ABSTRACT
The outbreak of coronavirus disease (COVID-19) has brought great challenges to the world. The objectives of this study were to describe the baseline characteristics and changes of biomarkers of these COVID-19 patients and identify predictive value of the above markers for patient death. Using patient death as the observational endpoints, clinical data of inpatients in a special ward for COVID-19 in Wuhan, China were retrospectively collected. Univariate and multivariate Cox regression analyses were used to evaluate prognostic value of baseline characteristics and laboratory data changes. This study included clinical data of 75 patients. Age, c-reactive protein (CRP) and interleukin-6 levels were independent predictors of patient death. Survivors were characterized as having declining neutrophil counts, D-dimer, N-terminal pronatriuretic peptide, troponin I (TnI) and c-reactive protein levels, while counts of lymphocyte gradually came back. Non-survivors were characterized with increasing white blood cell counts (WBC) and neutrophil counts. Changes of WBC, TnI and interleukin-6 were also independently associated with patient death. Older age, baseline CRP and IL-6 levels may be used as meaningful predictors to identify patients with poor prognosis. Changes of biomarkers should be closely monitored in the management of patients with COVID-19, while constantly increasing levels of WBC, TnI and interleukin-6 in the disease course also predict patient death.
Subject(s)
Biomarkers/analysis , COVID-19/blood , COVID-19/mortality , Adult , Aged , Analysis of Variance , Biomarkers/blood , Blood Cell Count/methods , Blood Cell Count/statistics & numerical data , COVID-19/epidemiology , China/epidemiology , Disease Progression , Female , Fibrin Fibrinogen Degradation Products/analysis , Humans , Lymphocytes/microbiology , Male , Middle Aged , Natriuretic Peptide, Brain/analysis , Natriuretic Peptide, Brain/blood , Neutrophils/microbiology , Peptide Fragments/analysis , Peptide Fragments/blood , Prognosis , Proportional Hazards Models , ROC Curve , Retrospective Studies , Troponin I/analysis , Troponin I/bloodSubject(s)
COVID-19/physiopathology , Diabetes Mellitus/physiopathology , Hypertension/physiopathology , Lung/pathology , Blood Cell Count/statistics & numerical data , C-Reactive Protein/analysis , COVID-19/blood , Clinical Chemistry Tests , Diabetes Mellitus/blood , Electronic Health Records , Female , Fibrin Fibrinogen Degradation Products/analysis , Humans , Hypertension/blood , L-Lactate Dehydrogenase/blood , Lung/diagnostic imaging , Lung/virology , Male , Retrospective Studies , Risk Factors , Severity of Illness Index , Tomography, X-Ray ComputedABSTRACT
COVID-19 induces haemocytometric changes. Complete blood count changes, including new cell activation parameters, from 982 confirmed COVID-19 adult patients from 11 European hospitals were retrospectively analysed for distinctive patterns based on age, gender, clinical severity, symptom duration, and hospital days. The observed haemocytometric patterns formed the basis to develop a multi-haemocytometric-parameter prognostic score to predict, during the first three days after presentation, which patients will recover without ventilation or deteriorate within a two-week timeframe, needing intensive care or with fatal outcome. The prognostic score, with ROC curve AUC at baseline of 0.753 (95% CI 0.723-0.781) increasing to 0.875 (95% CI 0.806-0.926) on day 3, was superior to any individual parameter at distinguishing between clinical severity. Findings were confirmed in a validation cohort. Aim is that the score and haemocytometry results are simultaneously provided by analyser software, enabling wide applicability of the score as haemocytometry is commonly requested in COVID-19 patients.