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Comparative Analyses of Clinical, Laboratory, and Radiological Findings between COVID-19 Deceased and Recovered
M R Shrestha1, A Basnet2, P Joshi3
1Department of Clinical Laboratory, Nepal Armed Police Force Hospital, Kathmandu, Nepal.
Insights
This study identified key indicators of mortality in COVID-19 patients. Elderly males with multiple comorbidities and specific lab/radiological findings like elevated D-dimer and C-reactive protein (CRP) showed higher mortality risk.
Area of Science:
- Medical research
- Infectious diseases
- Epidemiology
Background:
- Understanding COVID-19 mortality is crucial due to rising in-hospital deaths.
- Identifying specific patient indices can aid in predicting and managing severe outcomes.
Purpose of the Study:
- To compare clinical, laboratory, and radiological findings between deceased and recovered COVID-19 patients.
- To identify significant biomarkers associated with COVID-19 mortality.
Main Methods:
- A case-control study analyzed 187 COVID-19 patients (95 deceased, 92 recovered).
- Data collected included clinical, laboratory, and radiological findings.
- Statistical analysis was performed using SPSS version 17.0 (p < 0.05 significance).
Main Results:
- Deceased patients were older (median 66 vs. 51 years) and more frequently male (64.2% vs. 47.8%).
- Key differences included higher respiratory/pulse rates, more comorbidities, altered levels of liver enzymes (ALP, ALT, AST), proteins (TP, albumin), blood cells (leukocytes, lymphocytes, neutrophils, eosinophils), glucose, LDH, D-dimer, and CRP.
- Radiological findings showed increased bilateral, peripheral interstitial abnormalities, and ground glass opacity (GGO) in deceased patients.
Conclusions:
- Elderly male sex, multiple comorbidities, elevated respiratory/pulse rates, and specific laboratory markers (e.g., elevated D-dimer, CRP, LDH; lowered albumin, lymphocytes) are associated with COVID-19 mortality.
- Distinctive chest X-ray findings (bilateral, peripheral interstitial, GGO) are significant indicators of mortality risk.
Abstract:
Background Understanding the coronavirus disease 2019 (COVID-19)-specific indices has become important with increasing cases of COVID-related in-hospital mortality. Objective This case-control study compared clinical, laboratory, and radiological findings between deceased and recovered COVID-19 patients and identified the significant biomarkers associated with deceased patients. Method An analysis of clinical, laboratory, and radiological findings of COVID-19 patients admitted to the COVID-dedicated wards of Nepal Armed Police Force Hospital between March and December 2021 was performed using SPSS version 17.0, with statistical significance considered at p < 0.05. Result A total of 187 COVID-19 patients, comprising deceased [n=95, median (interquartile range, IQR) age: 66 (53-76) years, male: 61 (64.2%) (p=0.024)] and recovered [n=92, median (IQR) age: 51 (38-61) years, male: 44 (47.8%)], were included in the study. Compared to recovered COVID-19 patients, deceased patients had increased median respiratory (20 versus 29.5 breaths/minute) and pulse (83 vs. 86 beats/minute) rates; multiple co-morbidities (≥ 2) (11.9% vs. 32.6%) (p < 0.001); significantly (p < 0.05) lowered alkaline phosphatase (ALP), total protein (TP), albumin, lymphocytes, monocytes, eosinophil, hemoglobin and significantly (p < 0.05) elevated glucose, lactate dehydrogenase (LDH), alanine transaminase (ALT), aspartate aminotransferase (AST), leucocytes, neutrophils, D-dimer and C-reactive protein (CRP); and chest abnormalities including bilateral (p < 0.001), peripheral (p < 0.001) interstitial (p < 0.001) and ground glass opacity (GGO) (p=0.002). Conclusion Elderly, male sex, increased respiratory and pulse rate, presence of multiple comorbidities, lowered levels of ALP, TP, albumin, lymphocytes, monocytes, eosinophils, hemoglobin, elevated levels of glucose, LDH, ALT, AST, leucocytes, neutrophils, D-dimer, CRP, and chest X-rays showing bilateral, peripheral interstitial and GGO abnormalities were the significant indices associated with deceased COVID-19 patients.
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