ABSTRACT
BACKGROUND AND AIM: Markers that predict the need for intensive care unite of COVID-19 patients may reduce disease-related mortality. The aim of study is to evaluate diagnostic value of neutrophil-lymphocyte count and percentage in predicting intensive care requirement and mortality. METHODS: The study included 141 patients followed-up/treated for COVID-19 in Sivas Numune Hospital and 63 healthy controls. In the patient group, 65 people were treated as outpatients but, 76 patients needed intensive care. 30 of patients in intensive care unite did not survive. Blood count, CRP, and ferritin values were obtained retrospectively. Performance of markers in predicting the need for intensive care was evaluated by regression analysis and ROC curves. RESULTS: Lymphocyte count, neutrophil-lymphocyte percentage, CRP and ferritin concentrations showed significant differences for all groups (p<0.05), but there was no difference between intensive care patients and mortal cases. While lymphocyte count and percentage were low in mortal cases, other parameters were higher. In the linear regression analysis, lymphocyte percentage, CRP, and ferritin values were found to have significance in predicting the need for intensive care for patient group (p<0.05). In the ROC analysis, the areas under the curve for these parameters were found to be 0.907, 0.859, and 0.842, respectively. CONCLUSIONS: Since there was no significant difference between intensive care patients and dead cases, we could not determine a parameter to distinguish between two groups. However, evaluation of lymphocyte percentage, CRP, and ferritin values together can be used to predict intensive care requirements in COVID-19 patients.
ABSTRACT
Objectives: It is vital to determine the intensive care unit (ICU) requirement at an early stage to reduce the mortality rate in COVID-19 patients. The aim of the study was to find reliable predictive markers to determine the ICU requirement. Methods: We retrospectively reviewed the clinical and laboratory records of 151 COVID-19 patients. The predictive abilities of biochemical parameters and computed tomography (CT) score were evaluated to determine of ICU requirement. Results: The area under curve (AUC) values for procalcitonin, D-Dimer, C reactive protein (CRP), glucose, lactate dehydrogenase (LDH) and CT score were found higher than those for other parameters in the prediction of ICU requirement. The negative predictive values of these markers were higher than their positive predictive values. CT score was found to be highly correlated with fibrinogen and CRP. The glucose levels [odd ratio (OR): 95% CI;1.07, p-value: 0.014] and CT score [OR: 95% CI;1.05, p-value: 0.022] were associated with ICU requirement in COVID-19 patients. Conclusions: CT score, procalcitonin, D-Dimer, CRP, glucose, and LDH are potential predictors to rule out ICU requirement on hospital admission. Fibrinogen and CRP can be used to follow up and predict lung damages in patients with COVID-19.