assessment may enhance predictive accuracy.
Background:
Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has emerged in 2019 and caused a global pandemic in 2020, manifesting in the coronavirus disease 2019 (COVID-19). The majority of patients exhibit a mild form of the disease with no major complications; however, moderate to severe and fatal cases are of public health concerns. Predicting the potential prognosis of COVID-19 could assist healthcare workers in managing cases and controlling the pandemic in an effective way. Therefore, the objectives of the study were to search for biomarkers associated with COVID-19 mortality and predictors of the overall survival (OS).
Methods:
Here, clinical data of 6026 adult COVID-19 patients admitted to two large centers in Saudi Arabia (Riyadh and Hafar Al-Batin cities) between April and June 2020 were retrospectively analysed.
Results:
More than 23% of the study subjects with available data have died, enabling the prediction of mortality in our cohort. Markers that were significantly associated with mortality in this study were older age, increased d-dimer in the blood, higher counts of WBCs, higher percentage of neutrophil, and a higher chest X-ray (CXR) score. The CXR scores were also positively associated with age, d-dimer, WBC count, and percentage of neutrophil. This supports the utility of CXR scores in the absence of blood testing. Predicting mortality based on Ct values of RT-PCR was not successful, necessitating a more quantitative RT-PCR to determine virus quantity in samples. Our work has also identified age, d-dimer concentration, leukocyte parameters and CXR score to be prognostic markers of the OS of COVID-19 patients.
Conclusion:
Overall, this retrospective study on hospitalised cohort of COVID-19 patients presents that age, haematological, and radiological data at the time of diagnosis are of value and could be used to guide better clinical management of COVID-19 patients.
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