Hemodynamic, Oxygenation and Lymphocyte Parameters Predict COVID-19 Mortality

Area of Science:

• Critical care medicine
• Infectious diseases
• Public health

Background:

• COVID-19 mortality poses a global health challenge.
• Existing mortality prediction scores often require resources unavailable in limited health facilities.
• There is a need for accessible and effective prognostic tools for COVID-19 patients.

Purpose of the Study:

• To develop and validate novel, simple scoring systems for predicting 30-day mortality in COVID-19 patients.
• To assess the utility of Mean Arterial Pressure (MAP), PF Ratio, and lymphocyte absolute (MPL score) for mortality prediction.
• To evaluate the effectiveness of MAP, SF Ratio, lymphocyte absolute, and respiration rate (MSLR score) in predicting COVID-19 patient outcomes.

Main Methods:

• Retrospective analysis of 96 COVID-19 patients hospitalized between March and November 2021.
• Development of two scoring systems: MPL (MAP, PF Ratio, lymphocyte absolute) and MSLR (MAP, SF Ratio, lymphocyte absolute, respiration rate).
• Bivariate and multivariate analyses, Area Under the Curve (AUC), and Kaplan-Meier survival analysis were performed.

Main Results:

• The MPL score utilizes MAP < 75 mmHg, PF Ratio < 200, and lymphocyte absolute < 1500/µL (cut-off ≥ 2).
• The MSLR score includes MAP < 75 mmHg, SF Ratio < 200, lymphocyte absolute < 1500/µL, and respiration rate ≥ 24/min (cut-off ≥ 4).
• Both MPL and MSLR demonstrated similar sensitivity (79.1%) and specificity (75.5%), with AUC values of 0.802 and 0.807, respectively, predicting 30-day survival (p < 0.05).

Conclusions:

• MPL and MSLR scores are effective and accessible predictors of 30-day mortality in COVID-19 patients.
• These scoring systems are particularly valuable in resource-limited healthcare settings.
• The study highlights the potential of simple clinical parameters for prognostic assessment in infectious disease outbreaks.