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Do Laboratory Biomarkers Predict Survival In Severe Covid-19? A Cross-Sectional Study
Sher Bahadur1, Fawad Rahim2, Said Amin2
1Khyber Institute of Child Health, Medical Teaching Institute / Hayatabad Medical Complex, Peshawar.
Insights
In severe COVID-19, elevated C-reactive protein (CRP) and Lactate Dehydrogenase (LDH) levels predict survival. However, lymphopenia and increased D-dimers may not indicate poor outcomes.
Area of Science:
- Biochemistry
- Immunology
- Critical Care Medicine
Background:
- Severe COVID-19 is associated with significant inflammatory markers.
- Understanding the prognostic value of various biomarkers is crucial for patient management.
Purpose of the Study:
- To compare key biomarkers including lymphocyte count, C-reactive protein (CRP), ferritin, Lactate Dehydrogenase (LDH), and D-dimer between survivors and non-survivors of severe COVID-19.
- To evaluate the predictive value of these biomarkers for survival in severe COVID-19 patients.
Main Methods:
- Retrospective cross-sectional study of 69 severe COVID-19 patients with available biomarker and survival data.
- Analysis included baseline and peak/trough values for CRP, ferritin, LDH, D-dimer, and lymphocyte counts.
- Biomarker comparisons between survivors and non-survivors were performed using paired t-tests, with statistical significance set at p < 0.05.
Main Results:
- Significant increases in C-reactive protein (CRP) and Lactate Dehydrogenase (LDH) were observed in non-survivors but not in survivors.
- Both groups showed significant decreases in lymphocyte counts and significant increases in D-dimer levels.
- Serum ferritin levels did not show significant elevation in either group.
Conclusions:
- Serum CRP and LDH levels are valuable for risk stratification and predicting survival in severe COVID-19.
- Lymphopenia, elevated serum ferritin, and increased D-dimers may not be reliable predictors of survival in this patient population.
Background:
This study aims to compare lymphocyte count, C-reactive protein (CRP), ferritin, Lactate Dehydrogenase (LDH) and D-dimer among survivors and non-survivors of severe COVID-19.
Methods:
This retrospective cross-sectional analytical study included 69 patients for whom a record of the biomarkers and survival status was available. Baseline and peak values were selected for serum CRP, ferritin, LDH and D-Dimer. Baseline and trough lymphocyte counts were selected. Data were analyzed using SPSS version 21. Mean and standard deviation were used to compare the biomarkers with paired t-test. p-value <0.05 was taken as significant.
Results:
The mean age of the study population was 55.5±9.1 years and 50 (72.5%) were male. Among survivors, the increase in CRP level was not significant (from 15.80±9.8 mg/dl to 17.87±8.4 mg/dl, p=0.45) while it was significant in non-survivors (from 16.68±10.90 mg/dl to 20.77±12.69 mg/dl, p=0.04). There was no significant rise in LDH levels in survivors (from 829.59±499 U/L to 1018.6±468 U/L, p=0.20) while it increased significantly in non-survivors (from 816.2±443.08 U/L to 1056.61±480.54 U/L, p=0.003). The decrease in lymphocyte count and increase in D-Dimers in both the groups was significant (p=0.001). There was no significant elevation in ferritin in both the groups (p>0.05).
Conclusion:
In severe COVID-19 patients, serum CRP and LDH can be used for risk stratification and predicting survival. Lymphopenia, increase in serum ferritin and D-dimers may not predict survival.
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