ABSTRACT
Background: Coronavirus disease (COVID-19), caused by a betacoronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly evolved into a pandemic since it was first reported in December 2019. thus, SARS-CoV-2 has become a major global public health issue. Objective: The objective of this work is to compare demographics, comorbidities, clinical symptoms, biology and imaging findings between severe and non-severe COVID-19 patients and to identify clinical and biological risk factors and biomarkers for the development of severe COVID-19 as well as predictive thresholds for severity in order to best rationalize management and decrease the morbidity and mortality caused by this condition. Patients and methods: This is a single-center retrospective study, from June 25 to December 31, 2021, on 521 patients at the level of the unit COVID-19 of the central laboratory of the Mohammed VI University Hospital Center Oujda, then classified into two groups according to the severity of the disease. Results: Out of a total of 521 patients, a severe group including 336 cases (64.5%) and a non-severe group with 185 cases (35.5%). Hypertension, diabetes and obesity were noted in the majority of patients. Severe COVID-19 cases had higher C-reactive protein, procalcitonin, D-dimer, ferritin, elevated white blood cell count, and lower lymphocyte count than non-severe cases with a significant difference between the two groups. The areas under the curve (AUC) for C-reactive protein, procalcitonin and D-dimer were 0.886, 0.708, and 0.736 respectively. The optimal thresholds predictive of severity were 105 mg/l for C-reactive protein, 0.13 ng/ml for procalcitonin, 7420/µl for white blood cell count, and 0.55 mg/l for D-dimer. Conclusion: Comparison of the proportion of clinical, biological and radiological data between severe and non-severe cases of COVID-19, as well as identification of biomarkers for the development of severe form in the present study, will allow optimal streamlining of management with rapid triage of patients.
ABSTRACT
OBJECTIVE: Coronavirus disease 2019 (COVID-19) is a viral disease caused by severe acute respiratory syndrome coronavirus 2. The clinical manifestations and the evolution of patients with COVID-19 are variable. In addition to respiratory involvement, COVID-19 leads to systemic involvement and can affect the hematopoietic system. This study aimed to evaluate the prognostic value of hematological and hemocytometric parameters in predicting the severity of patients with COVID-19. METHODS: We performed a retrospective study at Mohammed VI university Hospital from 1 March to 11 November 2020. We collected demographic characteristics and hematological findings of incident COVID-19 cases. RESULTS: A total of 245 patients were included in our study. We found that the rate of lymphopenia was significantly reduced in patients who were severely affected by COVID-19. Additionally, the rate of neutrophilia, the neutrophil side fluorescence light signal, monocyte fluorescent intensity, monocyte size, the neutrophil-to-lymphocyte ratio, the platelet-to-lymphocyte ratio, and the lymphocyte-to-monocyte ratio were significantly elevated in patients who were severely affected by COVID-19. CONCLUSIONS: These results are consistent with the literature regarding the predictive value of these markers. A prospective validation in a large population with a longer follow-up is required.