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Biochemical and hematological factors associated with COVID-19 severity among Gabonese patients: A retrospective
Nadine N'dilimabaka1,2, Dieudonné Mounguegui Mounguegui3, Sonia Etenna Lekana-Douki1
1Unité Emergence des Maladies Virales, Département de Virologie, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon.
Insights
Biochemical markers and organ dysfunction, particularly kidney, liver, and lung, along with electrolyte imbalances, are key predictors of COVID-19 severity in Gabonese patients. Understanding these factors is crucial for managing the disease in Africa.
Area of Science:
- Medical Research
- Infectious Diseases
- Biochemistry
Background:
- COVID-19 exhibits diverse clinical presentations, influenced by immunity, genetics, and biochemistry.
- Africa, including Gabon, has lower reported COVID-19 fatality rates but limited data on biochemical markers and severity factors.
- Understanding disease severity predictors in Gabon is vital for the African context and future epidemic preparedness.
Purpose of the Study:
- To compare biochemical and hematological markers across different COVID-19 severity levels in Gabonese patients.
- To identify factors associated with COVID-19 disease severity in the Gabonese population.
- To provide insights into COVID-19 pathogenesis within an African setting.
Main Methods:
- Analysis of biochemical and hematological markers in 753 COVID-19 patients (asymptomatic, mild/moderate, severe/critical).
- Statistical comparison using Analysis of Variance (ANOVA) and Kruskal-Wallis (KW) tests.
- Binomial generalized linear models in R software incorporating comorbidities, age, sex, and biochemical parameters.
Main Results:
- Most biochemical and hematological parameters differed significantly across disease severity groups.
- Creatinine, phosphorus, D-dimers, platelets, and monocytes did not consistently vary with severity.
- Age, kidney, liver, and lung dysfunction, and decreased electrolytes (chloride, potassium, sodium) were the strongest predictors of severe COVID-19.
Conclusions:
- Biochemical markers and organ function are critical indicators of COVID-19 severity in Gabon.
- Age and electrolyte imbalances are significant predictors of severe disease outcomes.
- Findings contribute to understanding COVID-19 in Africa and inform public health strategies for emerging infectious diseases.
Abstract:
The COVID-19 disease presents a large range of clinical manifestations and includes asymptomatic, mild, and severe cases. The level of severity is related to parameters associated with immunity, genetics, and biochemistry. Africa shows one of the lowest COVID-19 fatality rates but very few data on the biochemical markers of COVID-19 in patients and the factors associated with disease severity are available for the continent. In Gabon, the COVID-19 fatality rate is only 0.63% but almost no data on biomarkers in COVID-19 patients have been published. Both the number of COVID-19 cases and the mortality rate reported in Africa in general, and in Gabon in particular, are lower than in non-African countries. As such, understanding the factors associated with disease severity in Gabonese patients is a crucial step to better understand the disease in the African context and prepare for future COVID-19 waves and other epidemics of emerging diseases. Here, we compared biochemical and hematological markers among 753 Gabonese COVID-19 patients with asymptomatic (184/753), mild/moderate (420/753), and severe/critical (149/753) forms of the disease using an Analysis of Variance (ANOVA) or a Kruskal-Wallis (KW) test. We modeled these parameters together with comorbidities, age, and sex to predict factors associated with disease severity by using a "binomial generalized linear model" utilizing the "package" stats of R software version 4.0.2. Our results showed that almost all the biochemical and hematological parameters (except creatinine, phosphorus, D-dimers, platelets, and monocytes) varied according to disease severity. However, age and the dysfunction of organs like the kidney, liver, and lung together with the decrease of electrolytes (chloride, potassium, and sodium) are the best predictors of disease severity in Gabonese patients.
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