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Published on: January 19, 2024
The Association of Hematological and Biochemical Parameters With Mortality Among COVID-19 Patients: A Retrospective
Asha K S1, Vandini Singh2, Yatiraj Singi3
1Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Raipur, IND.
Insights
This study analyzed COVID-19 patient outcomes in India, finding that elevated bilirubin, urea, uric acid, and leukocyte counts indicate a higher risk of death. Understanding these clinical and laboratory features can improve patient management strategies.
Area of Science:
- Medical Research
- Infectious Diseases
- Clinical Pathology
Background:
- Previous Indian studies on COVID-19 patient demographics and outcomes were limited by small sample sizes.
- A comprehensive understanding of COVID-19 disease progression and influencing factors in the Indian population is needed.
Purpose of the Study:
- To analyze the demographics, clinical characteristics, and laboratory parameters of hospitalized COVID-19 patients in India.
- To identify factors associated with mortality and discharge among COVID-19 patients.
- To correlate clinical and laboratory findings with COVID-19 patient outcomes.
Main Methods:
- A retrospective observational study was conducted using medical records of COVID-19 patients admitted to AIIMS, Raipur, India, between June 1 and August 31, 2021.
- Data included demographics, symptoms, hospitalization duration, laboratory results, and outcomes (discharged or deceased).
- Statistical analysis utilized chi-square or Fisher's exact tests, with significance set at p<0.05.
Main Results:
- The study included patients with a mean age of 53.77 years; 84.2% had moderate to severe COVID-19.
- Mortality rate was 26.3%, with 73.7% of patients discharged.
- Significantly elevated levels of serum bilirubin, urea, uric acid, hematocrit, total leukocyte counts, neutrophils, sodium, chloride, and phosphate were observed in deceased patients compared to discharged patients.
Conclusions:
- Clinical and laboratory features are indicative of COVID-19 disease pathophysiology and severity.
- Identifying specific laboratory markers associated with poor outcomes can aid in developing clinical management algorithms.
- Improved understanding of these factors can potentially enhance patient care and outcomes for COVID-19.
Abstract:
Background There have been reports published in the Indian setting that describe demographics, clinical characteristics, hospital course, morbidity, and death in coronavirus disease 2019 (COVID-19) patients; however, they are based on small numbers of cases. The current analysis of patients with known outcomes allowed us to gain a better understanding of the disease process and progression in COVID-19 patients, as well as correlate the factors that influence the outcome. Methods This was a record-based, retrospective observational study of patients admitted to a COVID-19 hospital (All India Institute of Medical Sciences (AIIMS), Raipur, India). Between June 1 and August 31, 2021, we gathered medical records of all hospitalized patients having a laboratory-confirmed COVID-19 diagnosis and a known outcome (discharged or died). The extracted data included basic demographics, signs and symptoms, duration of hospitalization, laboratory parameters, and outcomes. Categorical variables were analyzed using either the chi‑square test or Fisher's exact test. The level of significance was set at p<0.05. Results The mean age of the patients was 53.77±15.85 years. Of the patients, 84.2% have moderate to severe disease, and 15.8% of the patients have mild disease. Furthermore, 26.3% of the subjects were deceased, while 73.7% were discharged. The laboratory parameters that were significantly (p<0.05) raised among the dead compared to discharged patients included serum total bilirubin (mg/dL), serum direct bilirubin (mg/dL), serum indirect bilirubin (mg/dL), serum urea (mg/dL), serum uric acid (mg/dL), hematocrit (%), total leukocyte counts (/mm3), neutrophils (%), serum sodium (Na) (mEq/L), serum chloride (Cl) (mEq/L), and phosphate (mg/L). Conclusion Clinical and laboratory features reflect disease pathophysiology and hence assist doctors in determining the severity of medical sickness. They also help in the creation of clinical care management algorithms that may improve patient outcomes.
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